The Herpes Quick Reference Page  Written and edited by Keyser Soze.

Click here for a list of herpes definitions..


PLEASE NOTE: Only your doctor can diagnose herpes! This site is not designed for self-diagnosis. There are other, more serious, conditions which can mimic the herpes virus! It is very important that you go to a doctor and get a culture of the active lesion done. If this is not possible, there are blood tests available to determine HSV status.


What is Herpes?

Herpes is an infection caused by the Herpes Simplex Virus (HSV), which resides in the nerve ganglia after the initial exposure to the virus. Because the virus is so effective at "hiding out" in the nerve cells, the body is never able to eliminate the herpes virus completely. Instead, after the initial infection, the body produces antibodies which show up in the blood stream. There are several blood tests which indicates the presence or lack of these antibodies. The antibodies make it easier for the body to recognize and attack the virus when it re-emerges from the nerve cells in the form of an outbreak. For this reason, out breaks following the primary outbreak usually diminish in frequency and intensity over time. Some people may never have another outbreak. The following are some commonly answered questions regarding the herpes virus, infection, and outbreaks.

What do herpes lesions look like?

There are two common types of herpes which cause lesions in humans. Facial herpes lesions are often referred to as "cold sores" or "fever blisters" because people often get them when their immune system is compromised by a cold, fever, flu, or other illness. Facial herpes occurs on the lips, nose, and the surrounding areas and is most often caused by the type of the herpes virus known as "HSV-1". It manifests itself as a single or series of non-scarring sores which may or may not appear to weep sero-sanguineous fluid. Initially the lesion might appear as an irritated area, and this might be accompanied by burning, itching, or tingling in the region where the sore will eventually appear. The next stage is often the appearance of a sore or cluster of very small fluid filled blisters, but may look like anything from an insect bite to a pimple to an over-grown chicken pox lesion. After a period of a few days to a week or more (depending on the individual), the lesion begins to heal and should not leave a scar.

Genital herpes is caused either by HSV-1 or its sister virus HSV-2. In general, an individual with HSV-1 in the genital area has fewer and less severe outbreaks of lesions than someone with HSV-2 in the genital region. Please see Good Virus/Bad Virus for more information on the differences between the two viruses. Genital lesions are much harder to describe because they vary so much from individual to individual. For men, some describe it as a cold sore on the shaft of the penis, others as bumps and generalized itching/tingling in the genital region, still others get some sort of sore or bump on the inner thigh or sacrum (buttocks area). For women, the sores can occur on and around the labia, clitoris, vulva (outside of the vagina), or in the pubic area. Some people get lesions anally or on the buttocks as well. They may or may not look like cold sores, and some individuals have outbreaks that resemble yeast infections, paper cuts or chaffed areas. One sure sign that it's not a yeast infection is that it just doesn't clear up with conventional treatment (or treatments that have been successful in the past).

Can I transmit herpes if I don't have any active lesions?

Yes!!  One of the incorrect assumptions about herpes is that people can not transmit the virus unless lesions are present. Many people diagnosed before 1996 or so were given this information. It has since been proved false. There is a phenomenon known as AVS, or asymptomatic viral shedding, and it is estimated that the average person with herpes has AVS for 1-2 weeks out of the year, but it is believed that this varies with the number and severity of outbreaks. There is another situation where the virus may be passed on without lesions called subclinical shedding.  Some people recognize a period of subclinical shedding as being accompanied by itching, tingling, and burning, but no lesions. Some medications, such as Acyclovir (or Zovirax) are known to cause "phantom prodrome", which may or may not indicate the presence of subclinical shedding. There is still much to be learned about AVS  and subclinical shedding, and much further testing is necessary to determine what causes it, how often it occurs, whether the frequency of either changes over time, etc...
 

What is prodrome?

Prodrome is the 'warning sign' (or signs) that comes immediately before and outbreak. People commonly report itching,
burning and/or tingling while for others it can be a shooting pain in legs back.  Not everyone experiences prodrome, and for some, prodrome feelings are very mild or fleeting. With education and experience many people are able to identify what signals an outbreak for them.

Will my herpes come back?

Some people have chronic recurring herpes, while others have one or two outbreaks and never experience another symptom. Both types of people can transmit herpes via AVS! Some things that may trigger recurrences include: stress (both good and bad), sexual intercourse, caffeine, alcohol consumption, change in lifestyle or dietary habits, illness, and a myriad of other factors. For many women, outbreaks tend to occur around the time of their menses. Some individuals say that masturbation (friction) triggers outbreaks. Herpes is non-discriminating, and it is different for everyone.

Where can I go for help?

If you are concerned that you have or may have herpes, the only way to find out for sure is to go to your doctor. It is much easier for your doctor to help you if symptoms are still present at the time of your visit. There are several prescription medications which have been proven effective in decreasing the duration and severity of outbreaks. If a visit to your physician is not feasible for whatever reason, there are other resources available. In the US, Planned Parenthood is often a good resource as they have experience in the area of STDs, and the fees are developed on a sliding scale and are contingent on income. There are STD Clinics which offer confidential testing, diagnosis, and treatment as well. Both Planned Parenthood and confidential STD clinics can be found in your local yellow pages.

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