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• Highlights
• Introduction
• Symptoms
• Transmission
• Risk Factors
• Complications
• Diagnosis
• Similar Conditions
• Home Remedies and Prevention
• Treatment for Genital Herpes
• Treatment for Oral Herpes
• Resources
• References

Herpes simplex

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of herpes simplex.

Alternative Names

Genital herpes; Fever blisters; Cold sores

Home Remedies and Prevention

Most herpes simplex infections that develop on the skin can be managed at home with over-the-counter painkillers and symptomatic relief.

Symptomatic Relief

Several simple steps can produce some relief:

• Hygiene is important. Avoid touching the sores. Wash hands frequently during the day. Fingernails should be scrubbed daily. Keep the body clean.
• Drink plenty of water.
• Blisters or sores should be kept clean and dry with cornstarch or similar product. (Women should not use talcum powder because it may increase their risk for ovarian cancer.)
• Some people report that drying the genital area with a blow dryer on the cool setting offers relief.
• Avoid tight-fitting clothing, which restricts air circulation and slows healing of the sores.
• Choose cotton underwear, rather than synthetic materials.
• Local application of ice packs may alleviate the pain and help reduce recurrences by suppressing the virus.
• Lukewarm baths may be helpful. (For people who have pain on urination, some experts recommend urinating in the bath water at the end of the bathing time. This dilutes the urine and prevents burning the sores. Urinating in a cool shower is also helpful and is less offensive to many people. )
• Wearing sun block helps prevent sun-triggered recurrence of HSV-1.
• Sex should be avoided both during the outbreaks and the prodromes (the early symptoms of herpes), which include tingling, itching, or tenderness in the infected areas.
• Over-the-counter medications such as aspirin, acetaminophen (Datril, Panadol, Tylenol), or ibuprofen (Advil, Medipren, Motrin, Nuprin), can be used to reduce fever and local tenderness. Children should take acetaminophen. Never give children aspirin.

Stress Management

In one study, stress management techniques developed using cognitive-behavioral methods not only were effective in reducing depression in those with HSV-2 but blood test results also revealed lower levels of HSV-2 antibodies, a possible sign of decreased viral activity. In any case, reducing stress using relaxation techniques does no harm.

Herbal and Other Alternative Remedies

Many herbal and dietary supplement products claim to help fight herpes infection by boosting the immune system. There has been little research on these products, and little evidence to show that they really work. Some are capsules taken by mouth. Others come in the form of ointment that is applied to the skin. Popular herbal and supplement remedies for herpes simplex include:

• Echinacea ( Echinacea purpurea )
• Siberian ginseng ( Eleutherococcus senticosus )
• Aloe ( Aloe vera )
• Bee products that contain propolis, a tree resin collected by bees
• Lysine
• Zinc

Herbs and Supplements Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been several reported cases of serious and even lethal side effects from herbal products. Always check with your doctor before using any herbal remedies or dietary supplements. The following are special concerns for people taking natural remedies for herpes simplex: Echinacea can lower white blood cell levels when taken for long periods of time. This herb can also interfere with drugs that are used to treat immune system disorders. Siberian ginseng can raise blood pressure levels. Bee products (like propolis) can cause allergic reactions in people who are allergic to bee stings. Lysine should not be taken with certain types of antibiotics. Zinc taken in large amounts (more than 200 mg/day) can cause stomach upset.

Preventing Transmission

Infected people should take several steps to avoid transmitting the virus to others. It is almost impossible to defend against the transmission of oral HSV-1 since it can be transmitted by very casual contact.

Preventing Transmission During an Outbreak. When an outbreak of herpes occurs the following precautions are useful:

• Persons carrying any herpes virus should carefully wash their hands and nails after contact with the infected area so as not to transmit the virus to other sites on the body.
• Although transmission from objects such as toilet seats and towels is unlikely, keeping personal items separate during an active infection may help to reduce transmission to other household members. The virus can live for up to 2 hours on cloth and for 4 hours on plastic.
• If genital lesions are present, infected persons should abstain from sexual intercourse.

Preventing Sexually Transmitted Disease. Any infected man or a partner of an infected woman should wear a condom during any sexual activity, even when symptoms are not present. Condoms are also important during oral sex, as an increasing number of new genital herpes cases are due to HSV-1, particularly among younger people.

The use of condoms for preventing the transmission of HSV-2 is not foolproof. Even a small tear can permit passage of the virus. However, studies show that regular condom use can significantly reduce the risk of HSV-2 infection.

Condoms made of latex are less likely to slip or break than those made of polyurethane. “Natural” condoms made from animal skin do not protect against HSV infection because herpes viruses can pass through them.

Women appear to be better protected than men are by male condoms. The reason may be that men shed HSV-2 from the skin of the penis, which is covered by the condom. However, in women the virus is often shed from skin areas around the genital area, which can have contact to skin areas in the male outside the condom.

The female condom is another option for infected women or partners of infected men. The female condom covers a large area and is an effective barrier to sexually transmitted viruses.

Note on Lubricants and Spermicides. Only water-based lubricants (K-Y Jelly, Astroglide, AquaLube, glycerin) should be used. Oil-based lubricants (petroleum jelly, body lotions, cooking oil) can weaken latex.

Some condoms come prelubricated with sperm-killing substances called spermicides, which are no longer recommended. The standard active ingredient in spermicides is nonoxynol-9, which attacks the surface of the sperm cell. Nonoxynol-9 does not provide any additional protection against sexually transmitted diseases (STDs). It can cause yeast and urinary tract infections in women. In addition, it can cause irritation around the genital areas, which makes it easier for herpes and other STDs to be transmitted. In fact, research now suggests that it actually increases the risk for HIV in women.

• Review Date: 10/1/2006
• Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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