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Herpes simplex

Contents of this page:


Herpetic whitlow on the thumb
Herpetic whitlow on the thumb
Herpes simplex - close-up
Herpes simplex - close-up

Definition    Return to top

Herpes simplex is an infection that mainly affects the mouth or genital area.

Causes    Return to top

There are two different strains of herpes simplex viruses:

A finger infection, called herpetic whitlow, is another form of herpes. It usually affects health care providers who are exposed to saliva during procedures. Sometimes, young children also can get the disease.

The herpes virus can infect the fetus and cause abnormalities. A mother who is infected with herpes may transmit the virus to her newborn during vaginal delivery, especially if the mother has an active infection at the time of delivery.

It's possible for the virus to be transmitted even when there are no symptoms or visible sores.

Symptoms    Return to top

Exams and Tests    Return to top

Many times, doctors can tell whether you have a herpes-simplex infection simply by looking at the lesions. However, certain tests may be ordered to be sure of the diagnosis. These tests include:

Treatment    Return to top

Some cases are mild and may not need treatment.

People who have severe or prolonged cases, immune system problems, or frequent recurrences may need to take antiviral medications such as acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex).

People who have more than 6 recurrences of genital herpes per year may need to continue taking antiviral medications to reduce recurrences.

Support Groups    Return to top

Support groups and dating services are available for people with genital herpes.

Outlook (Prognosis)    Return to top

The oral or genital lesions usually heal on their own in 7 to 10 days. The infection may be more severe and last longer in people who have a condition that weakens the immune system.

Once an infection occurs, the virus spreads to nerve cells and stays in the body for the rest of a person's life. It may come back from time to time and cause symptoms, or flares. Recurrences may be triggered by excess sunlight, fever, stress, acute illness, and medications or conditions that weaken the immune system (such as cancer, HIV/AIDS, or the use of corticosteroids).

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider if you develop symptoms which appear to be herpes infection. There are many different conditions that can cause similar lesions (especially in the genital area).

If you have a history of herpes infection and develop similar lesions, tell your health care provider if they do not get better after 7 to 10 days, or if you have a condition that weakens your immune system.

Prevention    Return to top

Preventing herpes simplex is difficult since people can spread the virus even when they don't have any symptoms of an active outbreak.

Avoiding direct contact with an open lesion will lower the risk of infection.

People with genital herpes should avoid sexual contact when they have active lesions. Safer sex behaviors, including the use of condoms, may also lower the risk of infection.

People with active herpes lesions should also avoid contact with newborns, children with eczema, or people with suppressed immune systems, because these groups are at higher risk for more severe disease.

To decrease the risk of infecting newborns, a cesarean delivery (C-section) is recommended for pregnant women who have an active herpes simplex infection at the time of delivery.

References    Return to top

Workowski KA, Berman SM. Sexually Transmitted Diseases Treatment Guidelines, 2006. MMWR Morb Mortal Wkly Rep. August 4, 2006;55(RR-11):1-94.

Stoopler ET. Oral herpetic infections (HSV 1-8). Dent Clin North Am. 2005 Jan;49(1):15-29, vii.

Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000.

Update Date: 4/7/2008

Updated by: A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz, Kelli A. Stacy, ELS. Previously reviewed by Mark Levin, MD, Division of Infectious Disease, MacNeal Hospital, Berwyn, IL. Review provided by VeriMed Healthcare Network (6/8/2007).

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