Genital herpes is an infection caused by the herpes simplex
virus or HSV. There are two types of HSV, and both can cause genital
herpes. HSV type 1 most commonly infects the lips causing sores known
as fever blisters or cold sores,
but it also can infect the genital area and produce sores there. HSV
type 2 is the usual cause of genital herpes, but it also can infect the
mouth during oral sex. A person who has genital herpes infection can
easily pass or transmit the virus to an uninfected person during sex.
Both HSV 1 and 2 can produce sores (also called lesions) in and
around the vaginal area, on the penis, around the anal opening, and on
the buttocks or thighs. Occasionally, sores also appear on other parts
of the body where the virus has entered through broken skin.
HSV remains in certain nerve cells of the body for life, and can produce symptoms off and on in some infected people.
Most people get genital herpes by having sex with someone who is
having a herpes "outbreak". This outbreak means that HSV is active.
When active, the virus usually causes visible sores in the genital
area. The sores cast off (shed) viruses that can infect another person.
Sometimes, however, a person can have an outbreak and have no visible
sores at all. People often get genital herpes by having sexual contact
with others who don't know they are infected or who are having
outbreaks of herpes without any sores.
A person with genital herpes also can infect a sexual partner during
oral sex. The virus is spread only rarely, if at all, by touching
objects such as a toilet seat or hot tub.
Unfortunately, most people who have genital herpes don't know it
because they never have any symptoms, or they do not recognize any
symptoms they might have. When there are symptoms, they can be
different in each person. Most often, when a person becomes infected
with herpes for the first time, the symptoms will appear within two to
10 days. These first episodes of symptoms usually last two to three
weeks.
Within a few days, sores appear near where the virus has entered the
body, such as on the mouth, penis, or vagina. They also can occur
inside the vagina and on the cervix in women, or in the urinary passage
of women and men. Small red bumps appear first, develop into blisters,
and then become painful open sores. Over several days, the sores become
crusty and then heal without leaving a scar. Some other symptoms that
may go with the first episode of genital herpes are fever, headache,
muscle aches, painful or difficult urination, vaginal discharge, and
swollen glands in the groin area.
f you have been infected by HSV 1 and/or 2, you will probably have
symptoms or outbreaks from time to time. After the virus has finished
being active, it then travels to the nerves at the end of the spine
where it stays for a while. Even after the sores are gone, the virus
stays inside the nerve cells in a still and hidden state, which means
that it's inactive.
In most people, the virus can become active several times a year.
This is called a recurrence. But scientists do not yet know why this
happens. When it becomes active again, it travels along the nerves to
the skin, where it busies itself by making more viruses near the site
of the very first infection. That is where new sores usually will
appear.
The frequency and severity of the recurrent episodes vary greatly.
While some people have only one or two outbreaks in a lifetime, others
may have several outbreaks a year. The number and pattern of repeat
outbreaks often change over time for a person. Scientists do not know
what causes the virus to become active again. Although some people with
herpes report that their outbreaks are brought on by another illness,
stress, or having a menstrual period, outbreaks often are not
predictable. In some cases, outbreaks may be connected to exposure to
sunlight.
Because the genital herpes sores may not be visible to the naked
eye, a doctor or other health care worker may have to do several
laboratory tests to try to prove that any other symptoms are caused by
the herpes virus. A person may still have genital herpes, however, even
if the laboratory tests don't show the virus in the body.
Although there is no cure for genital herpes, your doctor might prescribe one of three medicines to treat it:
- Acyclovir (Zovirax) treats the first and/or later episodes of genital herpes.
- Famciclovir (Famvir) treats later episodes of genital herpes and helps prevent future outbreaks.
- Valacyclovir (Valtrex) treats later episodes of genital herpes.
During an active herpes episode, whether the first episode or a
repeat one, you should follow a few simple steps to speed healing and
avoid spreading the infection to other places on the body or to other
people:
- Keep the infected area clean and dry to prevent other infections from developing.
- Try to avoid touching the sores.
- Wash your hands after contact with the sores.
- Avoid
sexual contact from the time you first feel any symptoms until the
sores are completely healed, that is, the scab has fallen off and new
skin has formed where the sore was.
Usually, genital herpes infections do not cause major problems in
healthy adults. In some people whose immune systems do not work
properly, genital herpes episodes can last a long time and be unusually
severe. (The body's immune system fights off foreign invaders such as
viruses.)
Genital herpes, like other genital diseases that produce sores,
increases a person's risk of getting HIV, the virus that causes AIDS.
Also, prior to better treatments for AIDS, persons with HIV (because of
lower protection from their immune systems) had severe herpes
outbreaks, which may have helped them pass both genital herpes and HIV
infections to others.