How to properly treat genital herpes. Genital herpes What causes genital herpes

Update: October 2018

Herpes infection is widespread on Earth; it is known that about 90% of the world's population is infected with one or another herpes virus. Eight types (varieties) of the herpes virus have been identified and described: cytomegalovirus, varicella zoster virus, Epstein-Barr virus, and herpes simplex virus types 1 and 2 (HSV-1 and HSV-2). It is HSV-1 and HSV-2 that are the causative agents of genital herpes. Infection of the population with genital herpes reaches 40–50% by the age of 35–40 years.

Causes

Genital herpes is a highly contagious disease, that is, very contagious, and the probability of transmitting the infection to a sexual partner is 100% during its exacerbation. No, it has long been believed that genital herpes is caused by the herpes simplex virus type 2, but it has been proven that herpetic manifestations on the genitals can also be caused by HSV-1, which is characterized by symptoms of the so-called “cold” (formation of blisters around the mouth or on the lips) .

However, being infected with herpes does not mean that after infection a person will immediately become ill. The occurrence of herpetic eruptions is caused by a decrease in immunity for various reasons, and even upon contact with a patient, the sexual partner will not develop characteristic symptoms immediately; the manifestation of the disease can occur much later if conditions are favorable for the virus (decreased body defenses).

Genital herpes: routes of transmission

Sexual - as the name of this infection makes clear, the main route of transmission is sexual. Moreover, it does not matter what the sexual contact was:

Airborne— transmission of the virus by airborne droplets, in particular HSV-1, is also possible.

Household - a household route of infection cannot be ruled out, especially through wet household items and in the presence of wounds and cracks in the anus and genital area. Self-infection is also possible: transfer of infection from the lips to the genitals if hygiene rules are not followed.

From mother to fetus— there is also a vertical route of transmission, that is, with clinical manifestations of genital herpes during pregnancy, the fetus is infected either transplacentally or during childbirth when the fetus passes through the infected birth canal of the mother.

Risk factors

A relationship has been identified between the number of cases of genital herpes and the following factors:

• socio-economic status and financial situation (the lower they are, the higher the chances of “catch” the infection);
• gender (women are more often infected with genital herpes, but not because of weaker immunity, but due to the presence of a large area of ​​mucous membranes of the genital organs);
• age (a sharp increase in the incidence of genital herpes by the age of 30–40, which coincides with the age of sexual activity).

Based on the above, we can identify high-risk groups for the incidence of genital herpes:

• representatives of the fairer sex;
• antisocial layers of society (prostitutes, homeless people, drug addicts, alcoholics);
• homosexuals;
• representatives of the Negroid race (blacks suffer from genital herpes in 45% of cases, and Europeans only in 17%).

Risk factors for infection with genital herpes and the development of the disease include all immunosuppressive causes and promiscuity in sexual intercourse:

• promiscuous sexual intercourse;
• neglect of mechanical means of protection (condoms provide only 50% protection);
• stress;
• overwork, chronic fatigue;
• lack of vitamins;
• insufficient and malnutrition;
• unfavorable living conditions;
• significant physical activity;
• hypothermia;
• recent acute respiratory viral infections and a high susceptibility to respiratory diseases;
• use of an intrauterine device;
• abortions;
• climate change;
• taking medications that suppress the immune system (cytostatics, glucocorticoids);
• HIV infection;
• presence of cancer;
• chronic foci of infection (caries, sexually transmitted infections, chronic tonsillitis and others);
• excessive alcohol consumption;
• insolation (both sunbathing and visiting a solarium).

All factors that suppress immunity in genital herpes are also causes of exacerbation.

Forms of the disease

There are two forms of genital herpes: primary and recurrent. Primary genital herpes is said to occur when clinical signs appear for the first time after infection, which can happen after a couple of weeks or in some cases months. Recurrent herpes is a periodic exacerbation of the disease with the slightest weakening of the immune system. Depending on the number of exacerbations of relapses of genital herpes throughout the year, 3 degrees of severity are distinguished:

• mild degree – the number of relapses is 3 or less per year;
• moderate – exacerbations occur 4–6 times a year;
• severe - relapses occur monthly.

In turn, recurrent genital herpes has several forms of progression:

• atypical microsymptomatic or subclinical (symptoms are present, but do not cause excessive concern to the patient: slight itching, cracks instead of vesicles);
• atypical macrosymptomatic form(symptoms are expressed, but not fully manifested: there is itching and pain, but there are no blisters or there are vesicles, but there is no discomfort);
• abortive form(observed in patients who have previously received antiviral therapy and vaccine prophylaxis);
• asymptomatic form is the most dangerous, since there are no clinical signs, and the patient continues to be sexually active, spreading the infection through partners.

Signs of primary genital herpes

The symptoms of primary genital herpes occur 3–14 days after infection and persist for 21–35 days, with symptoms increasing during the first week.

• First, redness, swelling, and unbearable itching and burning appear in the area of ​​the affected skin and mucous membranes.
• After some time, bubbles (vesicles) filled with cloudy contents form in this place. The formation of bubbles is combined with general symptoms of intoxication: fever, muscle and abdominal pain, joint pain, weakness, sleep disturbances and nausea.
• In addition, the inguinal lymph nodes become enlarged, the labia or penis swell, and painful urination appears.
• After 5–7 days, the vesicles open and in their place small ulcers are formed that are not prone to fusion. The ulcers crust over, are not deep and do not bleed, and heal without scarring.
• The primary episode of the disease is characterized by bilateral (symmetrical, on both sides) rashes.
• As the process subsides and the ulcers heal (the epithelium peels off), the discomfort in the affected area disappears.

In the event of a secondary infection, the discharge from the ulcers becomes purulent, and the formations themselves are very painful.

Recurrent genital herpes

The diagnosis of recurrent genital herpes is established in the event of detection of clinical signs and antibodies in the blood to the reactivated (return of activity) type of herpesvirus. In almost 50% of cases, exacerbation of the disease occurs in the first six months from the initial episode. It is characteristic that the intensity and duration of the symptoms of recurrent herpes are less pronounced in contrast to the primary manifestation of genital herpes. The relapse lasts 4–10 days, and more often exacerbations occur when infected with HSV-2 type.

The prodromal period, characterized by itching, pain or burning in the affected area, lasts 12 to 36 hours. Neuralgic pain may appear, radiating to the lower back and legs. Then rashes appear on the reddened area of ​​the skin/mucous membranes, which are represented by both individual and grouped vesicles. Subsequently, the bubbles open and form erosions with uneven edges. General symptoms of recurrent herpes are either absent or represented by minor headache and weakness. Inguinal lymph nodes enlarge only with massive herpetic rashes.

Recurrent genital herpes can also occur in a different scenario, that is, in the form of atypical forms (arrhythmic, monotonous or subsiding course). With an arrhythmic course, relapses alternate with remissions without a clear periodicity (from 2 weeks to 6 months). Moreover, the longer the remission lasts, the longer and more pronounced the exacerbations and vice versa.

The monotonous course is characterized by frequent episodes of the disease and periods of remission, during which the symptoms of herpes undergo virtually no changes. The monotonous course of the disease is persistent and difficult to treat. The most favorable type is genital herpes of the subsiding type. With each new exacerbation, the severity of manifestations decreases, and the duration of remissions increases.

Herpetic rashes are extremely painful, which makes it difficult for the patient to move, go to the toilet and disturbs sleep, this cannot but affect the mental state (the patient becomes irritable, he develops phobias: fear of new rashes, fear for the health of relatives, thoughts of suicide).

Atypical and abortive forms

The following types of atypical forms of the disease are distinguished:

• edematous – when there is pronounced swelling of the affected surface of the skin/mucous membranes;
• hemorrhagic– vesicles are filled with blood;
• erosive-ulcerative– ulcers form very quickly at the site of herpetic eruptions;
• necrotic – formation of ulcers and necrotic areas in place of vesicles;
• rupioid - long-lasting flaky brown crusts are formed that protrude above the skin;
• subclinical - small, shallow cracks form in the affected area of ​​the mucous membrane or skin, which do not last long and are accompanied by discomfort (itching, pain); there are no characteristic vesicular rashes. There may also be a complete absence of a clinic.

Symptoms of an atypical form of genital herpes are recorded in 60–65% of patients.

The difference between the abortive form of genital herpes and others is the rapid resolution of the process (no more than 1 - 3 days), that is, the course of the relapse is very short - abortive. The following types of abortive course of the disease are distinguished:

• erythematous - there is only a reddened itchy lesion of the skin/mucous membranes;
• papular - a reddened and itchy area with slight elevation of the skin/mucous membrane, but no blisters;
• prurigo-neurotic– there are no vesicles, but there is pain along the nerve endings.

Common manifestations of genital herpes

In both men and women, the disease can manifest itself as:

• herpetic cystitis– frequent urge to urinate, blood in the urine;
• herpetic urethritis– at the beginning of urination there is pain and severe pain, there is blood in the urine;
• herpes of the anus and rectum– formation of cracks in the anus, which recur when the immune system is weakened, bleeding during bowel movements, pain and intense itching in the sphincter area (irritation of the hemorrhoids), increased gas formation.

Manifestations of genital herpes in men

Genital herpes in men begins acutely, the primary symptoms resemble a cold: the head “breaks”, the lower back ache, there is a rise in temperature, weakness and malaise. After some time, itching, tingling or burning in the groin, numbness in the pelvic area after sleeping or sitting for a long time occur.

Enlarged and painful inguinal lymph nodes can alert a man, but this symptom is not always observed. Only after discovering erythema and swelling on the mucous membrane of the penis, scrotum or perineum, the stronger sex rushes to the doctor. Literally after a few hours, less often days of the prodromal period, transparent bubbles swell in the area of ​​redness and swelling, localized on the foreskin and head of the penis, on the scrotum or inner thighs, cover the pubis, and in the case of anal intercourse, on the buttocks and around the anus. After a week, the vesicles open, turning into ulcers covered with a yellow coating. Then the ulcers “acquire” crusts and peel off.

Recurrent herpes in men occurs with less frequency than in the weaker sex, since the male body undergoes hormonal changes (pregnancy, menstruation) less often. But any serious illness, as well as stress (men are more susceptible to psychological stress due to the stereotype of “not showing weakness”) causes a relapse of the disease. And although exacerbations occur less frequently, they are more severe.

The consequences of genital herpes in representatives of the stronger sex include: herpetic prostatitis, urethritis and, less commonly, herpetic.

Manifestations of genital herpes in women

The symptoms of a primary episode of genital herpes in women generally do not differ from those in men. The disease, just like in the stronger sex, begins with a prodrome (weakness, fever, loss of appetite and nausea, arthralgia and myalgia, pain in the lumbar region and lower abdomen, numbness of the skin in the pelvic area).

The period of rash begins 2–3 days after the prodromal period and is characterized by the appearance of bubbles with cloudy liquid on the vulva (clitoral area, labia minora and majora, on the commissures), in the urethra, vagina and on the cervix. Vesicles may form in the anal area, on the inner thighs and perineum. In case of damage to the urethra, tingling and itching occur when urinating, and in severe cases, the herpetic infection spreads to the uterus and appendages.

Not always, but painful and enlarged lymph nodes in the groin are also noted. In most cases, genital herpes in the fair sex occurs in an atypical form (about 65%). In addition, women during the period of relapse of the disease note an increase in vaginal discharge, which becomes especially intense towards the end of the second phase of the menstrual cycle.

Typically, women have a much harder time psychologically with relapses of the disease, which leads to the development of depression, phobias (fear of sexual contact, fear of communication), suicidal thoughts, and neuroses.

Complications of the disease include:

• vulvitis;
• vulvodynia (itching and burning, there is weeping of the external genitalia, but there are no laboratory signs of inflammation);
• urethritis;
• adnexitis and salpingitis;
• chronic inflammation of the uterus;
• pelvic pain syndrome;
• emotional and mental disorders;
• problems in sexual life;
• decreased performance, psychasthenia (irritability and resentment, “close tears”).

Genital herpes during pregnancy

If a woman had cases of genital herpes before pregnancy, then the risk of transmitting the infection to the fetus and newborn is minimal, but only if there are no relapses during gestation (see). Genital herpes poses a huge danger during gestation during the initial episode of the disease or reactivation of the virus in the first 12 weeks and within a month before the expected due date. Exacerbation or primary infection of a herpetic infection leads to serious consequences in pregnant women:

• spontaneous termination of pregnancy;
• failed miscarriage (frozen pregnancy);
• premature birth;
• formation of malformations in the fetus;
• infection of a newborn when passing through the “infectious” birth canal.

In addition, genital herpes can cause recurrent miscarriage in the future, and even infertility.

Treatment

First phase of treatment

For genital herpes, the mainstay of treatment is antiviral therapy. The administration of antiviral drugs suppresses viral replication (reproduction), which quickly stops the clinical manifestations of the disease. Antiviral drugs are used both systemically (orally and parenterally) and locally (in the form of ointments, creams and suppositories). It is advisable to treat non-herpetic infections in a complex manner, by simultaneous administration of systemic and local drugs.

Today, such drugs as acyclovir, panavir, famciclovir and others have proven themselves. Etiotropic therapy (antiviral) involves phase 1 of the treatment of recurrent herpes. Antiviral drugs are prescribed according to a regimen of 2–5 times a day and last for 7–10 days or until the clinical phenomena completely disappear.

Simultaneously with the listed drugs, symptomatic therapy is prescribed, aimed at relieving pain and itching, as well as sedatives. In addition, in the first phase of treatment, ascorbic acid is indicated and a specific antiherpetic immunoglobulin is injected intramuscularly, which activates the patient’s immunity.

Second phase of treatment

It is carried out in the stage of subsiding of relapse (reduction of itching, formation of scabs on ulcers and their exfoliation). The administration of vitamins B1 and B6, autohemotherapy, and the use of antihistamines (tazepam, suprastin) and nonspecific (Eleutherococcus tincture, dibazol) and specific (lavomax) immunomodulators are indicated.

Third phase of treatment

It is carried out during the period of remission and is aimed at preventing relapses of the disease: the patient is vaccinated with a herpetic vaccine (duration of remission is at least 2 months), but vaccination is carried out necessarily after undergoing restorative and antiviral therapy.

After therapy

When treating genital herpes, stress, hypothermia and prolonged exposure to the sun should be avoided, the psycho-emotional state should be corrected, nutrition should be nutritious and rich in vitamins, and if necessary, bed rest should be prescribed.

Prevention of exacerbations

And, of course, all patients with recurrent genital herpes at the stage of exacerbation of the disease should avoid sexual contact, observe personal hygiene rules (wash the affected skin with warm water and soap) in order to avoid secondary infection. It is also prohibited to visit baths, saunas and swimming pools, and it is recommended to wear loose cotton underwear (prevents friction of the affected areas, allows the skin to “breathe” and reduces pain).

– a viral infection of the genital mucosa, characterized by the appearance of a group of blisters, and then erosions and ulcers. Accompanied by a local burning sensation, swelling, hyperemia, enlarged inguinal lymph nodes and symptoms of intoxication. It is prone to relapses and can subsequently lead to serious complications: a decrease in local and general immunity, the development of bacterial infections of the genitals, damage to the nervous system, the development of cervical and prostate cancer. It is especially dangerous in pregnant women, as it increases the likelihood of spontaneous miscarriage, pathology and even death of the newborn. Included in the group of sexually transmitted diseases (STDs).

General information

– a viral infection of the genital mucosa, characterized by the appearance of a group of blisters, and then erosions and ulcers. Accompanied by a local burning sensation, swelling, hyperemia, enlarged inguinal lymph nodes and symptoms of intoxication. It is prone to relapses and can subsequently lead to serious complications: a decrease in local and general immunity, the development of bacterial infections of the genitals, damage to the nervous system, the development of cervical and prostate cancer. It is especially dangerous in pregnant women, as it increases the likelihood of spontaneous miscarriage, pathology and even death of the newborn. Included in the group of sexually transmitted diseases (STDs).

The causative agent of genital herpes is a type of herpes simplex virus (HSV). The incidence of herpes infection among the world's population is about 90%.

There are several types of herpes virus that cause damage to the skin, mucous membranes, central nervous system and other organs (herpes simplex viruses types 1 and 2, cytomegalovirus, varicella zoster virus, Epstein-Barr virus, herpes zoster, etc.). Herpes simplex viruses types 1 and 2 cause oral and genital forms of the disease, with HSV type 1 affecting mainly the face, lips, and wings of the nose, and HSV type 2 most often causes genital herpes. HSV is often detected in conjunction with ureaplasma and cytomegalovirus.

Genital herpes has a sexual transmission route; with various forms of sexual contact, it easily penetrates through damaged skin and mucosal epithelium. After infection, HSV migrates to the nerve ganglia, remaining there for life. Reproduction of HSV in epithelial cells of the skin and mucous membranes leads to their degeneration and death. The infection is characterized by a chronic course and manifests itself cyclically: periods of activity or relapses (2-21 days), accompanied by the appearance of rashes in the form of blisters, alternate with periods of remission, when clinical symptoms disappear. Often, genital herpes is asymptomatic, but patients are still a source of infection.

Causes of genital herpes

Primary infection with HSV usually occurs by airborne droplets in childhood (in the population of children 6-7 years of age, the incidence rate is already 50%). The reasons for this are high population density, low socio-economic standard of living, and non-compliance with hygiene rules.

Secondary infection usually occurs as a result of sexual contact. A high incidence of genital herpes is observed among people aged 20-30 years. This is due to the early onset of sexual activity, promiscuity, frequent changes or the presence of several partners, and unprotected sexual intercourse. Venereology also includes internal causes as risk factors for genital herpes:

• decreased immune defense of the body;
• presence of STDs;
• gender of the person (it has been noticed that women suffer from genital herpes much more often than men);
• surgical termination of pregnancy, use of intrauterine devices.

The human immune system reacts to the penetration of HSV by producing specific antibodies, and with a normal level of immune reactions, clinical manifestations of the infection are not observed. Under the influence of a number of unfavorable factors that reduce the body’s immune reactivity, HSV is activated, which is manifested by rashes on the skin and mucous membranes, and neuralgic pain. Episodes of relapse of genital herpes often occur against the background of chronic stress, lack of vitamins, hypothermia, overheating, climate change, and colds.

Ways of transmission of genital herpes

Infection with genital herpes most often occurs through the mucous membranes of the genital organs, rectum, urethra or damage to the skin during genital, oral-genital and anal-genital contact.

HSV transmission is also possible:

• airborne droplets;
• vertically from a sick mother to the fetus (during childbirth in contact with the mother’s birth canal, transplacentally, ascending from the mother’s external genitalia through the cervical canal into the uterine cavity);
• in case of self-infection - autoinoculation (a sick person himself transfers the infection from infected areas of the body to uninfected areas - from the face to the genitals);
• by household means - rarely (through wet hygiene items).

Typically, infection with genital herpes occurs when the infected partner does not even know about the disease, since he does not have clinical manifestations of the disease (in the case of asymptomatic virus carriers).

Forms and manifestations of genital herpes

According to the clinical course, a distinction is made between primary genital herpes (the first episode of the disease) and recurrent (all subsequent episodes of the disease).

Recurrent genital herpes can occur in typical, atypical clinical forms and the form of asymptomatic virus carriage.

Primary genital herpes

The earliest symptoms of primary genital herpes include swelling, redness, pain, and burning in the area at the entrance gate of the infection. Local manifestations of genital herpes are often accompanied by fever, malaise, headache and muscle pain. After a few days, herpetic rashes appear - small blisters with transparent contents. The rupture of the vesicles is accompanied by the formation of painful erosive and ulcerative elements. When ulcers are localized on the genitals, painful urination is noted. Healing of the rash occurs within two weeks.

Recurrent genital herpes

The development of relapses of genital herpes occurs in 50-70% of patients who have suffered a primary infection. Depending on the frequency of repeated episodes, several forms of recurrent genital herpes are distinguished:

• mild form (exacerbations no more than 3 times a year)
• moderate form (exacerbations 4 to 6 times a year)
• severe form (monthly exacerbations)

The course of recurrent genital herpes can be arrhythmic, monotonous and subsiding.

The arrhythmic course of genital herpes is characterized by alternating remissions from 2 weeks to 5 months. Moreover, the longer the periods of remission, the more intense and prolonged the relapses of genital herpes, and vice versa.

With a monotonous course of genital herpes, frequent episodes of the disease are observed after slightly changing periods of remission. This type includes menstrual herpes, which has a persistent course and is difficult to treat.

Genital herpes of the subsiding type has a more favorable course. It is characterized by a decrease in the intensity of relapses and an increase in periods of remission.

The development of relapses of genital herpes occurs under the influence of various factors: hypothermia, sexual intercourse, stressful situations, overwork, and the occurrence of other pathologies (influenza, ARVI).

Symptomatically, relapses of genital herpes are milder than the primary disease, however, their consequences can be much more serious.

Rashes with genital herpes are accompanied by extreme pain, making it difficult for the patient to move, go to the toilet, and disrupt sleep. The psychological state of a person often changes: irritability, fear of new rashes, fear for the health of loved ones, suicidal thoughts, etc. appear.

Atypical forms of genital herpes

Atypical forms of genital herpes occur gradually, in the form of chronic inflammation of the external and internal genital organs (vulvovaginitis, colpitis, endocervicitis, urethritis, cystitis, prostatitis, etc.). The diagnosis of genital herpes is based on laboratory confirmation of the presence of herpes infection. Atypical forms of genital herpes account for more than half of clinical cases - 65%.

The atypical form of genital herpes is characterized by mild swelling, areas of erythema, pinpoint blisters, persistent burning and itching, and profuse leucorrhoea that cannot be treated. With a long course of genital herpes, enlargement and soreness of the inguinal lymph nodes are noted.

Based on the localization of herpetic eruptions, there are 3 stages:

• Stage I - genital herpes affects the external genitalia;
• Stage II - genital herpes affects the vagina, cervix, urethra;
• Stage III - genital herpes affects the uterus, appendages, bladder, prostate.

The higher the herpetic infection penetrates the genitourinary tract, the more serious the prognosis. An advanced form of genital herpes can lead to a state of immunodeficiency, and in women it increases the risk of developing infertility and cervical cancer. HSV is dangerous for people with weakened immune systems (HIV-infected) and those who have undergone organ transplantation.

Genital herpes and pregnancy

During pregnancy, genital herpes poses the greatest danger in the case of a primary infection, if no manifestations of the disease have previously been observed. There is a possibility of developmental defects if the mother’s illness occurs in the early stages of pregnancy, when the fetus is developing all the organs and tissues. HSV can be transmitted through the placenta, affecting mainly the nervous tissue of the fetus. Genital herpes increases the risk of spontaneous miscarriage, premature birth, fetal deformities and death.

Pregnant women with atypical forms of genital herpes are examined twice for HSV in the last 6 weeks of pregnancy. If a herpes virus is detected, a cesarean section is performed routinely to exclude possible infection of the fetus during passage through the birth canal.

The best option is to screen women for HSV at the stage of preparation for pregnancy, as well as during pregnancy during each trimester.

Genital herpes in newborns

Most often, infection of the fetus occurs in the first 4-6 hours of labor after rupture of the membranes, or during the passage of the fetus through the birth canal of an infected mother. Typically, HSV in newborns affects the eyes, oral mucosa, skin, and respiratory tract. After primary infection of a newborn, HSV spreads in the body through hematogenous or contact routes. The likelihood of infection in newborns increases when the mother is infected with genital herpes in the last trimester of pregnancy.

With a localized form of herpetic infection in newborns, redness, vesicles, hemorrhages of the skin and oral mucosa may appear, meningoencephalitis, keratoconjunctivitis and chorioretinitis (inflammation of the blood vessels and retina), and clouding of the lens may develop. Children infected with genital herpes often suffer from permanent neurological disorders.

Genital herpes can cause a generalized infection in newborns. Signs of a generalized herpetic infection appear 1-2 weeks after the birth of the child. Local symptoms include refusal to eat, vomiting, fever, jaundice, respiratory distress, bleeding, and shock. The death of a child can occur from acute blood loss and vascular insufficiency.

Diagnosis of genital herpes

When diagnosing genital herpes, the venereologist takes into account complaints, medical history and objective examination. Diagnosis of typical cases of genital herpes is usually not difficult and is based on clinical manifestations. Herpetic ulcers that exist for a long time should be distinguished from syphilitic ones.

Laboratory methods for diagnosing genital herpes include:

• methods for detecting HSV in material from affected organs (scrapings from the vagina and cervix, smear from the urethra, histological material from the fallopian tubes, etc.). For this purpose, the method of growing HSV in tissue culture and subsequent study of its properties is used; the method of recognizing the virus under an electron microscope is used;
• methods for detecting antibodies to HSV in blood serum (immunoglobulins M and G). They allow you to detect genital herpes even with asymptomatic cases and determine antibodies to HSV types 1 or 2. These include ELISA - a method of enzyme immunoassay.

Treatment of genital herpes

Current medications for HSV can reduce the severity and duration of genital herpes, but are not able to completely get rid of the disease.

To avoid the development of HSV resistance to classical antiviral drugs, including those intended for the treatment of genital herpes (acyclic nucleosides - Valacyclovir, Acyclovir, Famciclovir), it is recommended that they be used alternately, as well as in combination with interferon drugs. Interferon has a powerful antiviral effect, and its deficiency is one of the main causes of relapses of genital herpes.

A ready-made medicinal product containing both acyclovir and interferon is Gerpferon ointment. It also contains lidocaine, which provides a local anesthetic effect, which is extremely important for painful manifestations of genital herpes. The use of Herpferon in patients with genital herpes ensures healing of rashes already on the 5th day and significant relief of local symptoms.

Prevention of genital herpes

A way to prevent primary infection with genital herpes is to use condoms during casual sexual contact. However, even in this case, the likelihood of HSV infection through microcracks and damage to mucous membranes and skin not covered by a condom remains high. It is possible to use antiseptic agents (Miramistin, etc.) to treat areas where the virus may enter.

The recurrent course of genital herpes is observed when the body’s defense reactions decrease: illness, overheating, hypothermia, the onset of menstruation, pregnancy, taking hormonal drugs, stress. Therefore, to prevent relapses of genital herpes, a healthy lifestyle, good nutrition and rest, and taking vitamin supplements are important. Measures to prevent genital herpes also include maintaining intimate and sexual hygiene, and timely detection and treatment of sexually transmitted diseases.

A patient infected with HSV must warn his sexual partner about this, even if he does not currently have symptoms of genital herpes. Since infection through sexual contact is possible even in the absence of herpetic eruptions, in this case the use of a condom is also necessary.

After questionable unprotected sexual contact, you can resort to the method of emergency prevention of genital herpes with a locally active antiviral drug in the first 1-2 hours after intimacy.

To prevent self-infection, when the genital herpes virus is transferred by dirty hands from the lips to the genitals, it is necessary to fulfill basic hygiene requirements: thorough and frequent hand washing (especially in the presence of fever on the lips), using separate towels for the hands, face and body, as well as every family member.

In order to reduce the risk of HSV infection in newborns, surgical delivery (cesarean section) is recommended for pregnant women with genital herpes. When planning a natural birth, women with recurrent genital herpes are prescribed a prophylactic course of taking acyclovir.

After unprotected sexual intercourse, when planning pregnancy, as well as during sexual relations with an HSV carrier, it is recommended to be examined for genital herpes and other STDs.

Genital herpes is a viral infection that is sexually transmitted. This type of virus affects the genitals of men and women, and can also affect the anus and buttocks.

There are two types of herpes simplex:

• Type 1 is the cause of herpes around the mouth, causing almost 50% of cases of genital herpes;
• Type 2 affects only the genitals.

Once it enters the human body, it remains to live in its nerve cells forever.

Symptoms

Symptoms of the disease can be expressed in different ways: from mild sensitivity to severe blistering rashes, pain, and itching. During the illness, there is aches throughout the body, general malaise, and moderate fever.

During sexual intercourse, discomfort is especially felt. The rash is expressed by single and group blisters. This situation repeats for about 14 days, then the rash goes away without leaving any traces. With genital herpes, the following organs are most often affected:

• the entrance to the vagina and the vagina itself;
• cervix and its body;
• ovaries;
• the fallopian tubes;
• anus;
• urethra;
• bladder;
• ampulla of the rectum.

In men, the genital type of herpes most often appears on the penis and scrotum, on the thighs and buttocks. There are many places where the virus is affected, therefore, the consequences of the disease can be varied: from cystitis to rectal fissure.

Features in women

In women, symptoms occur in several phases.

1. During the first phase, general symptoms appear: fever, weakness, aches, itching and pain in the perineum. Also, sometimes there is pain in the hip area, radiating to the lower back, and swelling in the genitals. Redness appears. The period lasts 2-3 days.
2. Further, in places of redness, bubbles filled with liquid appear. These areas are very painful and itchy. Then the bubbles darken and become white-yellow. The acute period lasts 4-5 days.
3. The blisters burst, the liquid pours out, an ulcer forms, which then becomes covered with a crust. After 6-8 days, everything goes away: the skin is regenerated, the ulcers heal, the crusts disappear. There are no traces left.

Living with herpes is most difficult for women. For some of them, herpes disease causes consequences such as psychological disorders. This is due to the stress of realizing that she has contracted a sexually transmitted disease. Some withdraw into themselves, developing depression, neuroses, and fear of sex.

Type 2 herpes virus can be asymptomatic. A person may not even realize that he carries such a disease within himself, but at the same time he can be a dangerous transmitter of this disease to his partner.

More than 40% of virus carriers do not know that they are sick. That is why patients are in no hurry to go to the doctor, hoping that it will go away on its own and there will be no consequences.

The time when the first symptoms appear after infection is not clearly defined, how many there will be - there is also no exact answer. They can appear months or years later. It all depends on the human immune system.

Relapses

People who have had genital herpes may experience relapses, the recurrence period of which is from 2-3 times a month to once every few years. It also depends on the characteristics of the organism. Most often, relapses recur after 2-3 months.

Diagnostics

The disease can be diagnosed and its type determined by visual examination, however, laboratory tests may be required to confirm this fact. The simple type of herpes can be detected by analyzing vaginal discharge.

A blood test can also determine the presence of antibodies to the virus.

The analysis will show the presence of the virus, even if the disease is inactive during this period. Genital herpes can be a consequence of other more serious diseases. To live in peace, you need to be tested for AIDS, syphilis, hepatitis B, chlamydia, mycoplasmosis. Treatment from time to time needs to be carried out on both partners at the same time.

Treatment

Medicine still does not know how to completely cure herpes. However, the antiviral drugs that it offers today can get rid of severe symptoms and prevent their further consequences. The most common are anciclovir, valacyclovir, and farmir.

They reduce itching and accelerate wound healing. Acyclovir causes the fewest side effects, so it is most often prescribed to pregnant and nursing mothers. However, valacyclovir and farmir are more effective drugs.

But at the first symptoms, you should consult a urologist, who will prescribe the correct treatment in each specific case, taking into account the characteristics of the body. If you start using antiviral drugs in a timely manner, you can live without complications. Treatment time most often lasts 5 days.

If the formation of bubbles does not go away, treatment does not stop. People with frequent relapses are prescribed antiviral drugs for a long period of time.

Local and general anesthetics are used for pain relief. Antiviral ointments are not taken for genital herpes, as they are ineffective.

If, nevertheless, ointments are prescribed by a doctor, they must be applied with special sticks, and in no case with your finger, in order to prevent contact with healthy skin. During the treatment period, you need to drink as much fluid as the body can accommodate - this makes the urine less concentrated, then pain during urination is reduced.

Doctors prescribe vitamins. You should not use scented soaps, gels, or bubble baths; their consequences are increased dryness and itching. Most often, the 2nd type of genital herpes affects women, but it also does not bypass men. At the same time, men are much less likely to contact a doctor.

Infection

You can catch type 2 herpes virus in three ways:

• contact with a sick person, contact with his skin;
• through sexual intercourse, through oral and anal sex;
• pregnancy period - from mother to unborn child.

Of course, the main method of infection is direct contact between a man and a woman. Infection through household and airborne transmission is possible only through contact with personal hygiene items and towels.

Since the genital herpes virus lives in a person all his life, there must be some factors that provoke its appearance outside. Here they are:

• stress;
• hypothermia or, conversely, overheating;
• cold;
• alcohol;
• lack of substances such as vitamins;
• overwork and lack of sleep;
• immunodeficiency;
• chronic diseases.

Women have two more reasons why immunity decreases: menstruation and pregnancy. Menstruation significantly contributes to the increased frequency of relapses of genital herpes.

Relapses also occur during abortions and the installation of an intrauterine device. The use of oral protective contraceptives also causes an increase in relapses of the disease.

It is known that girls and women become infected with genital herpes 4 times more often than men, even having the same number of partners. This happens because the virus enters the body by contacting the vaginal mucosa.

What about sex life?

Does herpes affect the sex life of partners? Of course yes! Sexual activity during the period of illness should be completely excluded, since this type of virus is contained not only in the fluid of the vesicles, but also on clean skin, so transmission of the virus to a partner is very high.

Using a condom on the penis at this time is not a reliable means of protection, but to some extent it still protects against infection. The cessation of sexual activity should occur from the moment the first symptoms appear and for the period until they are completely cured.

Sex can be had at a time when there are no relapses, and if the partner understands and accepts all the risks. When genital herpes does not manifest itself in any way, the likelihood of infecting a partner is reduced.

However, a small number of infected particles are still present on the surface of the skin, so the risk of infection is always present. For cunnilingus and analingus, you can use a barrier contraceptive - Dentaldam.

During masturbation, you need to make sure that there are no cuts or other injuries on your hands. Having such contact, you must remember to wash your hands with soap after it. In some cases, the rash may spread to the skin of other parts of the body. Genital herpes does not cause infertility or damage the uterus.

Is it possible to protect yourself from genital herpes?

Yes, having contact with one partner. Casual sex increases the risk of infection many times over. An important means of prevention remains the use of condoms and Miramistin during sex. For women, vaccination is an essential preventive measure.

According to existing studies, 73% of women who were vaccinated and during the same period had any sexual contact with an infected man did not become infected themselves.

In addition, you always need to monitor the general state of your health, that is, your immunity, supporting it with a healthy diet, good sleep, physical exercise, and walks in the fresh air. Vitamins are required. It is important not to develop any colds or infectious diseases. All personal hygiene products should be strictly individual.

Having type 2 herpes, millions of people around the world live prosperously. It does not cause any complications with proper prevention of relapses and the fight against viruses during exacerbations. Leading a healthy life, genital herpes may never remind you of itself.

Photo: [email protected]/depositphotos.com

Genital herpes is one of the types of herpes infection. A total of eight varieties are known. The causative agent of the disease is a virus. It is found in the body of almost every person living on earth. Only 10% of people in whom pathogens are not found.

For most people, this virus lies dormant throughout their lives in nerve ganglia located near the spinal cord. It does not manifest itself in any way until a malfunction occurs in the human immune system. Primary infection is usually caused by HSV-1 (herpes simplex virus). When the disease relapses, HSV-2 is activated.

Genital herpes most often affects women, although men also sometimes suffer from this disease. Typically, ulcers affect the genitals, areas adjacent to them and the anus. Rarely, genital herpes appears directly on the perineum, cervix, and ovaries. The damage caused by the virus to the ovaries and uterus can be very severe. Genital herpes often leads to infertility and sometimes death of a woman.

Unlike everyday herpes, genital herpes is transmitted only through sexual contact. Oral-genital, oral-anal, genital-oral relationships with strangers are especially dangerous, although classic unprotected contact with a patient can also lead to infection. Using condoms does not eliminate, but reduces the risk of infection by approximately half.

How does infection occur?

In addition to the sexual method of transmission of genital herpes, infection is possible when a child passes through the birth canal during childbirth or the fetus passes through the placenta of a sick mother. In some cases, human infection can occur in the absence of sexual contact. Infection in this case is the result of non-compliance with personal hygiene rules, when a person transfers the virus from his lips to his genitals with dirty hands.

The virus, which once entered the body through microtraumas to the skin and mucous membrane of the genital organs, remains in the body for life. A person who has good immunity and leads a healthy lifestyle may not find out about the presence of the virus and will not become familiar with the clinical signs of the disease. However, under factors favorable to infection (severe fatigue, stress, hypothermia, colds, overheating in the sun, mental and physical trauma, prolonged alcohol intoxication, hormonal changes), the virus becomes more active and the disease worsens.

The most severe complication is neonatal herpes, when the child is infected from the mother during childbirth. The likelihood of transmitting the herpes virus to a newborn increases if the mother became infected in the last 3 months of pregnancy. Infection in newborns leads to serious damage to the child’s nervous system, blindness and even death. If it has been determined that during pregnancy the expectant mother’s herpetic infection has entered an active phase, then delivery by cesarean section is recommended to avoid the passage of the fetus through the birth canal.

Reasons for the development of genital herpes

Symptoms of the disease do not always appear externally. But their absence does not make the disease safe: a person infected with the virus is always dangerous for sexual partners. Any contact with the skin of an infected person can make his partner sick. Particularly susceptible to the virus are:

• Mucous membranes located in the mouth.
• Genital organs.
• The area adjacent to the anus, the anus itself.

That is why infection is possible through oral, genital, and anal sex. A partner with herpetic sores on the lips easily transfers the infection to the partner’s genitals during oral sex.

At-risk groups

The spread of the disease is directly related to the socialization of people.

Risk factors may include:

• Promiscuous sexual intercourse.
• A large number of sexual (familiar or unfamiliar) partners.
• It has been statistically proven that exactly half of the women carrying the virus are unmarried.
• Low social standard of living, lack of normal conditions and adequate nutrition.

Genital herpes can become even more dangerous because during the initial infection, signs of the disease do not always appear. The disease can also occur in a latent form, in which all symptoms are absent. Sometimes they are present, but appear so weakly that the sick person simply does not pay attention to them. But, regardless of the presence of symptoms, sexual contact with an infected person in most cases leads to infection.

Every person’s body tries to resist the disease. However, the fight against a genital virus becomes useless if a person:

• is in a state of chronic fatigue;
• experiences prolonged stress - emotional, mental, physical;
• was injured during sexual intercourse;
• suffers from reduced immunity;
• Sexual intercourse during menstruation increases the risk of genital infection.

Diagnosis of genital herpes

In some cases, to diagnose herpes with pronounced symptoms, a visual examination of the patient is sufficient. The appearance of a blistering rash in the genital area, accompanied by itching, burning and pain, is a reliable indicator of herpes. However, confirmation of the diagnosis is obtained in laboratory conditions by collecting material directly from the site of the rash. To identify the presence of the virus, a scraping is carried out from the cervix, urethra or rectum, taking into account the lesion. To diagnose antibodies in the absence of characteristic symptoms, the material being tested is the patient’s blood.

Herpes often occurs in combination with a number of other sexually transmitted infections. Therefore, an accurate diagnosis is made after testing for trichomoniasis, chlamydia, syphilis, AIDS and other infections.

Types of genital herpes

There are 4 types of sexually transmitted infections depending on how it manifests itself and who it affects:

1. If a person who has never been in contact with patients (or carriers of the virus) and does not have antibodies in the blood becomes infected for the first time, the first type of clinical manifestations of genital herpes is isolated.
2. When there are antibodies to the virus in the blood, but for the first time infection with genital herpes occurs, the second type of clinical manifestations is identified.
3. Recurrent (reactivating infection) - the third type.
4. Experts call asymptomatic manifestations the fourth type of clinical manifestations.

Each episode has its own clinical picture and its own primary symptoms.

From this point of view, genital herpes is:

• Typical.
• Atypical.
• Asymptomatic (this is equivalent to being a carrier of the virus).

Sometimes it can be difficult to determine what clinical picture is currently present in a woman. Washington doctors, who have been studying the disease for many years, believe that with primary infection there must be three of the following symptoms:

• Extragenital (external, not related to the genitals) - nausea, muscle pain, joint pain, headache, and sometimes fever.
• Rashes and redness in the genital area that last for at least 10 days.
• The presence of painful genital rashes.
• Damage to the mucous membranes of the pharynx, nose, skin of the buttocks, palms, etc.

Symptoms of primary herpes infection

Symptoms usually appear 3–8 days after unprotected sex with an infected partner. In women, the skin in the area of ​​the vulva, perineum, anus, and vagina becomes red and swollen. Vesicles (watery blisters) develop on congested skin, which later turn into open sores. After a few days they become covered with a purulent yellow coating. The skin in this area becomes sensitive, women complain of an unbearable burning sensation, debilitating itching, and sometimes pain in the area of ​​the rash.

More severe symptoms may also occur: frequent urination, heaviness in the abdomen (lower), headache, nausea or fever. Typically, pronounced symptoms disappear within a month. The disease becomes latent.

Symptoms of recurrent genital herpes

If a woman has suffered primary genital herpes, then there is a 70% chance that she will develop symptoms of a recurrent type. Depending on how often the exacerbation occurs, the severity of the disease is distinguished:

• In mild cases, symptoms appear once every few years.
• On average - up to 6 times a year.
• If severe - every month.

Symptoms of a recurrent disease may include:

• Damage to vesicles or ulcers of the skin of the face and torso.
• Gingivitis, stomatitis.
• Eye lesions.

Typically, these symptoms of genital herpes disappear as soon as the sores are localized to the genitals.

Depending on how genital herpes progresses, doctors distinguish:

• Arrhythmic type of course. In this case, periods of remission/exacerbation appear at different intervals: from 3 weeks to six months.
• The monotonous type is characterized by approximately equal time intervals between exacerbations/remissions. Typically, signs of genital herpes appear once every 3-4 months.
• Fading is different in that periods of remission in women become longer and longer, and symptoms become less noticeable.

Symptoms of atypical forms of genital herpes

With atypical genital herpes, not only the skin and mucous membranes are affected, but also (this is especially dangerous) the appendages and the woman’s uterus. Typically, an atypical disease develops as a consequence of recurrent herpes, although in some cases a primary infection is sufficient to damage internal organs. With atypical infection, signs of genital herpes can only appear:

• in severe, persistent leucorrhoea (unusual vaginal discharge);
• in almost invisible vesicles;
• in unbearable itching, severe burning that bothers the woman.

At the first stage, genital herpes affects the external genitalia, at the second stage - the urethra, cervix, vagina, at the third (the most severe) - the bladder, appendages, and uterus.

Advanced genital herpes can be accompanied by severe symptoms:

• Acute urinary retention.
• Nervous and mental abnormalities - irritability, drowsiness or, on the contrary, excitability, depression or depression.
• Headache.
• General weakness.

The causes of relapses can be:

• Mental or physical fatigue.
• Regular hypothermia.
• Flu, respiratory or other infections.
• Chronic diseases that weaken the immune system.

Treatment

When deciding how to treat herpes, the choice is made in favor of etiotropic and immunocorrective drugs.

Stage 1 - treatment of an acute condition

Acyclovir is the main drug for the treatment of acute and recurrent forms of genital herpes. It has a powerful etiotropic effect, being activated inside infected cells and inhibiting viral DNA polymerase. Acyclovir has very low toxicity to normal cells. The course of treatment includes enteral administration of acyclovir capsules. In patients with primary acute infection and in patients with manifestations of herpetic infection in immunodeficiency states of various etiologies, the dose can be doubled.

Since it is necessary to treat herpes with the mandatory use of ointments and creams, it is recommended to use 5% Acyclovir cream, which is applied to the affected areas of the skin and mucous membranes. Tebrofen in the form of 2 or 3% ointment, Interferon ointment and others are also used as local therapy. A peculiarity of the prescription of local antiviral ointments is the frequency of application to the affected areas (at least 5–6 times a day).

At the same time, based on indications, antibacterial therapy can be implemented, since it is more difficult to treat a patient with secondarily infected banal flora. It is undeniable to prescribe interferon inducers (neovir, reoferon, dibazol) and natural antioxidants (vitamins E and C) at this stage. When the exudative component is pronounced, prostaglandin inhibitors (indomethacin) are used.

Stage 2 - treatment of genital herpes in remission

Reducing the main clinical manifestations is the main goal of preparing the patient for vaccine therapy. Adequate nutrition, adherence to a rest and work regime, and sanitation of chronic foci of infection are indicated. Due to the violation of various parts of the immune system that persist in the remission phase, it is advisable to use adaptogens of plant origin (golden root, lemongrass) or immunomodulators (for example, neovir, Wobenzym, Dibazol).

Stage 3 - specific prevention of relapses

It is carried out using herpetic vaccines (inactivated, live, recombinant).

In case of exacerbations, long-term preventive treatment is carried out more than 6 times a year for several months. Thanks to this, it is possible to reduce the severity of repeated exacerbations and reduce the frequency of relapses by 75%.

Treatment involves mandatory adherence to strict rules of personal hygiene. The affected area should remain dry and clean. After touching the infected area, you should wash your hands to avoid spreading the infection.

Consequences of genital herpes

This may be a secondary infection of the ulcers. By scratching ulcers and itchy areas, a woman risks introducing infections into the wound that are caused by streptococci, staphylococci, etc.

A pregnant infected woman cannot bear a child. If a miscarriage does not occur, the child may be born with one of the forms of genital herpes or with deformities.

Damage to the uterus and other internal reproductive organs in most cases leads to infertility.

What can provoke an acute condition

• Overwork. If the body periodically experiences heavy loads, then at a certain point its strength will not be enough to contain the activity of the virus. And then the herpes worsens.
• Stress. They are also hard work for the body. It is known that many diseases arise precisely from nervousness. And herpes (or rather its relapse) is no exception.
• Injury. It is clear that any injuries and damage are a great stress for the body. He is forced to direct all his strength to healing, and at this time the herpes virus is activated.
• Overheating or hypothermia. These factors can also provoke a relapse of the disease, since the body and immune system can only work normally in the optimal temperature regime for a person.
• Vitamin deficiency and hypovitaminosis are often a trigger for the activation of the herpes virus.
• Strict diets and food restrictions. It is clear that for normal functioning the body must receive a sufficient amount of nutrients. And if this does not happen, then the protective forces are noticeably weakened.
• Other infections. For example, it often happens that a person has a cold and soon notices symptoms of genital herpes. Although herpes most often occurs near the mouth during a cold, the labia may well become the site of its manifestation.

How to reduce discomfort

Unfortunately, the world has not yet invented a medicine that can rid humanity of this virus. Drug therapy can alleviate symptoms, lengthen remission times, shorten healing time, and reduce the likelihood of transmitting the virus to partners. The doctor selects treatment individually for each patient. It is believed that the most effective is complex treatment, which is prescribed simultaneously by a gynecologist and an immunologist.

In case of exacerbation, women can supplement drug therapy with independent treatment, which must be agreed with a doctor:

• For headaches or fever, take paracetamol.
• Wear loose clothing, thereby reducing contact of affected areas with fabric.
• Do not overheat the affected areas.
• Take salt baths two to three times a day, immersing the infected area in a saline solution (a spoon per 0.5 liters of water).
• Avoid exposure to open sun, but take air baths to help the ulcers dry out.
• Sometimes during exacerbation, urination becomes painful. You can make the process easier by immersing yourself in warm water - the pain will be less.

How to reduce the risk of getting herpes

About half of people first become infected with herpes through airborne transmission. However, genital herpes is only transmitted through sexual contact.

In order to reduce the risk of infection, you must:

• Avoid frequent changes of partners.
• Be sure to use a condom.
• Avoid casual relationships.
• Be systematically checked and tested.
• Strengthen immunity.

Discussion 0

The only way to determine if you have genital herpes is to go to your nearest hospital or clinic. You need to tell your doctor that you think you have genital herpes. It can only be diagnosed if symptoms are present, so don't delay visiting your doctor. Do not apply any creams or oils to the affected area as your doctor will need to take a swab. Even if you are regularly screened, tests for herpes are usually not performed unless symptoms of herpes are detected on the skin. There are blood tests for herpes that show the presence of antibodies to the herpes virus. However, they are not very reliable; every third analysis is incorrect. Some clinics may offer a urine test to determine genital herpes, but you should beware of such offers, they are not true. A rash on your genitals does not necessarily mean you have genital herpes. They can be caused by herpes type 1 (labial herpes) or type 3 (chickenpox).

1. Do I need a doctor's referral to get tested for herpes?

This is not necessary; you can take the tests yourself.

1. Will details of the diagnosis be sent to my GP?

Visits to clinics and laboratories are confidential. Even if you took tests on a referral from a therapist to whom the results should be sent, you can always ask not to do this.

1. What is herpes simplex?

Herpes simplex refers to 2 types of viruses from the herpetic family: type 1 and type 2. They may be referred to as HSV-1 and HSV-2. Once they enter the body, they remain there forever. They can cause symptoms on the face, genitals, hand or fingers, but it is not uncommon for herpes to appear on other parts of the body.

1. What are the symptoms of genital herpes?

Symptoms begin with itching, tingling and soreness in the area affected by herpes. Common flu symptoms may also appear: muscle pain, headache, fever, pain and mild swelling of the lymph nodes in the groin, neck and armpits. The skin under the pubic hair may develop blisters, red spots, or bumps that are painful when touched. Later, these ulcers will become covered with a gray or yellow crust, which will gradually heal. The rash can also appear on the mucous membrane, for example under the foreskin in men or on the inside of the vaginal tubes in women. When infected for the first time, the rash and its healing may take up to 2-3 weeks. Most people experience repeated rashes - relapses. Subsequent outbreaks of the virus are much easier, ulcers heal faster, since the body has already produced antibodies. If relapses occur frequently, then most likely you have become infected with the second type of herpes virus.

1. How long will symptoms of genital herpes last?

After infection, symptoms appear from 2 to 14 days, most often 4-5 days. Once you are infected, genital herpes may take several years to show up. Therefore, you should not consider the appearance of herpes as evidence of your partner’s infidelity. About 65% of people do not develop symptoms when they are first infected.

1. Can herpes spread throughout the body?

It is extremely unlikely that the herpes virus will spread to other parts of the body, but it is still recommended to use ointments for herpes. For some, herpes may appear, for example, on the hands if they were used during sexual contact.

1. How common is herpes simplex?

Very common. By age 25, approximately 60% of people are carriers of herpes type 1 and another 10% are carriers of herpes type 2. Most people don't even realize they have herpes because they have no symptoms. In most people, herpes on the lip is caused by herpes type 1, genital herpes is caused by herpes types 1 and 2. Every year there is an increase in the number of people infected with the herpes virus.

1. What is the difference between herpes virus types 1 and 2?

They cause similar symptoms but are genetically different. Type 1 is more likely to appear on the face again and less likely if it occurs on the genitals. Type 2 – if infection occurs, it will appear on the genitals. Only laboratory tests can determine which type of herpes virus you have become infected with.

1. What other herpes viruses exist?

— The varicella zoster virus, also called herpes zoster, causes chickenpox and shingles. Shingles is a recurrence of chickenpox.

- Epstein-Barr virus, cytomegalovirus - they do not cause spots and ulcers, but they do cause flu-like conditions.

— Virus types 6, 7 and 8.

People often ask how herpes affects my health. The appearance of herpes indicates that your immune system is weakened. Herpes simplex does not have a negative effect on the body. It can be harmful if your immune response is severely weakened and the concentration of virus in your body is high.

1. How is the genital herpes virus transmitted?

Transmission of the virus is possible through direct contact: when there is contact of the affected area of ​​skin to skin with microtraumas. Herpes also easily penetrates mucous membranes through close contact. When the virus is active, it can be transmitted through oral sex. There is a small chance of transmission of the virus when it is active but there are no symptoms.

1. Can a partner infected with genital herpes spread the virus to another part of the person's body?

If you are already infected with genital herpes, there is an extremely low chance that it will appear elsewhere on your body. Our immune system protects against this. If you have symptoms on both your lips and genitals, this does not mean that the herpes virus can appear throughout - it is localized.

1. How can I protect my partner from getting infected?

If you have been diagnosed with genital herpes, this already means that you are a safer partner than others, because you know when you have had a relapse and when the wounds will completely heal. An infected person can easily protect their partner by using a condom. If you take antiviral pills daily, they will significantly reduce the asymptomatic activity of the virus, and the chances of becoming infected will be much lower. Infections caused by the herpes virus type 1 are more common, but your new partner may have both types and not know it.

1. Can using a condom prevent the transmission of genital herpes?

Yes, this will significantly reduce the risk of transmitting the virus. It is not able to penetrate the condom. However, if infected skin comes into contact with your partner's skin outside of the condom, infection is possible. Using a condom reduces the risk of transmitting the virus by 50%. Therefore, sexual contact should be avoided until symptoms have passed.

1. Can I spread herpes simplex if I don't have symptoms?

Sometimes it happens, but it's unlikely. When a virus is not active inside a cell, it cannot be infectious. If you feel itching or burning on your skin, then this is already a symptom and transmission of the virus is possible. People who already know they are infected react more quickly to the first symptoms, while others who have not been tested may ignore them.

1. What should I do if my partner already has herpes simplex?

- If you and your partner have genital herpes virus but have no symptoms, you cannot infect each other again.

- if you become infected with genital herpes from your partner’s labial herpes, then there will be no secondary rash on the genitals.

- if your partner has herpes on the lip, and you become infected with it, then it will not spread to the genitals unless you have oral sex.

- genital herpes cannot be transmitted to a partner’s lips, even if there was oral sex.

1. What should I do if my partner already had herpes on his lip?

If your new partner once had herpes on the lip (that is, the same type of virus), then it is unlikely that either of you gave it to the other. If you have different types of viruses, then your partner’s symptoms will be mild.

1. If my partner doesn't have genital herpes, how could I get it?

This means that your partner was once in contact with a person who has herpes, but does not manifest itself in any way. They may have had sexual contact while the virus was active. Another option is that you became infected from a person who also did not show symptoms, but is still a carrier. The first symptoms of a herpes infection may appear several years after the initial infection.

1. Can you get genital herpes through objects?

The chances of transmitting the virus are unlikely because the virus dies quickly in the environment.

1. Can my children get genital herpes from me?

Genital herpes is transmitted through direct contact, not from hands or objects. Even swimming together with small children is not a problem, since the virus is not transmitted in water. The herpes virus cannot be transmitted through bed. Even if you used the toilet, accidentally touched your genitals and forgot to wash your hands, it is unlikely that the virus will be transmitted. Regular hand washing with soap is a sufficient preventive procedure.

1. Can you get genital herpes from labial herpes?

Herpes on the lips can be transmitted to the genitals through oral sex. Moreover, herpes on the lips can appear from the genital herpes of a partner if its causative agent is herpes type 1. People can have sex if they have cold sores, but they should avoid kissing and oral sex.

1. Can you get genital herpes from kissing?

Genital herpes is not transmitted through kissing. In a similar way, the herpes virus type 1, that is, labial herpes, can be transmitted. In carriers of herpes type 1, the virus is found in the saliva.

1. What is the risk of infection between relapses?

Research has shown that a person can be contagious even when there are no symptoms. There may be enough viral particles present on the mucous membrane for the partner to become infected. The fewer relapses a person has, the less likely the person is to be infectious to others. Over time, the risk of asymptomatic infection decreases.

1. Why does genital herpes appear again?

Once in the body, the genital herpes virus travels along the nerve to the nerve ganglia, where it remains for life. Periodically, favorable conditions arise when the immune system weakens, and the virus, moving along the nerves, appears in the same area where it was before. At this time, primary symptoms may appear: pain, itching, burning - preceding the appearance of blisters. This indicates that the virus is trying to reactivate and will soon appear on the skin.

1. How often can genital herpes occur?

Some people may have no symptoms, while others may have frequent relapses. In this case, it is necessary to take antiviral drugs. Over time, relapses become less frequent and go away easier.

1. Should genital herpes be treated?

Treatment may not be necessary at all, since symptoms of the infection may go away even without treatment. However, if severe symptoms occur, treatment is necessary.

1. How is genital herpes usually treated?

The doctor will prescribe antiviral drugs to alleviate the course of the primary infection. The most commonly prescribed drug is acyclovir. If the first episode is mild and heals quickly, then you do not need pills. If herpes returns frequently, it is less treatable. Antiviral drugs must be started within 24 hours of the onset of relapse. If therapy begins after 24 hours, the effectiveness will be lower.

1. How to treat relapses of genital herpes?

Most people do not need antiviral therapy because their bodies are able to prevent recurring symptoms or because they live a truly healthy lifestyle. People who are less fortunate and have repeated relapses need to take antiviral tablets.

1 – a short course of therapy, which must be started within 24 hours from the onset of the first symptoms:

— Acyclovir 800 mg 3 times a day for 2 days, or

— Valacyclovir (Valtrex) 500 mg 2 times a day for 3 days, or

— Famciclovir (Famvir) 1 gram 2 times a day for one day.

2 – suppressive therapy, when tablets are taken daily for 6 months or more. Currently, these drugs are considered extremely safe. Acyclovir is considered so safe that after long-term use it is no longer necessary to undergo an annual test to determine its effect on the body.

— Acyclovir 400 mg 2 times a day, or acyclovir 200 mg 4 times a day, or

— Valacyclovir (Valtrex) 250 mg 2 times a day, or 500 mg 1 time a day, or

— Famciclovir (Famvir) 250 mg 2 times a day.

If relapses occur during this treatment, the daily dose should be increased by 1.5 times. It should be borne in mind that when you start taking a long course of pills, a relapse may occur after 4-5 days, but this does not mean that relapses will be frequent, you need to continue treatment and look at the further result.

1. Are there any side effects from taking antiviral drugs for genital herpes?

Most antiviral drugs are well tolerated because they target the virus rather than healthy cells. Therefore, such effects are observed extremely rarely. Experts say regular kidney function tests are no longer required for people taking acyclovir long-term. The drug has been successfully used for more than thirty years. In addition, it can be used during pregnancy.

1. How to reduce discomfort and speed up healing? Self-help for genital herpes.

If necessary, take a pain reliever: ibuprofen, paracetamol or aspirin. Be sure to wash your hands before and after touching the sores, as this can introduce bacteria and prolong the healing time.
You can use anesthetic ointments, for example, Lidocaine ointment/spray/solution 5%.
Keep wounds from drying out by using Vaseline.
The area of ​​the rash should be clean: treat it once a day with a warm solution of salt water (1 teaspoon per 1 liter of water) using a cotton pad.
Avoid using sanitary cleansers, scented soaps and deodorants.
To reduce itching, keep the area cold by applying an ice pack wrapped in a cloth for 60 to 90 minutes. Do not apply ice directly to the skin.
If urination is too painful, women can do this in the bathroom, running warm water over the area of ​​the rash. This will dilute the urine and reduce discomfort.

1. Sometimes there is pain around the buttocks or in the leg. What does it mean?

The herpes simplex virus can cause pain, which is also a symptom that the virus is trying to reactivate. If you have a good enough immune response, it will suppress the virus before visible signs appear on the skin.

1. How severe can a recurrence of genital herpes be and how likely is it?

Relapse is the recurrence of symptoms at or near the site where they first appeared. The likelihood of recurrence depends on the functioning of your immune system. Quite often they are minor and may appear as a small spot that heals after a few days. Symptoms may include nervousness and severe itching. But relapses are often milder than the initial infection.

1. Do all infected people experience relapses of herpes?

About 50% of people diagnosed with genital herpes experience symptoms only once during the initial infection and do not experience relapses. For others, relapses may occur several times a year or less/more often.

1. What needs to be done to ensure that relapses of genital herpes occur less frequently?

There is no need to do anything until you are sure that relapses do occur. You should not rely on the personal experience of other people, since there are no guarantees that the proposed methods will work for you. However, you need to know some general recommendations:

- Avoid stressful situations, as stress negatively affects our immune system and reduces our ability to fight the virus.
— try to get enough sleep and not get overtired.
- eat a balanced diet, eating as many vegetables and fruits as possible.
- Take vitamin E (200 mg per day) - it improves the immune response.
- Reduce alcohol consumption to a minimum and quit smoking.
- Do physical exercise every day: you can start with 20 minutes of brisk walking.
- try not to injure the skin of the genital organs: waxing, shaving, thongs, riding a bicycle or horse, excessive sexual activity.
- do not sunbathe naked, that is, avoid direct sunlight on the skin of the genitals. In addition, use sunscreen on your body.

1. Can I pass genital herpes to my child?

The mother or caregiver cannot infect the child with genital herpes. However, children may be susceptible to other types of viruses. If someone has herpes on their lips or face, then he/she should not kiss a small child.

1. Does genital herpes cause cervical cancer?

It was previously believed that the herpes simplex virus could be one of the causes of cervical cancer, but recent studies do not confirm this fact.

1. Can I donate blood if I have herpes?

If the virus is not detected in the blood, then you can donate blood.