Herpes Simplex - Common Skin Conditions: Skin Health

Content provided by the Faculty of the Harvard Medical School

Herpes simplex

There are two types of herpes simplex viruses. HSV-1 is the main cause of oral herpes, or cold sores. HSV-2 causes most cases of genital herpes, although HSV-1 can cause it, too.

More than 90% of people have been exposed to HSV-1 by the time they reach their 40s. It is transmitted by kissing or other contact with saliva. The first sign of a cold sore is pain, burning, or tingling followed about 24 hours later by a tender bump, which quickly becomes a blister. Within a week, the blister opens, leaving a shallow ulcer that crusts over and heals.

About 45 million people in the United States have genital herpes, a sexually transmitted disease that usually spreads through kissing, contact with infected skin, and intercourse. Small, itchy, burning blisters form in the genital area and, in some people, around the mouth. A pregnant woman with HSV infection can pass the virus to her baby during delivery, causing infections of the baby's skin, mouth, lungs, or eyes.

Symptoms of both may occur just once or in recurrent bouts. Cold sores usually appear for no apparent reason, but they can be triggered by intense exposure to sunlight, fever, skin trauma, menstruation, and emotional distress. Once you are infected with a herpes simplex virus, it remains in the body for the rest of your life.

Treating herpes simplex

Oral and genital herpes have no cure, but your doctor may prescribe an oral antiviral medication such as acyclovir, famciclovir, or valacyclovir to shorten the duration of the symptoms and help prevent recurrences or make them less severe. Newborns of mothers with genital herpes receive antiviral medications intravenously.

For cold sores, antiviral medications are most effective when taken as soon as itching and burning begin but before the blisters form. Sometimes doctors prescribe antiviral drugs to people before exposure to a cold sore trigger such as intense sunlight or a skin procedure such as dermabrasion. When herpes outbreaks occur frequently, doctors may prescribe antiviral medications to be taken regularly to minimize recurrences. Over-the-counter anesthetic ointments such as Zilactin can temporarily relieve pain and protect the affected area from cracking and irritation.

Last updated:	July 20, 2007