Herpes simplex virus (HSV) is a very common viral infection that results in painful, red outbreaks of blisters. The outbreaks commonly occur along the edges of mucous membranes such as the lips and genitals but can occur anywhere on the skin. HSV infection can cause general flu-like symptoms with the first exposure and then go into periods of remission with reoccurring outbreaks.
Inital Infection
The initial infection of HSV occurs after exposure of the skin or mucous membranes to an active outbreak in another person. Transmission is through direct contact and is likely to occur on the edge of mucous membranes like lips or on the genitals. Initial symptoms can range from mild tingling in the local area to systemic flu-like symptoms and swollen glands. The initial infection normally causes patches of blisters on the infected areas of skin.
Latency
After the initial infection, HSV normally goes into a period of remission where the virus retreats to the nerves of the affected skin areas. During the latency stages, HSV shows no signs or symptoms and is not contagious.
Recurrent Outbreaks
After some period of latency, recurrent outbreaks can occur. The timing and severity of these recurrences can vary considerably, with some people experiencing outbreaks monthly and others never having another outbreak at all.
Outbreaks are normally preceded by a prodrome, although the symptoms may be very mild. Prodrome symptoms can include tingling, itchiness, burning, numbness or other nerve symptoms in the area of skin affected. Typically the prodrome starts one to two days before the outbreak and lasts until the blisters begin to form.
Blisters occur over the same regions as initially affected. The blisters are small and fluid filled with red bases and can be single or in groups. The blisters usually break after a day or two and can last 2 to 3 weeks before completely clearing. When blisters appear, the virus is contagious, and care should be taken not to spread the virus to unaffected areas of the body or other people until the outbreak is completely healed.
Outbreaks can occur randomly, but some stressors seem to make them worse, such as other infections, lack of sleep, poor nutrition, trauma to the affected area, nervous stimulation and immune suppression.
Cautions and Complications of HSV
HSV is contagious and can even spread from one area to another on an individual person. People with immune compromise should be very careful not to expose new areas to the virus and to avoid other factors that cause outbreaks. Severe complications of HSV include infection of the eyes (herpetic keratitis), fingers (herpetic whitlow) and central nervous system (herpetic encephalitis and meningitis).
References
- Basic Pathology; Kumar, Contran and Robins; Sixth Edition
