Information about herpes by dermatologist Prof. Dr. Okamoto in Vienna
Characteristic symptoms of herpes
The incubation period (the time between infection and the appearance of the first symptoms) takes usually between 3 to 9 days (up to 6 weeks in some cases). However, the initial infection occure unnoticed, so that many people do not know whether they have had contact to the virus or not. Herpes, the symptoms after infection is characteristic: it starts with prodromal phase with tingling symptoms. Within 24 to 48 hours, small grouped blisters appear on that spot. After a few days, these blisters break and leave small ulcers. Sometimes, herpes is accompanied by systemic symptoms such as swelling of the neighboring lymph nodes, fatigue, and even fever. Usually, herpes resolves within 7 to 10 days. While herpes is a transient condition in otherwise healthy individuals, in severely immunocompromised patients, herpes can spread and lead to severe consequences. Herpes can occur everywhere on the body and is not limited to the lips or genital area.
Causes and triggers of herpes
As described above, the cause for herpes is an infection with the herpes-simplex-virus (HSV), which is very common: around 90% of the population is infected.
However, not everybody who had contact with the HSV develops herpes. Why someone develops herpes and others don’t is not entirely understood, but the risk seems to depend on the immune system and the age of the affected. Younger individuals are more prone to develop herpes while elderly people are less affected. Besides, other factors such as general health condition, other diseases (infectious, malignant, etc.), medication and physical factors such as ultraviolett radiation play a role.
There are 2 types of HSV: Type 1 und Type 2. HSV 1 is more frequent than HSV 2 and both types are infected by direct contact. HSV Type 2 is characteristic for genital herpes, even though neither types are limited to certain anatomic location.
HSV penetrates the skin and enters neurons in which it reaches the ganglion where it remains latent. Under certain conditions or influence of triggers HSV becomes active.
Here are the most common triggers of herpes:
- “stress” (emotional as well as physical)
- illnesses such as cold
- dental treatment
- UV-exposure, particularly sun burn
- immunosuppression due to diseases or medical treatment
- hormonal causes (menstruation, pregnancy, etc.)
Therapy of herpes
There are both topical (cremes) as well as systemic therapies (oral, i.v. infusions) agains herpes. One should start with the treatment already at the very first sign of herpes (prodromal phase or with the first blister). Herpes are prone to relapses. Unfortunately, HSV cannot be entirely eliminated from the body. Also, be aware of the infectious potential while blistering (e.g. avoid direct contact to the affected area).