Herpes – causes, complaints & therapy

The group of herpes viruses is a very large and diverse group of pathogens. These pathogens also include cytomegalovirus (CMV) or varicella-zoster virus – the latter is responsible for the disease with chickenpox in childhood and with shingles in adulthood.

However, mainly known as the herpes virus is the herpes simplex virus, of which one variant causes cold sores (herpes simplex type I) and the other variant causes genital herpes (herpes simplex type II).

A slight tingling, a small blister – these are the first signs of a herpes infection. What is primarily perceived as an optical impairment is basically much more and should not be underestimated.

Causes

The painful skin lesions are caused by the herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2), whereby the virus type HSV-1 is mainly responsible for the development of herpes in the face and lip area.HSV-2, on the other hand, is the cause of infections in the genital area. Once infected, those affected suffer from herpes for a lifetime. The viruses remain in the body, settle in the nerve node and can remain there until the next outbreak – unnoticed by the immune system.

A reactivation of the viruses can have different causes. In most cases, the outbreak of herpes is preceded by a weakened immune system. Food allergies can also trigger reactivation. The same is said of excessive sun exposure, colds or psychological stress.

What all herpes viruses have in common, however, is their ability to persist, i.e. to remain undisturbed in the human body without causing any symptoms.

From time to time, the infections break out again and again and cause the known skin rashes. Only in this phase of the disease is the virus transmissible, and always through direct skin contact.

Meanwhile, genital herpes (type II) is transmitted via sexual intercourse and is noticeable through skin lesions on the vagina or glans. While almost 90% of the population must have had contact with herpes viruses at least once, according to antibody detection, about 40% of adults report a single reactivation in the form of cold sores. Only in about 10% such reactivation occurs more frequently.

When to see a doctor?

Herpes is an infectious disease that usually does not require medical attention. The affected person usually notices severe itching and blistering, which is often associated with pain. If you keep the affected area clean and clean, you can expect a very pleasant course of the disease. However, herpes can also lead to unexpected complications, which may also need to be treated by a doctor. With a contaminated herpes infection, purulent inflammation can occur very quickly.

If the formation of pus fluid can be detected, then the visit to the doctor should not be postponed. Anyone who refrains from visiting the doctor in such a case is taking a very big risk. Very quickly, an infection with herpes can develop into an open wound. If dirt gets into this wound, there is even a risk of blood poisoning. If you want to nip such a complication in the bud, you should consult a doctor as soon as possible. The existing infection can be effectively combated and alleviated by appropriate medication.

Symptoms and course

The initial infection with the herpes simplex virus type I does not occur in the form of cold sores, but in the form of generalized inflammation of the oral cavity (stomatitis aphthosa). This feels for the affected person like tonsillitis or a cold-related pharyngeal inflammation, but distinguishes itself from these by the so-called aphthae, white blisters on the mucous membrane.

The illness lasts a few days and then goes away on its own. What remains are the herpes viruses, which retreat along nerve cells into the nerve ganglia of the sensory facial nerves, where they fall into a kind of “hibernation” unmolested by the immune system .

From there, the viruses can be reactivated at any time and for the rest of your life – this happens above all when the human immune system is weakened, be it due to stress , age, HIV infection , immunosuppressive drugs, for example in autoimmune patients or before organ transplants.

As soon as the virus is reactivated, it finds its way back along the nerve fiber and at the end it appears as a cold sore. This disease is also self-limiting, but can recur at any time.

A herpes infection should subside within 10 to 14 days. If you start treatment early, the healing process can be accelerated. Herpes becomes problematic when the pathogen spreads and spreads to other skin regions. A particularly dangerous infestation of herpes occurs when the eye is affected. At the latest, a doctor should be consulted.

Diagnosis

To diagnose herpes, the doctor asks about the symptoms present. Typical symptoms of cold sores are small blisters with purulent and crusted deposits in the lips or nose. If it is herpes on the genitals, those affected usually have pain when urinating or during intercourse and a watery discharge . If a cold sore is present, the patient’s lymph nodes are sometimes also swollen. The blisters are heavily encrusted if the disease has existed for a few days. Talking and looking at the blisters are often enough for the doctor to diagnose herpes. If the disease is still in a very early stage, the doctor can initiate further tests to confirm the diagnosis.

With the help of a smear from the blisters, the pathogen can be clearly detected. From this smear, the viruses are grown on cells and later identified. Laboratory tests are also possible. In order to determine whether it is the herpes virus type 1 or type 2, a blood test is always necessary. If there is an infection with the herpes virus, antibodies can be detected in the patient’s blood. Type 1 herpes viruses do not require treatment.

If there is a suspicion of encephalitis, the DNA of the herpes viruses can be detected in the cerebrospinal fluid.

Complications

Whether and which complications are to be expected depends on which member of the herpes virus family a person is infected with or which ones are currently active. Infections in the mouth and throat with type 1 herpes simplex virus usually heal without causing serious complications. In principle, however, this virus can damage all kinds of cells. A reactivation of the type 2 herpes simplex virus is usually accompanied by very unpleasant blisters in the genital region. Both types of herpes viruses can spread to the lungs and brain, causing severe inflammation there. In these cases, the viruses usually get into the nose and then migrate along the olfactory nerves to the brain. There they very often infect the temporal lobe, which can be life-threatening for the patient.

The varicella-zoster virus, which is responsible for shingles, can spread to sensitive nerve regions in the eye and ear. In these cases, there is a risk of serious complications, including impairment or loss of vision and hearing, especially if prompt therapy with antiviral agents is not carried out. Serious complications can also occur when women become infected with the cytomegalovirus (CMV) for the first time during pregnancy. This herpes virus can not only cause miscarriages, but also cause severe birth defects in the fetus.

treatment and therapy

The viral infection with herpes viruses can be treated with the drug aciclovir. However, many doctors do not prescribe the drug because it can have side effects and the success of the therapy is by no means certain.

The use of aciclovir is therefore always a matter of consideration. However, aciclovir has its justification in particular to avoid complications such as the dreaded herpes encephalitis, an infestation of nerve cells throughout the brain.

Furthermore, a cold sore cannot be safely treated. Treatment of the lip lesion with lip plasters that do not contain active ingredients can be attempted. These should cover the cold sore with the help of hydrocolloids and lead to faster healing.

Genital herpes in pregnant women should be treated in particular – otherwise there is a risk of infection of the newborn child during birth, which can lead to severe feverish symptoms affecting the central nervous system (herpes encephalitis).

Prevention

So far there is no vaccine against the virus. Good personal hygiene and a strengthened immune system are preventive measures. The best prevention of a herpes infection is to avoid direct skin contact with acute cold sore sufferers.If the skin infection is activated, sharing glasses, toothbrushes, towels, etc. should be avoided at all costs. Kissing should also be avoided in the case of an acute cold sore infection, as the risk of infection is particularly high in this way.

Prevention is particularly important for infants and small children, who can show more severe symptoms. In this case, a doctor should be contacted urgently.