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Herpes Simplex

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What is herpes simplex and how is it treated?

Herpes simplex is a common viral infection. If you’ve ever had a cold sore or fever blister, this is caused by the herpes simplex virus. Most cold sores are caused by herpes simplex virus type 1 (HSV-1). 

Other names for cold sores caused by HSV-1 are oral herpes, mouth herpes and herpes simplex labialis.


Many people who get the virus that causes herpes never see or feel anything. Signs and symptoms you may notice include:


  • Tingling, itching, or burning. Before the blisters appear, the skin may tingle, itch, or burn for a day or so.

  • Sores. One or more painful, fluid-filled blisters may appear. Blisters break open and often ooze fluid and form a crust, before healing. The first time sores appear, they will show up between 2 and 20 days after a person has had contact with an infected person. The sores can last from 7 to 10 days. Where the sores appear often varies with type.

    • Oral herpes (HSV-1). Most blisters appear on the lips or around the mouth. Sometimes blisters form on the face or on the tongue. Although these are the most common places to find oral herpes, the sores can appear anywhere on the skin.

    • Genital herpes (HSV-2): Sores typically occur on the penis, vagina, buttocks, or anus. Women can have sores inside the vagina. Like oral herpes, these sores can appear anywhere on the skin.

  • Flu-like symptoms. Fever, muscle aches, or swollen lymph nodes (glands) in the neck (oral herpes) or groin (genital herpes) are possible.

  • Problems urinating. Women with genital herpes may have trouble urinating or have a burning feeling while urinating.

  • An eye infection (herpes keratitis). Sometimes the herpes simplex virus can spread to one or both eyes. If this happens, you can have pain, light sensitivity, discharge, and a gritty feeling in the eye. Without prompt treatment, scarring of the eye may result. Scarring can lead to cloudy vision and even loss of vision.

Diagnosing herpes

During an outbreak, we often can diagnose herpes simplex by looking at the sores. To confirm that you have herpes simplex, we may take a swab from a sore and send this swab to our pathology department.


When sores are not present, other medical tests, such as blood tests, can determine if you may have been exposed to herpes simplex virus.


Treating herpes

There is no cure for herpes simplex viral infection. The good news is that sores often clear without treatment. Many people choose to treat herpes simplex because treatment can relieve symptoms and shorten an outbreak. Most people are treated with an antiviral cream or ointment that can relieve burning, itching, or tingling.


An antiviral medicine can shorten an outbreak of herpes. Prescription antiviral medicines approved for the treatment of both types of herpes simplex include:


  • Acyclovir

  • Famciclovir

  • Valacyclovir


Taken daily, these medicines can lessen the severity and frequency of outbreaks. They also can help prevent infected people from spreading the virus.  For those who have frequent outbreaks, antiviral medications may be taken to suppress recurrent flares.

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