What is it?
Herpes is an infection caused by herpes simplex virus, which are type 1 and type 2. Besides the genital region, the virus can infect the anus, buttocks, upper thighs, mouth, lips or face.
The virus invades the human body, often through a wound in the skin or the mucosa of the mouth or genital area. Once inside the cell, the virus uses the material of the host cell to reproduce. In this process, the cell is destroyed. The destruction of the cell is responsible for the characteristic signs and symptoms of herpes episode. Periodically, the virus can undergo reactivation, again causing the symptoms.
Transmission usually occurs when the disease is active. During an episode of herpes, genital or extra-genital infection can be transmitted from the start of the outbreak until last wound healing. Facial lesions can also be transmitted to the genital area by oral sex.
However, the infection can be transmitted even when no symptoms are noticed, during periods when there is the elimination of virus without apparent lesions. These periods cannot be predicted but can occasionally occur.
To reduce the risk of transmission of genital herpes, sexual intercourse should be avoided when there are signs and symptoms of disease or by the use of condoms.
A partner in a long duration relationship may show for the first time an outbreak of genital herpes without having had sexual contact with someone else. This occurs because one or both partners were already carrying the virus without, however, presenting symptoms.
In a period of low immunity, the virus can gain strength and trigger the multiplication process, causing the appearance of herpes for the first time without necessarily have been the recently transmited by others.
Genital herpes in either of the parents, generally does not affect the children and there is little risk of transmission provided that there are normal habits of hygiene. However, parents should be aware that the herpes virus can be transmitted by oral lesions through kissing, and can cause severe and widespread infection in the newborn.
Characteristics and symptoms
In women, genital areas most commonly affected are the vulva and entrance to the vagina. The cervix can also be reached. In men, the areas most affected are the glans (head of the penis), the prepuce (skin covering the glans) and the body of the penis. Both men and women may also exhibit lesions in the region around the anus, buttocks and groin.
The first infection
In general, symptoms of initial infection are more intense than those of viral reactivation because the body has not been exposed to the virus to develop antibodies. The initial episode can last more than 20 days and may be accompanied by symptoms like fever and swollen glands near the infection (lymph nodes), besides the typical lesions of herpes.
In most people, the first signs of disease are observed between 2 and 12 days after exposure to the virus. Symptoms may start with tingling, itching, burning or pain, followed by the appearance of a reddish and painful blotch. In a day or two vesicles (small blisters) with clear fluid or whitish yellow appear on the spot.
The blisters rupture rapidly leaving painful wounds that progress to healing in about 7-10 days. In some cases, the vesicles burst so fast they will not even be noticed and only the wounds are perceived.
Once in the body, followed by a nerve of the affected area, genital herpes virus installs itself in a nervous ganglion near the spine, where it remains latent. After the initial outbreak, the person affected by the disease can develop antibodies which keep the infection dormant indefinitely and never get to present a reactivation.
Other people, present new outbreaks of the infection, representing the viral reactivation. Reactivation occurs when the virus multiplies in the neural ganglion and the viral particles migrate through the nerve to the primary site of infection in the skin or mucous membranes (oral or genital).
The factors that trigger this reactivation vary from person to person. Among them are the physical exhaustion, other infectious processes, menstruation, excessive alcohol intake, sunlight exposure, conditions that weaken the immune system and emotional stress.
The repeated friction or trauma at the lesion site, for example, during intercourse, can also lead to the emergence of reactivation in some people.
Symptoms of reactivations are usually milder than the initial infection. Also tend to experience symptoms of tingling, burning, itching or pain before the appearance of lesions, characterized by redness and small blisters that burst leaving wounds that heal in about 7-10 days.
Frequent reactivations affect a minority of people who can present new episodes every month, which brings great discomfort and inconvenience.
There is not a way to permanently eliminate the virus of genital herpes, but there are treatments that provide effective relief of symptoms and disease control.
Medicines for local use, help reduce inflammation and speed healing of lesions as well as prevent secondary contamination by bacteria.
Antiviral therapy, consisting of oral medication, prevents the virus from replicating in the body. Treatment can shorten the duration of an episode of herpes, and should be instituted as soon as the first symptoms appear to improve its effectiveness.
In patients with very frequent reactivations, treatment can be used in a suppressive way. The patient takes medication daily to prevent or reduce the frequency of reactivation episodes. However, in these cases it is necessary the continued use. If discontinued, the virus may reactivate.
It is noteworthy that if the stress is acting as a trigger to new episodes, measures that might combat it will help controlling the reactivation. To maintain a healthy life, increases the organic defense and also help to control the disease.
- Herpes simplex
- Herpes zoster