Herpes simplex virus (HSV) causes blisters and open sores in the mouth, lips, skin, eyes and genitals. HSV-1 is the cause of most cold sores, while HSV-2 is the main infectious agent linked to genital herpes. These viral infections can heal on their own, although antiviral medications are an effective way to speed healing, reduce the frequency of outbreaks, and minimize the risk of transmitting the infection to others. Untreated infections sometimes get worse, particularly in people with weak immune systems, causing HSV to spread to other areas of the body or increase the risk of other infections.
Pain and Discomfort
Herpes infections go through predictable stages. In the first 12 to 24 hours of an outbreak, tingling, itching or burning occur in the affected area. Following this initial stage, blisters form, then pop and turn into open sores. After this, the ulcers form scabs and heal from beneath. There is little pain and discomfort in the initial stage -- and if antiviral therapy is started then, the virus replication can be halted and the blisters may not even form. So not treating HSV means going through all these stages -- and the usual pain and discomfort associated with an outbreak.
A significant danger of not treating herpes is that HSV can more easily be transmitted to others. Herpes is spread through direct contact with infected persons, and can be transmitted through sexual contact, kissing, or other ways infected body fluids come in contact with broken skin or mucous membranes -- such as the mouth or genitals. If antiviral therapy is started early enough to prevent blister formation, the risk of transmitting this virus to others is minimized.
If you are pregnant and have a history of herpes, or if you have a current outbreak, talk to your doctor -- since without treatment, your baby can get infected during vaginal delivery. Neonatal herpes infections can cause significant mouth sores that impair feeding, and can lead to infections that spread to the brain, eyes or other body organs. Untreated neonatal infections may cause severe complications including blindness, learning disabilities, seizures and death.
Herpes infections can worsen and spread, particularly in people with weak immune systems or in those taking medications that suppress immunity -- which is common in cancer therapy, treatment of autoimmune disorders, or after an organ transplant. Untreated herpes infections can spread to the brain, eye, lungs, esophagus or liver, causing more pain and complications -- and requiring additional treatment. Open sores also increase the risk of bacterial infection. Finally, people with active HSV-2 infections are more likely to contract the human immunodeficiency virus (HIV), since the open sores in the genital area or mouth provide a way for HIV to enter the body.
Antiviral medications, such as acyclovir, famciclovir, and valacyclovir are the most effective treatments for HSV. These medications do not remove the virus from the body. Instead, they halt virus replication and -- if started early or if taken regularly -- can prevent blisters from forming and reduce the severity and frequency of outbreaks. By stopping the HSV outbreak in its tracks, the complications of HSV infections can be minimized or avoided. If you suspect you are infected with HSV, talk to your doctor about a treatment plan, and take steps to prevent the spread of herpes to others.
Reviewed by Kay Peck, MPH RD