Dr. M.J. Bazos,
Herpes simplex is a virus in
the family of viruses that cause chickenpox, shingles, cold sores, and
mononucleosis. The principal cause is the herpes simplex virus type 1. This
particular virus type is the primary cause of fever blisters and cold sores. The
initial infection usually occurs in childhood. It is estimated that about 80% of
all adults have had exposure to the virus, but only a few can recall a specific
first infection. Herpes simplex is mainly transmitted by nonsexual intimate
contact with saliva of an infected individual; for example, a child kissed by an
adult relative who is shedding the virus but has no evidence of an infection.
The virus from an infected individual can enter your body by passing through a
break in your skin or through the tender skin of your mouth. It is extremely
difficult to trace the
a current outbreak may be the result of an infection acquired months or years in
the past. Herpes simplex is usually detected by inspection of the infected site.
You may know when a recurrence is about to happen because you may feel itching,
tingling, or pain in the places where you were first infected. The typical
appearance is heralded by a tingling or discomfort at the site of the outbreak;
then small blisters emerge and proceed to form ulcers and crusts. Healing occurs
over 10–14 days. In special circumstances, specific laboratory tests can
be used to verify the identity of the virus, but are not usually necessary in
typical cases. Herpes virus infections are not curable and may recur throughout
Living With Your
The typical appearance is
heralded by a tingling or discomfort at the site of the outbreak; then small
blisters emerge and proceed to ulceration and crusting. Healing occurs over
10–14 days. This is a chronic infection that is impossible to eradicate,
but millions of individuals are living a normal life with the disease.
there is no cure, the drugs acyclovir, valacyclovir, and famciclovir can be very
helpful. The recommended treatment for primary episodes is 200 mg of acyclovir
taken orally five times daily for 10 days, or 400 mg of acyclovir taken
orally three times daily for 10 days. Treatment can significantly shorten the
course. Acyclovir speeds up healing and can lessen the pain of herpes simplex
infection for many individuals. It is used to treat infections and can also be
used to lessen the number of recurrences. To soothe pain, take aspirin,
acetaminophen, or ibuprofen. Penciclovir (Denavir) is an effective topical cream
for treatment of recurrent herpes on the lips and face. Other topical antiviral
agents have been popular but have not been shown to abort recurrent episodes.
Many popular remedies are available including moisturizing or anesthetic lip
balms, but there is no evidence that they are effective. Common side effects of
the antiviral medications include nausea, vomiting, and itching. Allergic
reactions and side effects of the medication are possible.
• Take medication as
prescribed by your doctor.
stress. Reactivation of the virus can occur with emotional or physical stress
and menstruation. Therefore, stress reduction measures such as avoiding
stressful situations or learning how to deal with them effectively are
• Apply sunscreen to
susceptible areas. Sunlight is also a precipitating cause, and application of
sunscreen may decrease recurrences.
Learn to recognize the early symptoms of tingling or itching; then avoid kissing
anyone until the sores have completely
• Keep hands well
• Keep the lesion clean and
• Avoid shaving the affected
• Avoid sharing individual
• Do not scratch.
Scratching can lead to a secondary
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• For infections that
recur more than four to six times per
• For infections that involve a
sensitive organ or tissue such as the eye.