Herpes Simplex and Zoster
Also known as:
- Herpes Simplex type I (HSV-1), also known as cold
sores or fever blisters
- Herpes Simplex type II (HSV-2), also known as
genital herpes
- Herpes Zoster,
also known as shingles
What is it?
Herpes is a skin infection.
Who gets it?
Anyone can get Herpes Simplex type I. Herpes Simplex
type II appears in sexually active individuals. Herpes
Zoster can occur in anyone who has had the chickenpox
virus, but is more common in those over the age of 50.
What causes it?
HSV-1 is caused by the Herpes Simplex type I virus. It
usually occurs with a viral illness, such as a cold, or at
a time of stress. The Herpes Simplex type 2 virus causes
HSV-2. Herpes Zoster is caused by the varicella zoster
virus, which also causes chickenpox. Once you have been
infected with a form of the herpes virus, the virus
continues to live in the nerve cells of the skin or the
central nervous system, but doesn't cause any symptoms.
Something, such as an illness, stress, sunburn, or injury,
can cause the virus to become active again, which causes
the symptoms of HSV-1, HSV-2 or shingles. The virus may
also occur in people who are taking drugs to suppress the
immune system. Although shingles is not contagious,
someone who hasn't had chickenpox can develop chickenpox
if they have contact with fluid from a shingles blister.
HSV-1 and HSV-2 are contagious and are spread by contact
with the fluid in the blisters. HSV-2 is commonly spread
through any type of sexual contact. HSV-2 can also be
spread from a woman to the fetus if she becomes pregnant
while infected with this virus.
What are the symptoms?
Herpes may begin with an initial tingling, burning, or
numb sensation, followed by clusters of small, painful,
fluid-filled blisters. HSV-1 blisters usually appear
around the lips and surrounding skin. HSV-2 blisters
appear on the genitals, around the anus, and on the
buttocks. Within a few days, HSV-1 and -2 blisters are
covered with a thin, yellow crust as they begin to dry,
and the pain subsides. The blisters are gone within one to
two weeks. Herpes Zoster often begins with a general
feeling of sickness, including chills, fever, headache,
fatigue, nausea, and diarrhea. Symptoms usually occur on
one side of the face, back, or upper abdomen, which are
the areas most commonly affected by chickenpox. The
blisters follow a nerve path and usually appear in a line,
most often on just one side of the back and spreading
toward the abdomen. This area may be extremely sensitive
to touch. After several days, the blisters begin to dry
and scab. Some people develop the rash on one side of the
face, which can also cause eye inflammation. All symptoms
of shingles are usually gone within three to five weeks.
However, some people may suffer nerve damage that causes
pain to continue for months to years after the rash is
gone. This condition is called post-herpetic neuralgia.
HSV-1 and –2 symptoms can occur repeatedly, but most
people get shingles only once in their lifetime.
How is it diagnosed?
To diagnose any form of herpes, your doctor will study
your medical history and perform a physical examination.
Laboratory tests, such a viral cultures and blood tests,
can be performed to determine the type of virus causing
the symptoms.
What is the treatment?
Herpes is treated with an antiviral medication that
reduces symptoms and dries up the blisters. People who get
HSV-1 or -2 frequently or have severe outbreaks may take
this type of medication daily to prevent symptoms.
Over-the-counter pain relievers, such as acetaminophen or
ibuprofen, can help reduce pain. Cool compresses on the
affected area may also provide relief. More severe pain
may be relieved by prescription pain medications. In most
people, shingles goes away on its own after it has run its
course. Post-herpetic neuralgia is treated with
tranquilizers, sedatives, or antidepressants that are
taken at night. For all forms of herpes, it's important to
keep your skin clean and dry so you don't develop any
other types of infections in the blistered area. Your
doctor might also prescribe some type of antibacterial
ointment to help prevent infection. Severe infections,
such as those involving the eyes, may be treated with
corticosteroids drugs as well as antiviral therapy.
Self-care tips
You can help prevent HSV-1 and -2 by avoiding contact
with herpes blisters if you have herpes or know someone
who does. Wash your hands frequently, do not share food or
drink, and do not touch a blister, then touch others or
other areas of your body. Use sunscreen when outdoors to
avoid sun-related outbreaks. As with any illness, it's
important to get plenty of rest, follow a healthy diet,
and reduce stress levels. If you have shingles, you should
avoid contact with those who could contract chickenpox,
especially newborns, the elderly, people with weakened
immune systems, and pregnant women. People with a skin
condition called atopic eczema should avoid any exposure
to the herpes virus because it can develop into a possibly
fatal condition called eczema herpeticum.
Contact your doctor if your symptoms become worse or if
the blisters appear to be infected.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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