Herpes Simplex
Information about the causes, symptoms, and treatments of this viral infection affecting the skin and mucous membranes.
Symptoms and Causes
Herpes simplex, commonly known as herpes, is a viral infection that spreads easily and is transmitted through direct skin-to-skin contact.
Symptoms affect the skin and mucous membranes, most commonly the lips or genitals. However, in some cases, the infection may spread to the eyes, liver, or brain. If herpetic encephalitis progresses, it can be life-threatening. Therefore, early diagnosis and appropriate treatment of herpes are essential to prevent complications.
The virus remains in the body even after the infection has been brought under control. It remains latent in the nerve ganglia throughout life and may reactivate at any time or be transmitted to another person. Treatment therefore focuses on relieving symptoms and reducing the frequency of outbreaks..
Symptoms
Herpes simplex often causes no symptoms and, when symptoms do occur, they are usually mild. The most common symptoms include:
- Painful ulcers or vesicles that form crusts as they dry. They may appear in the following areas:
- Skin around the mouth.
- Lips.
- Oral mucosa.
- Genitals.
- Vagina.
- Cervix.
- Anus.
- Conjunctiva.
- Itching or burning sensation.
- Fever.
- Fatigue.
- General malaise.
Causes
Herpes is caused by infection with the herpes simplex virus (HSV), which can be of two types:
- Type 1 (HSV-1): In most cases, it spreads through oral contact and may affect the mouth and lips (oral herpes) as well as the genitals (genital herpes). In rare cases, it is responsible for ocular herpes. It may lead to herpetic encephalitis.
- Type 2 (HSV-2): A sexually transmitted infection that develops in the genital area. Although very uncommon, it may spread to the brain.
Risk Factors
Herpes simplex occurs in all types of individuals; in fact, it is estimated that most adults are infected. The risk of more severe symptoms or complications is greater in the following cases:
- Immunocompromised individuals:
- HIV or AIDS.
- Chemotherapy treatment.
- Immunosuppressive medications (corticosteroids, calcineurin inhibitors, antibodies, or antiproliferative agents).
- Atopic dermatitis.
- High-risk sexual behavior.
- Unprotected sexual contact.
- Having more than one sexual partner.
- Sex: genital herpes is more common and more severe in women due to the characteristics of the female reproductive system.
- Newborns whose mothers are infected with HSV.
Complications
Herpes simplex virus infection may lead to serious complications, such as:
- HIV: HSV-2 increases the risk of acquiring human immunodeficiency virus infection.
- Herpetic encephalitis: inflammation of the brain that may cause seizures and neurological deficits.
- Herpetic keratitis: inflammation of the cornea that may lead to blindness.
- Sepsis: a systemic infection that can damage vital organs.
- Neonatal herpes: although uncommon, the virus may be transmitted during childbirth. In newborns, it may cause neurological disability or death.
Prevention
To prevent herpes simplex transmission, the following measures are recommended:
- Do not share objects that come into contact with saliva (cutlery, drinking glasses, lip cosmetics, pacifiers, etc.).
• Avoid oral and genital contact with individuals who have symptoms of HSV infection.
• Use condoms during sexual intercourse.
Which specialist treats herpes simplex?
Herpes simplex virus infection is diagnosed and treated within the specialty of Medical-surgical dermatology and Venereology. If the infection spreads to other organs, specialists in Ophthalmology and Neurology may also be involved in patient management.
Diagnosis
In most cases, herpes simplex is diagnosed based on symptom assessment and examination of the affected area. When there is diagnostic uncertainty, a sample is taken from the ulcers for culture and laboratory analysis.
Although not routinely performed, a blood test may be used to determine the presence of antibodies against the virus. It also allows differentiation between HSV-1 and HSV-2 infection.
When ocular herpes is suspected, the eye is examined using a slit-lamp examination to assess the condition of the cornea. If cerebral involvement is suspected, magnetic resonance imaging (MRI) is performed to identify structural changes in the brain, or a lumbar puncture is carried out to analyze cerebrospinal
Treatment
Treatment for herpes consists of oral or topical antiviral medications to eliminate ulcers or prevent their development. In recurrent infections associated with pain, topical anesthetics may be administered for symptomatic relief.
Treatment should be started as soon as the first symptoms are noticed, ideally when tingling sensations are felt in the skin, even before ulcers appear.
