Herpes sores follow a similar cyclical pattern and appear first like pimples that turn into small vesicles.  Then, the skin becomes crusty, and eventually a scab is formed.  It can take up to several weeks for the lesions to heal, during which time there may be one outbreak followed by another.  Certain risk factors may increase the likelihood of an outbreak, such as: asthma medication, lack of sleep, stress, decreased immunity and ultraviolet rays.

The flares are caused when your immune system falters. This can be due to a number of reasons. Anything from daily stressors, lack of sleep, poor nutrition, weight gain, concurrent illnesses etc may cause your immune system to be distracted from the Herpes Simplex Virus (HSV) infection. The moment that happens, the virus will flare resulting in rashes, cold sores, ulcers or blisters on your body.
Since genital herpes affects the private parts, people tend to think that the virus acts differently on men and women. However, the symptoms of genital herpes are very similar in males and females. The most important difference is that the virus can cause complications in pregnant women, who can pass the infection on to their babies. Other than that, there is no such thing as a male or female genital herpes virus, the infection is caused by the same virus in both sexes.
Herpes symptoms commonly show in or around the mouth. Sores may also occur at the back of the throat, causing the lymph nodes in the neck to swell. Mouth herpes is very common in children, as their parents or relatives can pass it on to them easily by a greeting or goodnight kiss. To get a better understanding of oral herpes, let us take a look at its causes.

To reduce the chance of acquiring HSV-1, avoid touching saliva, skin, or mucous membranes of people who have HSV-1 lesions. Prevention of genital HSV may be accomplished by latex condoms, but protection is never 100%. Spermicides do not protect against HSV. Some clinicians recommend using dental dams (small latex squares) during oral sex, but like condoms, they are not 100% protective.
Canker sores are sometimes thought to be caused by HSV, but this is not true. Canker sores occur only inside the mouth, on the tongue, and on the soft palate (roof of mouth), not on skin surfaces. Although they reoccur, they are not contagious, usually are self-limiting, and have almost no complications. Canker sores are caused by substances that irritate the lining of the mouth.
You've probably heard of herpes and know it can come in two strains, genital or oral. But that's about as far as most people's knowledge of the STI goes. No shade, BTW. Our sex education in this country is so dire, it's not our fault. But, we do need to know much more about the symptoms, treatments, cures and tests for oral herpes because according to the World Health Organisation, 67 per cent of humans have the infection.
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That being said, if on paper the HSV titres are high, indicating a high viral load in the body, this can be an indicator of an impending flare. Knowing this, we can prescribe antiviral medications with the aim of suppressing the virus activity. The idea is that we reduce the viral load of HSV, therefore helping the body’s immunity better contain the virus.

Prodrome: Early in the phase of reactivation (also called an outbreak), many people experience an itching, tingling, or painful feeling in the area where their recurrent lesions will develop. This sort of warning symptom – called a “prodrome” – often comes a day or two before lesions appear. To be on the safe side, it’s best to assume virus is active (and, therefore, can be spread through direct skin-to-skin contact) during these times.
In all cases, HSV is never removed from the body by the immune system. Following a primary infection, the virus enters the nerves at the site of primary infection, migrates to the cell body of the neuron, and becomes latent in the ganglion.[14] As a result of primary infection, the body produces antibodies to the particular type of HSV involved, preventing a subsequent infection of that type at a different site. In HSV-1-infected individuals, seroconversion after an oral infection prevents additional HSV-1 infections such as whitlow, genital herpes, and herpes of the eye. Prior HSV-1 seroconversion seems to reduce the symptoms of a later HSV-2 infection, although HSV-2 can still be contracted.
The frequency and severity of recurrent outbreaks vary greatly between people. Some individuals' outbreaks can be quite debilitating, with large, painful lesions persisting for several weeks, while others experience only minor itching or burning for a few days. Some evidence indicates genetics play a role in the frequency of cold sore outbreaks. An area of human chromosome 21 that includes six genes has been linked to frequent oral herpes outbreaks. An immunity to the virus is built over time. Most infected individuals experience fewer outbreaks and outbreak symptoms often become less severe. After several years, some people become perpetually asymptomatic and no longer experience outbreaks, though they may still be contagious to others. Immunocompromised individuals may experience longer, more frequent, and more severe episodes. Antiviral medication has been proven to shorten the frequency and duration of outbreaks.[79] Outbreaks may occur at the original site of the infection or in proximity to nerve endings that reach out from the infected ganglia. In the case of a genital infection, sores can appear at the original site of infection or near the base of the spine, the buttocks, or the back of the thighs. HSV-2-infected individuals are at higher risk for acquiring HIV when practicing unprotected sex with HIV-positive persons, in particular during an outbreak with active lesions.[80]
You should stop having sexual contact as soon as you feel warning signs of an outbreak. Warning signs may include a burning, itching, or tingling feeling on the genitals or around the mouth. Do not have vaginal, anal, or oral sex — even with a condom — until seven days after the warning signs stop or the sore heals. The virus can spread from sores not covered by the condom. It can also spread in sweat or vaginal fluids to places the condom doesn't cover.
If there is enlargement of the spleen, strenuous physical exercise should be avoided to prevent rupture. With the exception of possible complications, mono is rarely fatal and recovery is complete. Once recovered from the mono, you will usually have lifelong immunity from further infection because the body produces antibodies. If too hasty a departure is made from bed rest, however, a relapse may be experienced.
The herpes virus can be shed from an infected person even when there are no lesions visible. So caution is important. Some may wish to take the daily prophylactic oral drug Valtrex (an antiviral oral medication) to help cut down on shedding. Herpes can also be transmitted on any skin: fingers, lips, etc. Depending on sexual practices, herpes simplex can be transferred to genitals and or buttocks from the lips of someone who has fever blisters. Honesty between partners is very important so these issues can be discussed openly.

In infants for whom the condition is quickly diagnosed and controlled by antiviral medication, prognosis is good. However, in untreated and undiagnosed infants, the virus can attack the body’s organs systems, causing serious and potentially life-threatening complications, including seizures and Encephalitis, which can cause brain and/or spinal damage.

Consequently, you may already have the virus. A doctor can determine this with a blood test for Herpes 2 (Ig), a type-specific immunoglobulin. If you are already infected, you won’t be at risk for a new infection — you and your boyfriend already share the virus. But knowing your herpes status will tell you whether you are capable of infecting a future partner.
Herpetic whitlow and herpes gladiatorum Herpes whitlow is a painful infection that typically affects the fingers or thumbs. On occasion, infection occurs on the toes or on the nail cuticle. Individuals who participate in contact sports such as wrestling, rugby, and football (soccer), sometimes acquire a condition caused by HSV-1 known as herpes gladiatorum, scrumpox, wrestler's herpes, or mat herpes, which presents as skin ulceration on the face, ears, and neck. Symptoms include fever, headache, sore throat, and swollen glands. It occasionally affects the eyes or eyelids.
A doctor will base a presumptive diagnosis on information provided by the patient and on the physical examination. The characteristic appearance of the herpes sores leaves little doubt about the diagnosis, so the typical appearance of the sores is key to the diagnosis. This appearance helps distinguish oral herpes from oral thrush, shingles, gonorrhea, and syphilis. In addition, chapped or sunburned lips can resemble oral herpes, but the tissue stain (Tzanck smear, see below) shows no virus-induced cell changes. Further testing is usually not necessary but is sometimes done.
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