Herpes

What do you want to know about herpes?

This article contains public sector information licensed under the Open Government Licence v3.0.

What is herpes?

Herpes is the medical name of an infection caused by a type of virus called the herpes virus. There are many different types of herpes virus that can affect humans. The most common type of herpes infection is caused by the herpes simplex virus, and this type affects the mouth and genital area. 

The herpes simplex virus is an extremely common virus that affects a large proportion of people worldwide in both developing and developed countries.

The two types of herpes simplex virus are:

Close up of woman with cold sore on her upper lip, about to apply cream onto it with her finger.

There are also other types of herpes viruses. The next most common types of herpes virus, outside of infection with herpes simplex, include:

Finally the least common types of herpes virus include:

What are the different types of herpes?

Herpes simplex virus type 1 (HSV-1) is a very common and contagious infection that affects many people  all over the world. The majority of HSV 1 infections cause oral herpes, which is herpes that affects the mouth, and is commonly called cold sores. This type of herpes virus can also affect the genitals, and this is commonly called genital herpes.

Close up of a woman's lips with a herpes cold sore on the top lip.

What are the symptoms of a HSV-1 infection?

 

The majority of people who have HSV-1 do not have any symptoms even though they are carrying the virus. This means that most people with this type of herpes infection don’t even know that they are infected. This makes it very easy for them to accidentally spread the virus to other people.

 

However, some people do develop symptoms. They may experience the following symptoms around the mouth or genital area:

 

  • A tingling/itching/burning sensation 
  • The appearance of painful blisters or ulcers on or around the mouth (commonly known as cold sores)or on or around the genital area.
  • Recurrent appearance of ulcers or blisters, especially when you are feeling run down, stressed or suffering with another illness.

It is important to note that you will only get symptoms in areas of the body that have been directly infected. For example, if you get cold sores around your mouth, this does not mean you will get ulcers or blisters around the genital area as well. This will only happen if both areas have both been infected.

 

Herpes and cold sore on a man's tongueWhere can oral herpes (cold sores) develop?

 

Cold sores commonly affect:

 

  • Lips
  • Around the mouth
  • Tongue
  • Gums
  • Roof of the mouth

 

Where can genital herpes develop?

 

People with genital herpes  may experience painful blisters or ulcers on the:

  • Vulva
  • Labia
  • Vagina
  • Buttocks
  • Anus
  • Penis
  • Scrotum
  • Inside of the thighs


How often can you get HSV-1 outbreaks?

 

You may get an outbreak of herpes just once in your life. However, it is more common for people to experience repeated symptoms of herpes, especially if  they are suffering with another illness or feeling stressed or rundown. The first herpes outbreak is usually more painful and severe compared to recurring ones. 

 

How can you treat HSV-1 outbreaks?

 

Medications called antivirals are commonly used to treat outbreaks of HSV-1. These can be taken as a tablet, or applied as a cream to the blisters. These medications will help reduce the amount of time the blisters are visible and help reduce how severe they are, however they cannot cure the virus itself. 

 

Examples of antivirals used to treat HSV-1 include: 

 

  • Aciclovir
  • Famciclovir
  • Valacyclovir 

How is HSV-1 transmitted?

 

Both HSV-1 and HSV-2 are mainly passed on from direct skin-to-skin contact when the virus is active on affected areas of skin (e.g. the face, mouth, hands, genitals). They can also be passed on if you come into contact with open sores or fluids of someone that is infected. 

 

It’s important to note however, that HSV-2 is almost exclusively passed through sexual contact, which causes genital herpes. HSV-1 on the other hand, can be passed on through skin-to-skin contact that does not have to be sexual.

 

Two thirds of people infected with HSV do not have symptoms. However they can still pass the disease onto someone else. A normal area of skin is still able to pass HSV-1 or HSV-2 onto another person. 

 

You are more likely to pass on the virus in the first few months of being infected, however some partners who have been together for years never pass the virus on. People who are aware they have the HSV virus are also less likely to transmit the virus because they know the triggers and symptoms to look out for, so they can protect their partners.

Herpes simplex virus type 2 (HSV-2) is the other most common type of herpes virus that is usually linked to genital herpes. People who have symptoms of HSV-2 tend to experience:

  • Mild tingling or shooting pains in the legs or buttocks 
  • High temperature
  • Body aches
  • Swollen lymph nodes
  • The appearance of one or more painful blisters or ulcers on the genital area

Herpes lesions on a penis shaft with close up of herpes virus.The painful blisters tend to occur in the following places:

  • Vulva
  • Labia
  • Vagina
  • Buttocks
  • Anus
  • Penis
  • Scrotum
  • Inside of the thighs


How severe are HSV-2 outbreaks?

If someone with HSV-2 has repeated outbreaks of blisters, they tend to be less severe each time. Blisters usually take between 2 and 14 days to appear after infection, however some people never show symptoms. In others, symptoms can also take years to appear after being infected, and therefore it is important to note that genital herpes does not always mean your partner has been unfaithful. 

How can you treat HSV-2 outbreaks?

Medications called antivirals are commonly used to treat outbreaks of HSV-2. These can be taken as a  tablet, or applied as a cream to the blisters. They will help reduce the amount of time the blisters are there for, and reduce how severe they are, but they cannot cure the virus itself. 

Examples of antivirals used to treat HSV-2 include: 

  • Aciclovir
  • Famciclovir 
  • Valacyclovir 

How is HSV-2 transmitted? 

Both HSV-1 and HSV-2 are mainly passed on from direct skin-to-skin contact when the virus is active on  affected areas of skin (e.g. the face, mouth, hands, genitals). They can also be passed on if you come into  contact with open sores or fluids of someone that is infected. 

It’s important to note however, that HSV-2 is almost exclusively passed through sexual contact, which causes genital herpes. HSV-1 on the other hand, can be passed on through skin-to-skin contact that does not have to be sexual in nature. 

Two thirds of people infected do not have symptoms. However they can still pass the disease onto someone else. A normal area of skin is still able to pass HSV-1 or HSV-2 onto another person. 

You are more likely to pass on the virus in the first few months of being infected, however some partners who have been together for years never pass the virus on. People who are aware they have the HSV virus are also less likely to transmit the virus because they know the triggers and symptoms to look out for, so can protect their partners.

Varicella-zoster virus is another type of herpes virus, commonly called chickenpox. It is extremely common, affecting almost everyone in the world by the time they are adults. It causes small fluid-filled blisters all over the body that can be very itchy. 

Chickenpox on a baby's back and neckChickenpox is passed from person to person through droplets or direct contact with the blisters. When you get infected, it can be 10-20 days before you show any signs of infection.

Symptoms of chickenpox include:

  • Feeling generally unwell
  • Tiredness
  • Loss of appetite 
  • High temperature
  • Fluid-filled, red itchy blisters


What is the treatment for chickenpox?


Chickenpox usually goes away on its own without needing any specific medical treatment. Over time, the blisters become crusty. When this happens, you are no longer contagious and you cannot pass on the virus to someone else. 

In some cases, when the infection is severe, it can cause other problems in the body like pneumonia, encephalitis (inflammation of the brain) and bacterial infections. Infants and people who have a weakened immune system are more likely to have severe chickenpox with complications. 

Treatments that can be used to make someone with chickenpox feel more comfortable include:

  • Drinking lots of fluids
  • Cooling lotions to make the blisters itch less
  • Paracetamol to help with aches and pains and control temperature 
  • Antihistamine medications to help with the itching 
  • Cool baths to soothe the skin 

After someone is infected with chickenpox, the virus stays in their body and can be reactivated later in life. When it is reactivated, it appears as a medical condition called shingles. 

There is a vaccine available for chickenpox but it is not widely given at the moment.

Cytomegalovirus (CMV) is another common type of herpes virus that can affect people of all ages. It is usually harmless, but can sometimes cause problems in:

  • Babies 
  • People with a weakened immune system (such as those with active cancer and who are on treatment)

How do you get infected with CMV?


CMV can be spread through close contact with someone that currently has the infection. It may be passed through:

  • Saliva
  • Blood 
  • Urine

Young children often get CMV for the first time at nursery, and like the other herpes viruses, once you are infected with it, it stays within your body for the rest of your life. CMV can be reactivated when you are feeling run down. There is also a chance that you can be reinfected with a different strain of CMV.

Doctor checking his a young boy for any swollen lymph nodes in his neck.If you do have symptoms of CMV you are likely to have:

  • A high temperature
  • Tiredness
  • Muscles aches all over your body
  • Swollen lymph nodes
  • Sore throat
  • You may just feel generally unwell


What is the treatment for CMV?


Treatment is not generally used in CMV unless someone has a weakened immune system or a baby is born with CMV. In these cases, antiviral medications are usually given to weaken the virus. 

If you have symptoms, they will usually disappear on their own after around 3 weeks. Supportive treatments like taking paracetamol for fever and muscle aches can be used. 

Epstein-Barr virus (EBV) is another type of common herpes virus, and it can also be called infectious mononucleosis, glandular fever, or mono depending on which country you live in.

Who usually gets EBV?

EBV most commonly affects teenagers and young adults, and it can make you feel very unwell during the illness. It can also occur in children, but they are less likely to have symptoms or feel unwell. 

Couple kissing each other on a beachHow is EBV transmitted?

EBV spreads very easily from person to person. It is most commonly spread through saliva and is often called the ‘kissing disease’.

It can also be spread through other bodily fluids like blood and semen, and even through blood transfusions and organ transplants. When you get infected with EBV, you can spread it to others for several weeks before you develop any symptoms. 


What are the symptoms of EBV?


Symptoms of EBV include:

  • High temperature
  • Feeling generally unwell
  • Muscle aches
  • Sore throat 
  • Swollen lymph nodes particularly in your neck
  • Swollen spleen
  • Swollen liver
  • A rash

If you go to see your doctor, they may do a blood test to confirm if you have EBV by looking for cells called antibodies. 

What is the treatment for EBV?

There is no specific treatment for EBV. You should start to feel better 2-3 weeks after your symptoms start. However, some people can feel tired for months after the symptoms have disappeared.

Human herpesvirus 6 is one of the less common types of herpesviruses, and it is sometimes known as Roseola Infantum or Sixth disease

Roseola affects babies and toddlers before the age of 3. Like all the other herpesviruses, when you are infected, the virus can lay dormant in your body for many years and become reactivated later on in your life. 

What are the symptoms of human herpesvirus 6?

Babies and toddlers infected with human herpesvirus 6 will often have the following symptoms for 3-5 days before a rash appears:

  • A sudden high temperature
  • No appetite 
  • Cold-like illness

The rash that develops after these symptoms normally starts on the chest, tummy and back, before it spreads onto the neck, face and arms. The rash does not tend to be itchy or cause any discomfort, and it usually disappears within a few days. 

Very rarely, some toddlers with this infection suffer with complications such as causing seizures or encephalitis (inflammation of the brain).

What is the treatment for human herpesvirus 6?

Antivirals are not given in this type of herpesvirus. Usually the treatment is paracetamol and anti inflammatory medications to ease the symptoms of the infection. 

Can human herpesvirus 6 be reactivated later on in life?

There is some research into the reactivation of human herpesvirus 6 and how it can affect people with long-term conditions. It is thought to play a part in triggering some autoimmune conditions like thyroid diseases, or play a part in female infertility. However this is not confirmed yet as research is still being conducted in this area. 

Human herpesvirus 7 (HHV 7) is another type of herpes virus that is closely linked to cytomegalovirus and human herpesvirus 6. It was discovered in 1989 so it is still a relatively new discovery. 

Many childhood rashes are thought to be caused in part by HHV 7, and it is thought to cause childhood illnesses similar to measles and rubella. It has also been found in some skin disorders such as psoriasis, and some patients who have rejected transplanted organs. 

Although the genetic structure of the virus has been discovered, how it affects people is not yet fully understood, and research is ongoing.

Human herpesvirus 8 (HHV 8) is the last type of herpes virus and is often referred to as Kaposi's sarcoma. Kaposi's sarcoma is actually the name of a specific type of cancer caused by this type of herpesvirus.
 

How is human herpesvirus 8 spread?

 

HHV 8 is usually spread through saliva, blood or semen, or transmitted from mother to baby during labour. HHV will not go on to cause cancer unless you have a weakened immune system. 

 

Kaposi's sarcoma usually occurs in people with advanced HIV infection and people with a very weakened immune system, for example after an organ transplant. 

 

What are the symptoms of Kaposi's sarcoma?

 

Symptoms of Kaposi's sarcoma include red or purple lesions that look like bruises on the skin or in the mouth. These lesions get bigger over time and often merge together to form lumps. Internal organs can also be affected, causing the following symptoms:

 

  • Stomach pains 
  • Diarrhoea
  • Limb swelling (lymphoedema)
  • Breathlessness
  • Coughing up blood 
  • Chest pain 

If you are thought to have Kaposi's sarcoma, the doctor will often take a sample of the lesion from the skin or mouth. If it is thought to be affecting your internal organs, you may need to have a camera test down your throat into your stomach, or a body scan.

 

What is the treatment for Kaposi's sarcoma?

 

Kaposi's sarcoma can be very well controlled with medication, and very rarely leads to someone dying. 

If it is found in someone with HIV, usually taking their normal antivirals will help to control it. 

 

For someone that has had an organ transplant, their medication used to stop them from rejecting their new organ will also help to slow down the progression of their Karposi’s sarcoma.

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