What is herpes?
Herpes refers to infections caused by herpes simplex viruses (HSV) that attack the skin and often form small, fluid-filled blisters. There are two principal HSV strains: herpes simplex virus type 1 (HSV-1), responsible for most cold sores around the lips or face, and herpes simplex virus type 2 (HSV-2), which causes the majority of genital herpes. Although each strain commonly affects one area, both can produce either oral or genital lesions. In Australia, roughly 75 percent of adults have been exposed to HSV-1, and about 10 percent to HSV-2, with women more frequently infected by HSV-2 than men. Once acquired, the virus remains in the body for life, though it may lie dormant for years.
How is herpes transmitted?
HSV enters the body through the mucous membranes of the mouth, genitals, or anus, or via tiny breaks in the skin.
- HSV-1 spreads mainly through direct contact, kissing, skin-to-skin contact, or sharing objects like drink containers, utensils, towels or toothbrushes with someone who has an active cold sore. Most HSV-1 infections occur during childhood.
- HSV-2 is passed by skin-to-skin contact during vaginal, anal or oral sex with an infected person, and can also transfer via kissing, foreplay or non-penetrative sexual activities. Transmission risk is highest when blisters are present, but infection can occur even when there are no symptoms.
Herpes symptoms
Many people never notice any signs of HSV or experience only mild symptoms. When an outbreak happens, typical symptoms include:
- Cold sores
- Genital blisters or ulcers
What triggers a herpes outbreak?
After the initial infection, HSV retreats into nerve cells under the skin and can remain inactive for years. When reactivated, it travels back to the skin surface and causes symptoms. Although the exact triggers are unclear, common factors include:
- Viral illnesses such as a cold
- Sunburn or intense sunlight
- Hormonal fluctuations (e.g. menstruation)
- Stress or emotional upset
- Sexual activity
- Surgical procedures
- A weakened immune system
How is herpes diagnosed?
It can usually be identified by their appearance, but a clinician may swab a lesion to confirm HSV. If you suspect genital herpes, seek medical evaluation promptly: a swab from the affected area is tested for the virus, and blood tests may occasionally be ordered.
How is herpes treated?
There is no cure for herpes; management focuses on easing symptoms during outbreaks and reducing recurrence risk. Practicing safe sex is essential to prevent spread of genital herpes.
Treating cold sores
Your Cooleman Court pharmacy stocks antiviral creams, which are the first-line remedy for cold sores. Apply as soon as you feel a tingle or spot the initial blister or raised lesion. There are also oral antiviral tablets, ask your pharmacist which formulation suits you best. Additional steps to ease discomfort include:
- Gently pressing ice packs against the blisters
- Smearing povidone-iodine ointment (e.g. Betadine) on affected areas
- Taking over-the-counter painkillers
- Resisting the urge to pick at scabs or rupture blisters
If you suffer from severe or recurrent cold sore episodes, your doctor might prescribe daily oral antivirals to help keep the virus dormant.
Treating genital herpes
Managing genital herpes typically involves prescription antiviral drugs, which can lessen both the severity of an outbreak and the chance of passing the virus to a partner. For best results, begin treatment within 72 hours of noticing any symptoms. You can also alleviate discomfort by:
- Applying a pharmacist-recommended topical anesthetic cream or ointment
- Using cold compresses on the lesions
- Taking OTC pain relief medication
- Soaking in a warm salt bath (mix 1 tsp salt in 2 cups water, or 1 cup salt per full bath)
Complications of herpes
Cold sores
Generally mild and self-limiting, cold sores can sometimes become secondarily infected, requiring antibiotics. Less common complications include:
- Herpetic whitlow (infection of the fingers)
- Eye infections with serious consequences
- Widespread infection in people with eczema (medical emergency)
Genital herpes
Potential complications include:
- Increased risk of acquiring other STIs, including HIV
- Neonatal herpes, which can cause brain damage, blindness or death in newborns
- Urinary retention or other bladder issues
- Rare cases of meningitis
- Proctitis (inflammation of the rectal lining)
When should you see your doctor?
If you suspect genital herpes or any STI, seek medical advice to obtain a correct diagnosis and treatment. Cold sores usually heal without medical intervention, but consult a healthcare professional if you have:
- A weakened immune system
- Severe or persistent symptoms
- Signs of secondary bacterial infection
- Blisters spreading to the eyes or other body parts
- Frequent or unusually large outbreaks
Can you prevent herpes?
While complete prevention isn’t always possible, you can lower transmission risk by:
- Washing hands after touching any blisters
- Avoiding touching your eyes after contact with sores
- Not sharing personal items (towels, utensils, toothbrushes)
- Refraining from kissing if you or your partner has an active cold sore
- Using condoms or dental dams during sexual activity, even when no sores are visible
- Avoiding sexual contact during an outbreak
- Steering clear of partners with active blisters
- Abstaining from oral sex when cold sores are present