Genital Herpes

Genital Herpes

Genital herpes is a common, highly infectious disease caused by a virus. It is transmitted from one person to another during sexual activity.


Genital herpes causes blisters or groups of small ulcers (open sores) on and around the genitals in both men and women. Genital herpes cannot be cured; however, there are medications that can be prescribed to treat outbreaks and minimize the symptoms.


Genital herpes is extremely widespread, largely because it is so contagious. Carriers can transmit the disease without having any symptoms of an active infection.


At least 45 million Americans are infected with the genital herpes virus, with approximately one million new infections each year. As many as 80%-90% of those infected fail to recognize genital herpes symptoms or have no symptoms at all.


The highest rates of infection are seen among the poor, those with less education, those usingcocaine, and those with many sexual partners.


Signs of genital herpes tend to develop within three to seven days of skin-to-skin contact with an infected person. Genital herpes infections look like small blisters or ulcers (round areas of broken skin) on the genitals. Each blister or ulcer is typically only 1 to 3 millimeters (1/32 inch to 1/8th inch) in size, and the blisters or ulcers tend to be grouped into "crops".


Usually the blisters form first, then soon open to form ulcers. Herpes infections may be painless or slightly tender. In some people, however, the blisters or ulcers can be very tender and painful.


Location of genital herpes


In men, genital herpes sores (lesions) usually appear on or around the penis. 


In women, the lesions may be visible outside the vagina, but they commonly occur inside the vagina where they can cause discomfort or vaginal discharge but cannot be seen except during a doctor's examination. 


The ulcers or blisters may also be found anywhere around the genitals (the perineum) and in and around the anus.


First outbreak of genital herpes


The first genital herpes outbreak is usually the most painful, and the initial episode may last longer than later outbreaks. Symptoms may last for two to four weeks.


Some people develop other signs of genital herpes infection, particularly with the first episode including:


  • fever, 
  • muscle aches, 
  • headaches (may be severe), 
  • vaginal discharge or painful urination,
  • swollen and tender lymph nodes in the groin (these swell as the body tries to fight the infection).


Later outbreaks of genital herpes


If the disease returns, later outbreaks generally have much less severe symptoms. Many people with recurrent disease develop pain or a tingling sensation in the area of the infection even before any blisters or ulcers can be seen. This is due to irritation and inflammation of the nerves leading to the infected area of skin. 


These are signs that an outbreak is about to begin. The condition is particularly contagious during this period, even though the skin still appears normal.


Genital herpes is caused by the herpes simplex virus (HSV). There are two types: HSV-1 and HSV-2. Most genital herpes infections are caused by HSV-2. HSV-1 is the usual cause of what most people call "fever blisters" in and around the mouth and can be transmitted from person to person through kissing.


Less often, HSV-1 can cause genital herpes infections through oral sexual contact. The genital sores caused by either virus look the same. 


Genital herpes is spread by direct contact with an infected person. Sexual intercourse and oral sex are the most common methods of spreading genital herpes. Any type of skin-to-skin contact, however, is capable of spreading herpes.


Note: People with herpes may spread the disease even if they do not realize they have an infection. Furthermore, there is strong evidence that people with herpes can transmit infection even while their disease appears to be inactive and no sores can be visibly seen.


Many people remember having an episode of genital herpes when it occurs. But as many as 90% of those infected fail to recognize the symptoms or have no symptoms at all. It is not clear whether these people never had an initial herpes outbreak or whether they never noticed a mild infection. 


In these individuals genital herpes is still contagious, and they may have additional outbreaks, nonetheless.


Medical research has not been able to find a way to halt the spread of herpes and the number of infected people keeps growing. In the United States alone, 45 million people are infected, with an additional one million new infections occurring every year. 


Presently, genital herpes cannot be cured. Moreover, genital herpes can be transmitted by viral shedding prior to and following the visual signs of symptoms. There are however some drugs that can shorten outbreaks and make them less severe or even stop them from happening. Among these drugs are: acyclovir,valacyclovir and famciclovir. 


Acyclovir is an antiviral drug used against herpes viruses, varicella-zoster, and Epstein-Barr Viruses. This drug reduces the pain and the number of lesions in the initial case of genital herpes. Furthermore, it decreases the frequency and severity of recurrent infections.


It comes in capsules, tablets, suspension,injection, powder for injection, and ointment. The ointment is used topically and it decreases pain, reduces healing time, and limits the spread of the infection. 


Valacyclovir is also used to treat herpes virus infections. Once in your body, it becomes the anti-herpes medicine, acyclovir. It helps relieve the pain and discomfort and the sores heal faster. It only comes in caplets and its advantage is that it has a longer duration of action than acyclovir. 


Famciclovir is another antiviral drug that belongs to the same class of acyclovir and valacyclovir. Famciclovir is a prodrug that is converted to penciclovir in the body. The latter is the one active against the viruses. This drug has a longer duration of action than acyclovir and it only comes in tablets. 


Individuals infected with the genital herpes virus should:


  • avoid excessive heat or sunlight, which makes the irritation more uncomfortable;
  • not use perfumed or antibacterial soaps, feminine deodorant, or douches;
  • wear comfortable, loose fitting cotton clothing;
  • take aspirin, acetaminophen (Tylenol and others), or ibuprofen (Advil, Motrin, Nuprin, etc.) if helpful;
  • use cool cloths on the affected area if it soothes the pain.
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