Herpes: Information & herpes specialists

Leading Medicine Guide Editors
Author
Leading Medicine Guide Editors

Herpes is a viral disease that most often manifests itself in the form of painful blisters on the lips. Almost 90 percent of all men and women in Germany carry herpes viruses. While the actual cold sore is rather harmless, its relatives, genital herpes and herpes zoster, can cause serious illness.

Here you will find further information as well as selected herpes specialists and centers.

ICD codes for this diseases: B00

Article overview

What is herpes?

Herpes is a viral infection that manifests itself in blisters and crusts, especially on the lips. An outbreak of herpes lasts for around two weeks until the immune system has fought off the viruses.

The disease progresses in outbreaks. After the first outbreak, herpes can disappear for a longer period of time. The virus then withdraws into the ganglion cells of the nervous system, where it cannot be reached by the immune system. Once you are infected, you cannot get rid of the virus.

Renewed outbreaks (known as reactivation) occur mainly when the immune system is weakened. Stress or sunlight can also trigger a relapse in some people.

The herpes virus is highly contagious and is transmitted through physical contact.

Herpes is often mistakenly regarded as a sexually transmitted disease and associated with kissing. This is true insofar as the virus is transmitted when herpes is active. However, infection usually occurs in infancy or childhood through a kiss between the parents.

Herpes labialis
Herpes labialis (cold sores)

Causes of herpes disease

The group of herpes viruses includes many different viruses, but they all have one thing in common. They cause red areas of skin with characteristic and painful blisters.

By far the most common herpes viruses are

  • Herpes type I ("cold sores"),
  • herpes type II ("genital herpes") and
  • herpes zoster ("shingles").

Herpes simplex type I occurs primarily on the face. Until years ago, herpes simplex type II was limited to the genital area(penis, vagina, anus).

Due to the more liberal use of various sexual practices, the virus "settlement areas" are now intermingled. Unprotected oral sex can lead to herpes simplex type I appearing on the genitals. Conversely, herpes simplex type II also appears in the mouth and on the lips.

The herpes virus is usually transmitted via contact with the skin and mucous membranes. Herpes is spread through direct contact with the highly infectious fluid from the herpes blisters.

After the symptoms have healed, infection is still possible depending on the affected area. The virus is then transmitted via

  • saliva,
  • vaginal or prostate secretions and
  • semen

passed on.

However, the risk of infection is much greater with active vesicles.

Smear infections are also possible. In this case, the herpes viruses are transmitted when sharing glasses, for example.

This can also lead to a herpes outbreak in the eyes. There, the herpes viruses may lead to corneal and conjunctival inflammation. There is then a risk of blindness in newborns. However, infestation of the eyes is rare.

How can you recognize herpes?

A few days after infection, small red blisters form. They hurt and can burst very easily. The regional lymph nodes are often swollen.

The herpes blisters heal again after two to three weeks, forming a crust. Immunosuppressed and HIV patients generally tend to have severe, protracted and repeated courses.

Unlike cold sores and genital herpes, herpes zoster leads to a general feeling of illness. Anyone who suffered from chickenpox as a child carries the varicella zoster virus permanently.

Zoster ("shingles") causes extensive redness with countless blisters on the skin. Shingles breaks out

  • in old age,
  • due to an immune deficiency or
  • due to stress

more frequently.

In addition to these skin reactions, the following also occur more frequently

The acute zoster disease heals after a few weeks. Patients are usually given painkillers and antivirals to alleviate the symptoms until they have healed.

However, the months to years after the zoster are much more serious. Post-zoster neuralgia continues to cause pain in muscles and joints long after the shingles have healed. It can severely impair quality of life.

Gürtelrose (Herpes Zoster) auf dem Rücken
Herpes zoster (shingles) also manifests itself as a skin rash with characteristic blisters © snesivan | AdobeStock

How is herpes treated?

The treatment of herpes in any form (herpes labialis, herpes genitalis, herpes zoster) can only be purely symptomatic. A definitive cure is still not possible today. Once the skin symptoms have subsided, the virus withdraws into the nervous tissue and becomes inactive. However, it can break out again at any time.

Nevertheless, there are some ways to at least alleviate the symptoms. The methods range from home remedies to antiviral agents. The most common treatment is with the antiviral drug acyclovir. However, acyclovir is ineffective against dormant viruses in the ganglion cells.

Herbal preparations can also be used as a supplement. They sometimes have an antiviral and antibacterial effect. In severe cases, e.g. as a result of an immune deficiency, antibacterial substances are very helpful as they can prevent superinfection of the herpes blisters with bacteria.

Honey has always been a tried and tested remedy for inflammation. It is effective against bacteria (antibacterial) and viruses (antiviral).

Black tea has very similar effects. Its high content of tannins (bitter substances, tannic acids) kills viruses and inhibits inflammation. Place a cold or warm tea bag on the area affected by herpes.

Drying out the herpes blisters also helps. Essential oils can help with this, such as

  • Rosehip oil,
  • St. John's wort oil,
  • jojoba oil,
  • lemon balm oil,
  • marigold oil or
  • tea tree oil.

Tooth powder and baking soda also have a drying effect.

How to protect yourself from herpes

Herpes cannot be reliably prevented. The virus is too widespread for that.

One exception is protection against the varicella zoster virus. It causes chickenpox and shingles. Infants can be vaccinated against the virus and thus enjoy a certain degree of protection. However, other simplex viruses are not affected by this.

Labial herpes is rather difficult to protect against. A kiss is often sufficient for transmission. Children usually get the virus through their parents' care and a kiss.

However, the situation is different with genital herpes. Doctors and health experts recommend this:

  • Use condoms during sexual intercourse
  • Condoms also help to keep sex toys clean
  • Avoid contact with the blisters and weeping skin areas
  • Refrain from oral sex if there are blisters and/or small ulcers on the penis, vagina or lips

There is no one hundred percent protection against herpes. The Federal Center for Health Education(BzgA) offers anonymous online and telephone consultations for those interested.

What is the prognosis for a herpes infection?

The course of herpes depends on the individual factors of the person affected. As a rule, cold sores heal without leaving any residue.

Genital herpes is usually harmless, although very painful. However, the often inflamed herpes blisters increase the risk of contracting other sexually transmitted diseases. This mainly concerns diseases such as

Their pathogens can use the mucous membrane damaged by herpes to penetrate the bloodstream.

In the case of immunodeficiency or HIV function, very severe courses of the disease can also occur. These are referred to as systemic or generalized herpes infections. There is then a risk of viral encephalitis (meningitis), for example, which is associated with a high mortality rate.

However, predominantly healthy people with a functioning immune system usually cope very well with herpes infections. Herpes then heals without any visible consequences.

What other viruses from the group of herpes viruses are there?

The Eppstein-Barr virus and Pfeiffer's glandular fever

Kissing disease is caused by the Eppstein-Barr virus (EBV for short). It is also known as "Pfeiffer's glandular fever" or infectious mononucleosis. EBV is a close relative of the simplex virus. It is transmitted via saliva, giving the disease its name as the kissing disease.

The initial infection usually occurs in adolescence or young adulthood. Flu-like symptoms occur first. They are followed by

  • fever,
  • fatigue,
  • feeling ill,
  • Sore throat due to the severely swollen lymph nodes,
  • headaches,
  • cough and
  • chills.

Tumors can occur later in life as a result of the disease. The Eppstein-Barr virus can be detected in up to 80 percent of nasopharyngeal tumors. The cancer often develops decades after the primary infection has been cured.

As a viral disease, Pfeiffer's glandular fever cannot be treated causally, but only symptomatically. Antipyretic and pain-reducing agents are used. Antibiotics are prescribed in the event of a bacterial superinfection in the area of the inflamed tonsils or lymph nodes.

Sufferers should strictly adhere to the prescribed rest. Otherwise there is a risk of complications, such as

The cytomegalovirus and cytomegaly

An equally widespread representative of the herpes viruses is the cytomegalovirus (herpesvirus 5, human cytomegalovirus). It only occurs in humans. The infestation of the adult population in Germany is around 40 percent. In the Third World, the virus reaches infestation rates of up to 100 percent.

Infection usually occurs in childhood. Here too, saliva and other bodily fluids are the transmission route.

Almost 90 percent of those infected do not even notice the cytomegalovirus infection. It is then an asymptomatic infection. In the other rare cases, symptoms such as fever and swelling of the lymph nodes occur.

Overall, cytomegaly is similar to Pfeiffer's glandular fever. For people with an intact immune system, the disease is easy to control. It then heals without consequences.

However, pregnant women and their unborn children are particularly at risk. The unborn child has an approximately 40 percent risk of also becoming infected when the mother is first infected. This usually results in severe deformities in the child, such as

  • Heart muscle damage,
  • intestinal disorders,
  • hearing impairment and
  • movement disorders.

This herpes virus often only causes vague, flu-like symptoms in the mother. As a result, the infection and therefore the risk to the child often remains undetected.

A second group of at-risk patients are people with a weakened immune system. These include

  • Transplant recipients (have received a new donor organ) and
  • people infected with HIV and
  • AIDS patients.

In these patients, the cytomegalovirus can trigger systemic inflammation, including pneumonia.

As with all other herpes infections, cytomegaly is treated purely symptomatically. The following are used

  • Antipyretic agents,
  • antibiotics against accompanying bacterial infections and
  • antivirals to reduce the viral load of the disease somewhat.

There is no protection against this herpes virus. There is no vaccination and no special protective measure that could prevent infection. However, pregnant women are advised to have themselves and their partner tested for cytomegalovirus infection.

The test for antibodies against the cytomegalovirus is not a fixed health insurance benefit for prenatal care. It is therefore a self-pay service. However, at around €13, the cytomegalovirus test is not too expensive. It is a good investment which, in the best-case scenario, can reduce the risk to the child.

Dermatologists and gynecologists can provide further help and comprehensive advice on the subject of "Herpes & Co.".

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