Herpes: Everything You Need To Know About HSV-1 and HSV-2

Herpes is a virus-induced skin infection. It is caused by the herpes simplex virus (HSV) and spreads through skin contact.

What Is Herpes? Categories of Herpes

There are different types of herpes simplex viruses. These can be broadly classified into three categories:

Alphaherpesvirus

These are cytolytic viruses that grow rapidly by developing latent infections in neurons. This type of HSV can be further categorised into two types – Herpes simplex virus type 1 (HSV-1) and 2 (HSV-2) and Varicella- zoster virus. These viruses manifest themselves through symptoms like vesicular rashes in the early stages of the skin condition, as well as on their recurrence.

Betaherpesvirus

This is caused by cytomegalovirus (CMV), which grows slowly. These cause enlarged growths called cytomegalic in the cells that they affect. They mostly grow in the cells of the kidneys and secretory glands. The newly-discovered human herpes virus 6 (HHV-6) belongs to this category. HHV-6 is responsible for a children’s disease called roseola infantum.

Gammaherpesvirus: The third category of HSV includes the Epstein Barr Virus (EBV). This affects lymphoid cells and remains latent here.

What Is Herpes? HSV-1 and HSV-2

From these three categories, HSV-1 and HSV-2 are the most common. Let’s discuss these in detail.

HSV-1: This virus mostly affects the mouth or areas around it. This is very contagious. Patients usually acquire this during childhood and it stays throughout their lives. Oral herpes is also referred to by other names like oral-labial, orolabial, and oral-facial herpes. A small percentage of HSV-1 can also be genital herpes, that affect the genitals or anus. 

HSV-2: This virus is predominantly sexually transmitted. It is another cause of genital herpes. Like HSV-1, this is highly contagious and lifelong. It can be treated, but not cured.

HSV-1 or HSV-2 can gradually develop into meningitis, an inflammatory condition of the upper surface of the brain and the spinal cord. It may also lead to encephalitis or swelling of the brain, although both these diseases occur only in rare cases.

Signs and Symptoms

Symptoms widely differ amongst patients. The symptoms also vary from mild to severe. The skin disease can also be asymptomatic, that is, it does not show any external manifestations.

The common symptoms are:

• Fever blisters
• Cold sores or sores on the lips
• Rashes in the infected area
• Open sores or ulcers in and around the mouth
• One or multiple fluid-filled blisters or sores in the genital or anal area
• Headache
• Inflammation of the lymphatic glands
• Burning sensation, itching, or pain in the mouth, especially before the growth of mouth ulcers
• Pain, tingling, and/or itching during urination
• Unexplained vaginal discharge
• Recurrence of mouth ulcers and blisters
• After a week or lesser, the sores and blisters caused by HSV-1 may start crusting and start healing all by itself
• Mild shooting or tingling pain in the hips, legs, and buttocks before the growth of genital ulcers

The initial outbreak of the skin condition is usually the most severe. The severity and the frequency of its recurrence tapers off gradually in 2 to 3 weeks. Repeated outbreaks also do not occur for a prolonged span of time.

Diagnosis

Herpes simplex symptoms, for oral as well as genital herpes, often resemble that of other skin diseases induced by allergies. Your doctor may diagnose the skin condition from the appearance and location of the symptoms. Otherwise, biopsy test and/or blood test are the only effective ways to diagnose the skin disease that is the underlying cause of the symptoms. A biopsy test removes a small part of the cells or tissue from the affected site. Healthcare professionals evaluate this cell or tissue under a microscope to diagnose the presence of the HSV.

What Is Herpes? Causes

HSV-1 mostly leads to the skin disorder of the mouth, and in some cases, genital herpes. Individuals may transmit oral herpes at the time of kissing or oral sex.

Genital herpes, caused by HSV-1 or HSV-2, can occur as a result of oral-genital contact during oral, vaginal, or anal sex with an individual who is infected with the disease.

Mild symptoms of the disease can also be passed on to a newborn if the mother had been infected with HSV-1 genital herpes at the time of birth. Transmission of HSV-2 can occur from the skin to the genital or anal area.

There are certain specific factors that increase the risk of a recurrence:

• Other bacterial and viral infections
• Stress
• Menstruation

Treatment

For the skin condition of the mouth, the most recommended treatment is antiviral drugs like oral valacyclovir. These medications control the duration and severity of the symptoms, and also reduce the frequency of outbreaks. Certain prescription-based anti-viral medications specialize in decreasing the risk of transmission and recurrence.     

For genital herpes, the following are the prescribed treatments:

• Sit in a bathtub of warm water for 15 to 20 minutes. 
• Avoid bubble baths to prevent flare-ups of the symptoms.
• Avoid tight-fitted clothes to reduce the risk of aggravations of the condition.
• Keep the genital area clean and dry for controlling the recurrence and flare-ups of the symptoms.

Patients may need to make lifestyle changes to prevent recurrence of HSV. These include using safe sex practices, such as using the following:

• Internal and external condoms
• Lube that is condom-safe
• Dental dams

Learn more about Infectious Skin Diseases here.