สาเหตุ อาการ การติดเชื้อ การรักษาเริม (Herpes simplex) - Herpes simplex - Causes, Symptoms, Infections and Treatments

Herpes simplex

Herpes simplex is an infectious virus spread through skin contact or sexual transmission of HSV-1 or HSV-2, a virus that causes oral herpes or genital herpes, causing itchiness, blistering, cold sore

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Herpes simplex

Herpes simplex is an infectious virus spread through skin contact or sexual transmission of HSV-1 or HSV-2, a virus that causes oral herpes or genital herpes, respectively. They cause itchiness, blistering, cold sore, burning pain, and fever, though some people may not show any signs or symptoms of the disease. The contagious virus is not curable, but medications can lessen the symptoms. Those with herpes simplex infection can relapse when their immunity is low.

What causes herpes simplex?

Herpes simplex is due to the herpes simplex viruses (HSV-1, HSV-2) with person-to-person transmission through direct and indirect contact with an infected person's secretions, particularly on the mouth, and genitals, such as by kissing, drinking from the same glass, sharing the same lipstick, having sex without wearing a condom or performing oral sex, causing oral and/or genital herpes, and herpes skin rash on the part of the body affected. Parents with herpes simplex can spread the virus to their children through kissing, skin contact, or sharing items contaminated with saliva.

How many types of herpes simplex?

There are two herpes simplex types causing lesions in different body areas. The two types of herpes simplex are as follows:

  1. Herpes simplex virus type I: HSV-1 causes cold sores or clear fluid blisters on the mouth, face, nasal cavity, or any part of the skin above the navel. Oral herpes is due to contact with the secretions of a person infected with HSV-1, such as saliva causing cold sores, clear fluid blisters, rashes, and burning pain.
  2. Herpes simplex virus type II: HSV-2 is usually transmitted via intercourse with a person infected with the HSV-2 virus, causing itching, irritation, clear fluid blisters, and pain in the penile area in males or the vaginal area in females. 

Modes of herpes simplex infections

HSV-1 virus:

  • Kissing
  • Skin contact near the mouth of a person with herpes simplex
  • Sharing eating utensils or objects with an infected person, such as glasses, drinking straws, lipstick, and razors
  • Receive oral sex from an HSV-infected person; the virus can spread to the genitals.

HSV-2 virus:

  • Intercourse without wearing a condom, whether penile-vaginal, penile-anal, or vaginal-vaginal sexes.
  • Giving or receiving oral sex from a person who is infected.
  • Close skin-to-skin contact with an infected person, even without ejaculation
  • Contamination from infected open wounds or blisters, including an infected breastfeeding mother.
  • Mother-to-child transmission occurs when mothers who were infected while pregnant give birth.
  • Infection by sharing sex toys with an infected person.

Herpes simplex symptoms start with an unbearable itch at the HSV-infected site
What are the symptoms of herpes simplex?

Herpes simplex symptoms start with an unbearable itch at the HSV-infected site and progress to clear fluid blistering that is inflamed and painful at the base of the swollen red rash of the cold sores. The symptoms can last anywhere from a few days to 1-2 weeks, passing on to others through direct contact. The clear-water blisters will burst, ooze, and bleed, eventually forming a scab as the wound heals. Herpes is a contagious disease that is not curable. Symptoms may come and go and have the potential to reappear. After the symptoms have subsided, the HSV virus remains embedded and hidden in the nerve ganglion area throughout the body, causing no symptoms until the body's immunity weakens; and herpes simplex symptoms will reoccur. The symptoms include the following:

  • Clusters of cold sores or clear fluid blisters that develop on the lips, tongue, face, or genitals.
  • Itching, irritation, and burning pain in the genital or anal regions. 
  • Dyspareunia (burning pain in the vagina during sex)
  • Tingling and burning sensation.
  • Fever, headache, muscle aches, and possibly swollen lymph nodes.
  • Burning urination.
  • Vaginal discharge with an amine-like odor (in women)
  • Red, swollen genitalia

Can herpes simplex recur?

Herpes simplex can recur as soon as 7 days after the first episode if activation of the hidden HSV virus in the ganglion region occurs. The hidden virus travels along the nerves to their endings, where it causes symptoms. The recurrent disease's symptoms are less severe and heal faster in terms of the number of cold sores, itching, or burning sensations than the initial episode.

Factors that can cause a recurrence of herpes simplex include:

  • Low bodily immunity
  • Inadequate rest
  • Other viral infections or develop a high fever.
  • Taking immunosuppressive drugs such as steroids
  • Hormonal fluctuation during menstruation.
  • Surgery that affects nerves
  • Hot weather, exposure to sunlight
  • Malnutrition
  • Stress

How is herpes simplex diagnosed?

The doctor diagnoses herpes simplex by taking a medical history, asking about symptoms, and examining the characteristics of the cold sores or clear fluid blisters. The doctor will then perform laboratory tests such as the PCR (polymerase chain reaction) by taking blood or wound tissue samples and performing a viral culture, checking antibody levels to determine the immune response to the HSV infection. The PCR Test provides accuracy and distinguishes between HSV-1 or HSV-2 types.

What is the treatment for herpes simplex?

If the test result indicates herpes simplex, the doctor will prescribe antivirals to inhibit the HSV virus from multiplying and pain relievers for pain if needed. Therefore, it is crucial to see a doctor as soon as possible for antiviral prescriptions to help reduce inflammation from infection, alleviate pain, and prevent the spread of cold sores. Herpes simplex is treatable with the following medications:

  • Anti-HSV medications include acyclovir, famciclovir, and valacyclovir.
  • Pain relievers taken orally, such as paracetamol or ibuprofen.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Topical pain relievers such as benzocaine, L-lysine, and docosanol.

การรักษาด้วยการให้ยาต้านไวรัสเพื่อยับยั้งการเพิ่มจำนวนของไวรัส HSV ร่วมกับยาระงับความเจ็บปวด - If the test result indicates herpes simplex, the doctor will prescribe antivirals to inhibit the HSV virus from multiplying and pain relievers for pain if needed.
What is the prevention of herpes simplex?

The best way to prevent herpes simplex is to reduce and avoid risky behaviors that could lead to infection or being a carrier of the disease to others, such as not sharing personal belongings, not coming into contact with people or objects that could be contaminated with saliva or secretions, always wearing a condom before sex, cleaning the body thoroughly, eating nutritious food, exercising regularly, and getting enough rest to maintain a healthy immune system and help reduce the risk of infection.

What are the complications of herpes simplex?

Complications of oral and genital herpes are the spread of the infection to other parts of the body, such as:

  • Eye infection that can impair vision.
  • Brain infection can cause brain inflammation.
  • Maternal infection during pregnancy, with a high risk of in-utero fetal infections.

What are the symptoms of genital herpes simplex in women?

Female genital herpes simplex symptoms include itching, clear fluid blisters, burning pain, and tingling in the genital area. Then, cold sores develop with a swollen red rash or burning sores around the cervix, genitals, groin, buttocks, anus, and vaginal discharge, an amine-like odor, burning sensations while urinating or having sex, and a fever.

What are the symptoms of genital herpes simplex in men?

Male genital herpes simplex symptoms include an unbearable itch, swollen redness, cold sores, and clear-fluid blisters on the penis. Typically, the most common regions for tingling and discomfort are the head of the penis, the skin around the penis, the anus, the scrotum, the buttocks, and the groin, as well as burning sensations when urinating, sore genitals while inserting or having sex, and a fever.

What should I do if I suspect herpes simplex?

Anyone suspected of having herpes simplex symptoms should have an evaluation by a medical professional. Early detection and treatment can help to stop the virus's spread and relieve itching and soreness. Those with a history of herpes simplex infection should have regular physical exams to avoid complications from low immunity.

Herpes simplex is a disease that currently has no cure. The HSV can hide in the body for long periods without causing symptoms and can transmit the disease to others at any time. Wearing a condom before having sex, not touching other people's saliva, and having an annual blood test to measure the body's immunity can reduce the chances of contracting the herpes simplex virus.

Article by

  • Dr Rapeephan R.Maude
    Dr Rapeephan R.Maude A Doctor Specializing in Infectious Disease
  • Dr Mattana Patiyasikunt
    Dr Mattana Patiyasikunt Internal Medicine Specialist in Dermatology

Published: 18 May 2023

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