All you need to know about Herpes

Last updated date: 06-Feb-2023

CloudHospital

22 mins read

Herpes simplex

Herpes simplex virus type 1 (HSV-1) is a linear dsDNA virus that causes primary and recurrent vesicular eruptions, especially in the orolabial and genital mucosa.

Herpes simplex virus type 1 is considered to be very contagious, it’s present worldwide.

Statistically, most HSV-1 infections arise throughout childhood. The infection is permanent, as it is a lifelong condition. Many of the HSV-1 infections are in or around the mouth (oral herpes, orolabial, oral-labial, or oral-facial herpes). There are also HSV-1 infections related to genital herpes (genital and/or anal area).

Orolabial herpes, herpetic sycosis (HSV folliculitis), herpes gladiatorum, herpetic whitlow, ocular HSV infection, herpes encephalitis, Kaposi varicelliform eruption (eczema herpeticum), and severe or chronic HSV infection are all possible manifestations of HSV-1 infection.

According to the World Health Organisation (WHO), it has been reported that in 2016, almost 3.7 billion people under 50 years old were HSV-1 positive. These people account for 67% of the global population. It is quite interesting that the highest rate of prevalence of HSV-1 infection has been recorded in Africa, where 88% of the population was positive, while the lowest prevalence rate of HSV-1 infection was in the opposite geographical and economic part of the World, the American continent, where only 45% of the population was infected. However, the prevalence rates of HSV-1 infection changes from region to region.

 

Risk factors for HSV-1 infection

The risk factors for HSV-1 infection vary according to the kind of HSV-1 infection. In the case of orolabial herpes, risk factors include any action that exposes one to the saliva of an infected patient, such as sharing drinkware or cosmetics, or mouth-to-mouth contact.

Close shaving with a razor blade in the context of an acute orolabial infection is the main risk factor for herpetic sycosis. Participation in high-contact sports such as rugby, wrestling, MMA, and boxing are risk factors for herpes gladiatorum.

Risk factors for herpetic whitlow include thumb sucking and nail-biting in the presence of orolabial HSV-1 infection in the child population, and medical/dental profession in the adult population although HSV-2 most commonly causes herpetic whitlow in adults.

Skin barrier failure is a key risk factor for eczema herpeticum. Atopic dermatitis, Darier disease, Hailey-Hailey disease, mycosis fungoides, and all kinds of ichthyosis are examples of this. Mutations in the filaggrin gene, which are observed in atopic dermatitis and ichthyosis Vulgaris, are also linked to an increased risk. The use of topical calcineurin inhibitors such as pimecrolimus and tacrolimus is one of the pharmaceutical risk factors for dermatitis herpeticum.

Immunocompromised states, such as transplant recipients (solid organ or hematopoietic stem cells), HIV infection, or leukemia/lymphoma patients, are risk factors for severe or persistent HSV infection.

 

Epidemiology

It is estimated that nearly one-third of the world's population has had symptomatic HSV-1 at some point in his or her life. HSV-1 causes a primary infection in persons who do not have antibodies to HSV-1 or HSV-2.

Non-primary initial infection is characterized as infection with one of the HSV subtypes in individuals who have antibodies to the other HSV subtype (i.e., HSV-1 infection in a patient with HSV-2 antibodies, or vice versa). Reactivation causes recurrent infection, which usually manifests as asymptomatic viral shedding.

In the United States, around 1 in 1000 babies get a neonatal herpes simplex virus infection as a result of HSV contact after vaginal birth. Women who have recurrent genital herpes have a low risk of vertical transmission of HSV to their newborns. Women who have a genital HSV infection during pregnancy, on the other hand, are at a greater risk.

In terms of epidemiology, herpes encephalitis is the primary cause of deadly encephalitis in the United States, and ocular HSV infection is a significant cause of blindness in the United States.

 

Herpes symptoms

Being positive for herpes does not necessarily mean that symptoms will occur, as most of the infected people are asymptomatic.

Herpes flare-ups usually consist of painful blisters and open sores. Before the occurrence of the sores, the infected person could feel itching, tingling, or burning in the flare-up area.

After initial herpes flare-up, the blisters can recur, from time to time. The frequency of recurrence varies from person to person.

The most prevalent cause of orolabial herpes is HSV-1 (a small percentage of cases are attributed to HSV-2). It is crucial to highlight that most cases of orolabial HSV-1 infection are asymptomatic. When there are symptoms, the "cold sore" or fever blister is the most typical presentation. Symptomatic orolabial HSV-1 infections in children frequently manifest as gingivostomatitis, which causes discomfort, halitosis, and dysphagia. It can cause pharyngitis and a mononucleosis-like condition in adults.

Symptoms of a primary orolabial infection appear three to one week after contact. Prior to the beginning of mucocutaneous lesions, patients frequently have a viral prodrome that includes malaise, anorexia, fevers, painful lymphadenopathy, localized pain, soreness, burning, or tingling.

Primary HSV-1 lesions are often seen on the mouth and lips. The patient will thereafter have painful clustered vesicles on an erythematous foundation. These vesicles have a distinctive scalloped border. These vesicles may eventually develop into pustules, erosions, and ulcerations. The sores crust over and the symptoms disappear after 2 to 6 weeks.

Recurrent orolabial infection symptoms are often milder than those of the original infection, with a 24-hour prodrome of tingling, burning, and itching. Recurrent orolabial HSV-1 infections often impair the lip's vermillion border (as opposed to the mouth and lips as seen in primary infection).

Initial or recurring HSV-1 infections can harm the hair follicle, which is known as herpetic sycosis (HSV folliculitis). This will appear on the beard of a guy who has a history of shaving with a close razor blade. Lesions range in size from scattered follicular papules with erosion to massive lesions affecting the whole beard region. Herpetic sycosis is self-limiting, with degraded papules disappearing in 2 to 3 weeks.

Herpes gladiatorum lesions will appear on the lateral neck, side of the face, and forearms 4 to 11 days following exposure. A high level of suspicion for this diagnosis is essential in athletes since it is frequently misinterpreted as bacterial folliculitis.

HSV-1 infection on the digits or periungual may also cause herpetic whitlow. Herpetic whitlow manifests as deep blisters that may subsequently dissolve. An acute paronychia or blistering dactylitis is a common mistake. Herpetic whitlow can also cause lymphadenopathy of the epitrochlear or axillary lymph nodes, which might mimic bacterial cellulitis.

The neonatal herpes virus appears between days 5 and 14 of life and prefers the scalp and the trunk. It can cause widespread cutaneous lesions as well as the involvement of the oral and ocular mucosa. The central nervous system (CNS) may be involved, resulting in encephalitis with lethargy, poor feeding, bulging fontanelle, irritability, and convulsions.

HSV infection can cause severe and persistent illness in immunocompromised patients. Rapidly growing ulcerations or verrucous/pustular lesions are the most typical manifestations of severe and persistent HSV infection. It is not unusual for individuals to have involvement of the respiratory or gastrointestinal tracts and manifest with dyspnea or dysphagia.

 

Transmission of HSV-1

HSV-1 is mainly transmitted by oral-to-oral contact. Contacting infected sores, saliva or other surfaces in or in the proximity of the mouth could easily lead to contracting the virus.

HSV-1 can also cause genital herpes. This kind of herpes is contracted after contact between the genital area and the infected oral area.

Even if there are no flare-ups and the virus seems to be inactive in its host, it can still be transmitted by contact between the mouth or skin with other surfaces that do not seem infected.

The highest risk of transmission is during the flare-ups by contact with the active sores.

Normally, persons that are already infected with HSV-1 and had an oral flare-up are not subjects for HSV-1 infection of the genital area.

A very important fact about HSV-1 infection is that it does not protect the infected person from infection with HSV-2.

In very rare situations, a mother that has genital herpes, caused by HSV-1, can transmit it to her child during birth. This is known as neonatal herpes.

According to the World Health Organization, there are ongoing studies in order to develop a vaccine that will prevent the infection with HSV-1.

 

Diagnosis of HSV-1 infection

HSV-1 serology is the gold standard for determining HSV-1 infection (antibody detection via western blot). The viral polymerase chain reaction is the most sensitive and specific technique (PCR). Serology, on the other hand, remains the gold standard. Alternative diagnostic procedures include viral culture, direct fluorescent antibody (DFA) test, and Tzanck smear.

It's vital to note that the Tzanck smear only detects multinucleated large cells, therefore it can't tell the difference between HSV and VZV. The DFA essay, on the other hand, can tell the difference between the two.

 

Complications of HSV-1 infection

People with a weakened immune system, for example, people that are HIV positive, could have more severe symptoms and a higher recurrence of HSV-1 infection. In very rare cases, the HSV-1 infection can lead to complications that are dangerous, such as encephalitis (infection of the brain) or keratitis (infection of the eye).

Another HSV-1 complication is neonatal herpes. This type of herpes develops when a baby is exposed to either HSV-1 or HSV-2 in the genital tract, during birth. Though neonatal herpes is a rare condition (it happens in about 10 out of every 100.000 births worldwide, it is a complicated condition that can result in neurologic disability or even death. 

Women that are positive for genital herpes before pregnancy are mostly out of risk. The risk rises considerably when a woman is infected for the first time with the HSV during pregnancy, as during early infection, the highest virus load is found in the genital tract.

Another complication that can occur due to both type 1 and type 2 HSV infection, is of psychosocial nature. As the oral herpes flare-up could be unaesthetic, it might also affect the infected person's social life, as it might point to stigma or even psychological distress.

Furthermore, in the social context, genital herpes can affect the quality of life and also sexual relationships.

As time passes by, infected persons usually adapt themselves to the situation and get used to living with the virus. 

 

Herpes simplex treatment

Though the infection with herpes is a lifelong condition and it cannot be cured, herpes flare-ups can be treated. The list of medications that are used to calm down the symptoms consists of antiviral medications such as famciclovir, valacyclovir, or acyclovir and they are very efficient.

It is suggested to take acyclovir 3 to 5 times daily or Valacyclovir 1 gram by mouth twice a day for 10 to 14 days to treat eczema herpeticum.

Persistent suppression is the goal of treatment for immunocompromised people with severe and chronic HSV. Oral acyclovir is suggested for persistent immunosuppression in immunocompromised persons.

If you happen to experience a herpes outbreak, in order to accelerate the healing of  the affected area, you should be aware of the following recommendations:

  • Keep the affected area clean and dry;
  • Avoid touching the sores or blisters;
  • Clean hands after contact with the infected area;
  • Avoid skin-to-skin contact from the time you first notice signs of herpes until the sores have healed.

 

Prognosis

The great majority of HSV-1 infections are asymptomatic, and those that are symptomatic have mild recurring mucocutaneous sores. The prognosis of HSV-1 infection differs according to the symptoms and location of the infection.

The majority of the time, HSV-1 infection is characterized by a long period of dormancy and reactivation. HSV encephalitis is linked with a significant fatality rate; roughly 70% of untreated cases are deadly. The prognosis of ocular HSV is equally bleak if the patient suffers globe rupture or corneal scarring, as both conditions might result in blindness.

 

Herpes simplex virus type 2 (HSV-2)

The other herpes virus, the Herpes Simplex Virus type 2 is also spread worldwide. The difference between HSV-1 and HSV-2 is that HSV-2 is transmitted exclusively sexually, causing genital herpes. Though genital herpes can be caused by HSV-1 as well, the main cause for genital herpes is the infection with HSV-2.

According to the World Health Organization, during 2016, HSV-2 was responsible for causing genital herpes in approximately 491 million people aged from 15 to 49 years old. In other terms, about 13% of the world’s population was infected with HSV-2 at the moment of the report.

Moreover, the data obtained from WHO shows that the infection with HSV-2 is far from being even between males and females. Out of the approximately 491 million persons infected, 313 million were women, while just 178 million were men.

The difference of infection rates between men and women is considered to be due to the fact that the transmission of the virus is more effective from men to women, while the transmission from women to men is considerably less effective.

Herpes simplex virus type 2 (HSV-2) infection is frequent, affecting around 22% of individuals aged 12 and older, totaling 45 million adults in the United States alone. While HSV-1 is known to produce genital lesions and frequently affects the perioral region, HSV-2 is more usually considered when patients report genital lesions. 

Despite this, the majority of breakouts of the illness will show with nonspecific symptoms such as genital itching, irritation, and excoriations, potentially delaying diagnosis and treatment. As a result, more exposure to uninfected people is possible.

According to the same source, the highest prevalence of the HSV-2 infection was reported in Africa (44% of the population were infected women, while only 25% were men) and the lowest in America (where 24% of the population were infected women and only 12% percent of the population were infected men).

Reports from the World Health Organization show that the prevalence rate increases with age, even if most of the newly infected, at that time, were actually adolescents.

 

Risk factors for acquiring HSV-2 infection

Direct contact with fluids (i.e., saliva) from a seropositive individual harboring viral product, most commonly during sexual intercourse, is a risk factor for HSV-2 infection. HSV-2 is mostly spread through sexual contact, which accounts for its predominance beginning in puberty.

HSV can only remain infectious on damp surfaces for days due to its limited stability outside the body. As a result, transmission routes other than sexual intercourse are frequently minimal. In pregnant women, both primary and recurrent HSV infections can result in intrauterine transmission and congenital HSV infection. 

 

Epidemiology

Herpes genitalis is still one of the most often spread sexually transmitted illnesses (STI). While HSV-2 is responsible for the vast majority of cases, uncommon but growing occurrences of herpes simplex virus type 1 have been discovered (HSV-1). Both HSV-1 and HSV-2 are mostly transmitted through direct contact with open sores.

HSV is still one of the most prevalent causes of genital ulcers in the United States, and more than 23 million new cases are recorded each year worldwide.

 

Symptoms of HSV-2 infection

HSV-2 infection can be asymptomatic, just like HSV-1 infection , or it can present mild symptoms that can stay unrecognized. According to clinical studies, only around 10% to  20% of those that arrive at the clinic do report a prior diagnosis of HSV-2 infection. Moreover, the same clinical reports that were closely studying people for new HSV-2 infections have highlighted the fact that out of those that were newly infected, up to a third had symptoms.

HSV-2 infection causes genital herpes. The characteristics of genital herpes are represented by one or more genital or anal blisters or open sores. The open sores are called ulcers. When the HSV-2 infection is recent, the symptoms of genital herpes can also consist of fever, body aches, or swollen lymph nodes.

It's vital to highlight that HSV-2 doesn't usually cause painless ulcers. Systemic symptoms such as fever, headache, and malaise might occur and are frequently caused by concomitant viremia, which has been documented in up to 24 percent of patients in one research.

Moreover, those that are infected with HSV-2 could also feel mild tingling or pain in the legs, hips or buttocks, before the occurrence of the open sores in the genital or anal area.

 

Diagnosis

 

Recommended Laboratory Assessments 

  • A direct swab of vesicular lesions (within 72 hours of onset) 
  • Skin swabs are obtained by unroofing vesicles with a sterile needle, urethra swabs, the cervix using the vaginal speculum, urine, conjunctival swabs, and rectal swabs obtained by proctoscopes.
  • HSV serotyping
  • HSV PCR 
  • Tzank smear

Consider urinalysis and culture if your symptoms are similar to those of an acute urinary tract infection.

 

Transmission of HSV-2

Transmission of HSV-2

The main characteristic of HSV-2 is that it can exclusively be transmitted through sexual intercourse.

The virus is transmitted via contact with genital surfaces or skin, sores or fluids of an infected person. Even if there is an initial lack of symptoms in the infected people, the virus can often be transmitted only by contact between the infected person’s skin and the other person’s genital or anal area.

Just like HSV-1, rarely, HSV-2 can be transmitted from mothers to their newborns, causing neonatal herpes.

 

Complications of HSV-2 infection

Studies show that HSV-2 and HIV are creating a powerful synergy. Being infected with HSV-2 considerably increases the chances of contracting a new HIV infection, by almost three times. Also, those that are infected with both viruses, are more likely to spread HIV to others. Moreover, HSV-2 infection is common among those that are already infected with HIV. Statistics show that between 60% to 90% of those infected with HIV are also infected with HSV-2.

In comparison with HSV-1 infection, whose possible complications are somehow limited and the hosts are usually healthy, HSV-2 infection is considerably more dangerous if it's caught by people who have a compromised immune system. For example, those that are infected with both HSV-2 and HIV are very likely to present more severe symptoms and the frequency rate might also be higher.

Nonetheless, HSV-2 infection can lead, very rarely, to truly serious and dangerous health complications, such as meningoencephalitis, esophagitis, hepatitis, pneumonitis, retinal necrosis, or disseminated infection.

 

Prevention of HSV-2 infection

In order to keep partners safe from HSV-2 infection, individuals that are experiencing a genital herpes flare-up should temporarily avoid sexual intercourse, as the virus is at its contagious peak during flare-ups.

Those that have symptoms pointing to an HSV-2 infection are also recommended to perform an HIV- test, in order to obtain more focused HIV prevention procedures, such as pre-exposure prophylaxis.

Though condoms do not completely mitigate the risk of contracting the HSV-2, they can partially reduce it. Unfortunately, HSV-2 can be contracted by simple contact with the skin of the genital area that is not covered by the condom. For men, medical circumcision could represent a partial life-long protection measure against HSV-2, HIV (Human Immunodeficiency Virus), and HPV (Human Papillomavirus) infection.

In order to prevent neonatal herpes, pregnant women that are aware of their HSV-2 infection must communicate it to the responsible doctors.

According to the World Health Organization, there are current researches on the prevention of HSV-2 infection, through vaccination or even topical microbicides (solutions that are applied in the vagina or rectum in order to prevent and protect against sexually transmitted infections – STIs).

 

Management of genital herpes

The treatment of genital herpes focuses on avoiding transmission and decreasing viral shedding by antiviral medication and sexual transmission risk counseling.

 

Primary Treatment

Regardless of therapy, primary infections with many ulcerating lesions will heal in around 19 days. Treatments are often classified as either main or secondary. When an individual has their first breakout of infection, this is referred to as primary infection (previously seronegative for HSV). Secondary (or non-primary) infection refers to an infection in a patient who already has immunity. The treatment is the same for both patient groups.

Antiherpesviral drugs that function as nucleoside analog–polymerase inhibitors and pyrophosphate analog–polymerase inhibitors are examples of antiherpesviral agents. Acyclovir, which has antiviral efficacy against all herpesviruses and has been FDA authorized for the treatment and suppression of both HSV and VZV, remains the basis of therapy.

Penciclovir (which is more commonly used as a topical therapy for HSV labialis) and ganciclovir are two further therapies (which have suppression activity against CMV). These drugs are preferentially absorbed by virus-infected cells and prevent viral multiplication. All patients should be treated to avoid a lengthy duration of their symptoms, ideally promptly after the first lesion appears.

  • Acyclovir

Acyclovir is available in topical, oral, and intravenous forms. The oral formulation has a limited bioavailability, which has been enhanced with the addition of valacyclovir (see below). Acyclovir's advantages include its minimal side effect profile, which allows it to be tolerated for lengthy periods of time. Suppressive therapy with acyclovir can prevent or postpone up to 80% of recurrences, lowering shedding by more than 90%.

When administered at high doses, reported negative effects to include renal damage and neutropenia. Resistance has been documented in immunocompromised individuals and those who are immunocompetent who are receiving acyclovir as a suppressive treatment for genital herpes.

 

Prognosis

Although there is no treatment for HSV-2, early detection of symptoms and rapid initiation of medication can result in early viral replication inhibition. Abstinence during known virus shedding can reduce the probability of seronegative partner transmission. The Herpesviruses as a group cause severe neurological morbidity, and regrettably, HSV-2 remains in the seropositive individual for life.

 

Complications

HSV-2 infection in the genital tract has been linked to an increased risk of HIV infection. As a result, be aware that testing for HIV infection may affect HSV-2 therapy.

  • Meningitis: Aseptic meningitis affects 36% of women and 13% of men, resulting in hospitalization for a proportion of those affected. As previously noted, during the prodrome of genital herpes and herpetic eruption, infected persons may have more systemic symptoms such as headaches, neck stiffness, and low-grade fever. Such symptoms should prompt an emergency lumbar puncture and CSF investigation, which frequently reveals lymphocytic pleocytosis. While CSF can be submitted for viral culture, PCR is the preferred diagnosis method.
  • Acute retinal necrosis: Symptoms include unilateral or bilateral red eye(s), periorbital discomfort, and decreased visual acuity. The examination reveals episcleritis or scleritis, as well as necrosis and retinal detachment. It is possible that HSV-2 meningoencephalitis will arise.

 

Oral Herpes

Oral herpes, which can be referred to as orolabial, oral-labial, or oral-facial herpes, most often, affects the lips and the surrounding skin. It can be caused only by HSV-1. This kind of herpes can also affect areas such as the gums, roof of the mouth, and inside the cheeks. In some situations, it can trigger fever and muscle aches, as well.

The symptoms of oral herpes do include blisters and open sores. The sores that occur on the lips are known as “cold sores”. Besides the non-aesthetic appearance, oral herpes flare-ups consist of itchiness and a burning feeling as well, the same as any other herpes.

 

Genital Herpes

Genital herpes caused by herpes simplex virus type 1 usually has mild symptoms or it can even be asymptomatic. If symptoms appear, they are characterized by one or more genital or anal blisters or ulcers. Though genital herpes, caused by HSV-1, does not usually reappear, any genital herpes flare up could be severe. 

 

Genital Herpes symptoms in women

The initial herpes outbreak appears 2 weeks after contracting the virus from an infected person.

The genital herpes flare up is preceded  by symptoms like:

  • Itching, tingling, or burning feeling in the vaginal or anal area;
  • Flu-like symptoms, including fever;
  • Swollen glands;
  • Pain in the legs, buttocks, or vaginal area;
  • A change in vaginal discharge;
  • Headache;
  • Painful or difficult urination;
  • A feeling of pressure in the area below the stomach.

The preceding symptoms are followed by the occurrence of blisters, sores, or ulcers on the area through which the virus has been contracted. These areas could be:

  • The vaginal or anal area;
  • Inside the vagina;
  • On the cervix;
  • In the urinary tract;
  • On the buttocks or thighs;
  • On other parts of your body where the virus has entered;

In some cases, the first genital herpes outbreak can happen months or even years after the infection.

After the initial genital herpes flares up, you might experience subsequent ones. In time, the genital herpes flare ups will gradually become less frequent and less intense.

The most dangerous aspect of genital herpes in women is that a mother can infect her child during birth.

The risks to which the child is exposed to, due to neonatal herpes, are:

  • Early birth;
  • Brain, skin or eye problems;
  • Inability to survive.

The child could easily be protected from infection with neonatal herpes if the doctors are aware of the mother’s condition from the beginning of the pregnancy. Currently, Nowadays, there are effective herpes medications that block the herpes infection process during birth.

Genital Herpes in men

 

Genital Herpes in men

Usually, genital herpes in men is a less common condition, as it is most common in women.

The initial genital herpes outbreak usually happens 2-30 days after the infection. The symptoms include painful blisters on the penis, scrotum, or buttocks.

As a partial prevention method, medical circumcision can be helpful in preventing genital herpes in men.

 

Herpes Zoster

Herpes Zoster or Shingles, as it is also referred to, is a viral infection caused by the same virus that causes chickenpox.

Those who develop Herpes Zoster have already had, decades earlier, chickenpox. The Varicella Zoster Virus (VZV) firstly causes chickenpox and only years after it reactivates and causes Shingles.

Shingles is distinguished by a red skin rash that usually triggers burning pain. Normally, Shingles' presentation  is a stripe of blisters on only one side of the body: torso, neck or face.

The first symptoms of Herpes Zoster consist of small patches that cause pain and burning, which is followed by a red rash.

The herpes rash includes:

  • Red patches;
  • Liquid filled blisters that are easy to break;
  • Wraps around from the spine to the torso;
  • Itching;
  • Pain.

Some of those that experience the Herpes Zoster might develop symptoms that are more serious, such as:

  • Fever;
  • Chills;
  • Headache;
  • Fatigue;
  • Muscle weakness.

Unfortunately, the flare up of Herpes Zoster can also cause, but in very rare situations, symptoms such as:

  • Pain or even rash in the eye area;
  • Pain in one of the ears and even loss of hearing;
  • Dizziness;
  • Loss of taste;
  • Bacterial infections. 

 

Herpes on face 

The rash of shingles mostly appears on only one part of your back or chest, but it can also climb up to one part of the face.

If the rash gets close to the ear, it could stimulate an infection whose result could be as harmful as hearing loss, poor balance, or even problems in moving the facial muscles.

Herpes in the eye or ophthalmic herpes zoster appears in about 10% to 20% of those that have shingles.

In the case of an eye herpes zoster, a rash composed of blisters could occur on the eyelids, forehead, or even lead to herpes on the nose.

This kind of herpes can easily affect the optic nerve and the cornea, leading to serious injuries, such as loss of sight or even permanent scarring.

In case of ophthalmic herpes, you should immediately consult a doctor. Starting the treatment in a maximum of 72 hours since the herpes outbreak could prevent complications.

Herpes in the mouth or even herpes on the tongue is a result of shingles that can be truly painful and can also alter the infected person's quality of life as it will make it very difficult to eat or to speak. Also, herpes inside the mouth can affect the taste.

 

The names of the most popular ointments and tablets for facial herpes.

  • Penciclovir (Denavir)
  • Acyclovir (Zovirax)
  • Famciclovir
  • Valacyclovir (Valtrex)
  • Docosanol
  • Home remedies (L-lysine, Vitamin C, E, B12)

 

Herpes on Buttocks

The buttocks can be affected by Shingles as well. As Shingles’ characteristic is to affect only one part of the body, in the case of herpes on buttocks, only one of them might be affected by the flare up.

The symptoms of shingles on the buttocks consist mostly of an itching and painful rash. Some of those that are experiencing herpes on buttocks could feel pain without a visible rash.

 

How to distinguish Herpes and Impetigo

Impetigo is a skin illness that affects people of all ages, although it is most frequent in youngsters. Impetigo is caused by common bacteria and frequently begins with a tiny scrape. It is more common during the summer, especially among children who live in close quarters.

 

How to distinguish Herpes and Canker Sore on Tongue

Canker sores are painful round or oval lesions that develop on soft tissue within the mouth, such as the tongue, inside sides of the lips, or cheeks. The herpes simplex virus causes cold sores. They can form on or around the lips, but they can also appear on other parts of the face, such as the tongue, gums, or throat.

 

Conclusion 

Herpes is a lifelong condition. Any flare ups resulting from the viral infection can be easily managed and healed. Unfortunately, there is no cure for this virus but hopefully, in the near future, there will be vaccines available to protect younger generations from getting infected with the virus. Maybe the existence of a vaccine will gradually eradicate the virus for good.