What causes herpes?
Herpes, which occurs on the skin of the face, the red rim of the lips and the oral mucosa, is caused by the Herpes Simplex virus (herpes simplex virus).
It should be noted that the so-called herpes simplex is of 2 types -
- herpes simplex virus type 1 (HSV-1) -
causes damage to the skin of the face, red border of the lips, oral mucosa, eyes,
- herpes simplex virus type 2 (HSV-2) - causes the so-called genital herpes.
What does herpes look like: at the beginning of the disease, you can observe the formation of bubbles, which burst with a few days to form erosions. If herpes has formed on the skin or red border of the lips, then the surface of erosions is covered with crusts. If we are talking about a mucous membrane, then in this case the surface of erosion becomes covered with a yellowish fibrinous film over time.
Where does herpes come from -
Initially, a child is born with immunity to the herpes virus. Specific antibodies to the herpes virus that the child received from the mother’s blood are gradually disappearing from the child’s blood. This occurs approximately in the period from 6 months to 3 years maximum. During this time, the child is infected with a virus from his parents, but as long as a high antibody titer in the blood remains, there are no clinical manifestations of the disease.
How herpes is transmitted -
- through kisses (touching the face of the skin),
- while eating with one dish or one spoon,
- when using someone else's towel to wipe,
- when you use personal items with which a person who is sick with herpes contacts, or even just a “carrier”.
The most infectious are people with clinical manifestations of herpes. As soon as the blisters dry up - the risk of infection from such a person decreases. However, infection is possible even from a person who does not have any clinical manifestations, but is a carrier of the virus (that is, during contact even with the apparently healthy skin of such a person).
What causes herpes exacerbation -
After infection, the herpes virus enters the nerve cells and spreads along the nerve trunks, through which the virus enters the nerve ganglia, where it will last a lifetime as a sleeping infection.
However, when exposed to certain factors (which are described below), the virus is activated, again moving along the nerve trunks to the surface of the skin, where it causes blisters, ulcers and sores. Relapses can be repeated 1 time per year or 2 times per year (sometimes more often), which depends on the state of the immune system and the nervous system.
Factors that cause herpes relapse -
- contact with a person with clinical manifestations of herpes,
- reduced immunity against influenza or ARVI,
- reduced immunity against the background of HIV, hepatitis, steroids, chemotherapy,
- physical fatigue and emotional stress
- cuts and scratches in this place
- in women, the predisposing factor is critical days,
- long stay in the sun.
A striking feature of herpes is the emergence of a group of bubbles filled with fluid. Before their eruption, there is always an incubation period (lasting from several hours to a day), when there are no clinical manifestations yet, but the virus has already been activated. During this period, you may feel itching or burning of the affected skin. Further symptoms depend on the location of the rash ...
- Herpes on the red edge of the lips (fig.7-9) -
lips and skin around the mouth - this is the most common localization of herpes. The bubbles that appear on the skin and the red border of the lips burst and dry after 2-3 days. The affected surface is covered with crusts, which are stored for a period of 7 to 10 days. In no case can the crusts be ripped off, because removing crusts can also lead to a new outbreak of herpes.
Detailed information about the most effective treatment for herpes of this localization - read the article: "How to quickly get rid of herpes on the lip"
- Herpes on the face (fig.7-9) -
foci of herpes can appear on any parts of the skin of the face, which is usually associated with a violation of the integrity of the skin (scratches, cuts, abrasions). Typical localization - herpes on the cheeks and nose, earlobes, chin, forehead. The skin around the eyes may also be affected, but we have identified this type of lesion in a separate column.
Depending on the extent of the skin lesion and the severity of the clinical manifestations, either an antiviral skin cream or a cream in combination with tablets antiviral preparations can be prescribed. You can see a detailed review of drugs for treatment at the end of the article.
- Herpes on the oral mucosa and tongue (fig.10-12) -
if the bubbles appear on the oral mucosa, then this disease is called herpetic stomatitis. After the bubbles on the mucosa burst - in their place erosions are formed (covered with whitish-yellow fibrinous bloom), around which there is a bright red rim of the inflamed mucosa.
In children, herpetic stomatitis is very often accompanied by gingivitis. In this case (in addition to multiple bubbles and erosions in some part of the oral mucosa), you can see bright red inflamed gums, which are sometimes still covered with a whitish bloom.
Detailed information on drugs and treatment regimens read in the article:
→ "How to cure herpes on the oral mucosa"
- Herpes of the cornea, skin around the eyes (fig. 13-15) -
The herpes simplex virus can spread to one or both eyes, and most often this happens when you infect the virus with unwashed hands that have recently touched the affected skin. Most often, the virus infects the top layer of the cornea, causing keratitis in it. Conjunctiva, iris, retina are less common. Concomitant rash may appear on the skin of the eyelids, forehead and nose.
Symptoms: pain, blurred vision, sensitivity to light in one eye (if one eye is affected), feeling of "sand in the eyes". It should be borne in mind that herpes of the eye is very dangerous, and late or incorrect treatment can lead not only to dryness of the cornea and the appearance of scars on it, but also to deterioration of vision, the appearance of constant pain, and even blindness and loss of the eye.
Treatment of ocular herpes should be carried out immediately after the symptoms are detected and includes active therapy with the latest generation of antiviral tablets, antiviral eye drops, and treatment of the skin around the eyes with antiviral creams.
Common symptoms of herpes -
Primary herpes can occur with flu-like or ARVI-like symptoms: fever, muscle aches and even swelling of the neck lymph nodes. But such acute symptoms are observed only in 10% of all patients. In other cases, the general condition of the body is not disturbed (24stoma.ru).
How to permanently get rid of herpes - currently there is no vaccine or drug that would allow you to cope with herpes forever. After infection, the herpes virus is permanently stored in the nerve trunks. However, there are special drugs that will help reduce healing time, reduce pain, and some even can reduce the risk of re-manifestation.
Features of the treatment of herpes in children and adults -
Herpes - treatment in adults and middle-aged / older children is no different. The choice of drugs will depend exclusively on the severity of herpes manifestations and the state of the immune system.
In the treatment of young children, it must be borne in mind that they have difficulty taking tablet preparations, including the treatment of the oral mucosa with a gel. Therefore, in young children, antiviral means in the form of suppositories are used, for example, the drug Viferon.
1. Treatment of herpes on the skin and red border of the lips -
Treatment of herpes at the specified location is carried out with antiviral drugs:
→ means that are applied to the lesion (creams, gels, ointments),
→ by oral medication (tablets),
→ less commonly by intravenous administration.
- Antiviral creams, ointments and gels -
The most common drug in Russia is the antiviral drug Acyclovir. Acyclovir-based preparations: Acyclovir-cream 5% (Russia), Acyclovir-ointment 5% (Russia), Zovirax cream (UK), Acyclovir-hexal cream (Germany), Acyclovir-Sandoz cream (Switzerland) ...
Creams and ointments with acyclovir should be applied to the lesion 5 times a day for 7 days (there are no contraindications for age). It should be noted that the form in the form of a cream is more preferable before an ointment, since antiviral substances from the cream penetrate the skin a little better than from the ointment. Acyclovir is predominantly effective in patients who get herpes only for the first time.
Disadvantages of drugs based on acyclovir -
Acyclovir is a fairly old drug. Despite the high prevalence in pharmacies, in about 10–30% of patients this drug is ineffective due to the insensitivity of virus strains to acyclovir. In addition, the drug components very poorly penetrate the skin to the site of virus reproduction, while acyclovir itself has a very low tropism for the herpes virus.
Modern antiviral creams -
these drugs include cream "Fenistil-pentsivir" on the basis of the antiviral component "penciclovir" (Figure 18). The drug not only has several times greater efficiency, but also extremely low resistance of virus strains to this agent (about 0.2%). Cetomacrogol and propylene glycol contained in the composition - maximally facilitate the penetration of active ingredients through dead skin layers and crusts.
In addition, after the last application, the multiplication of viruses is blocked for about 2x more. Clinical studies have revealed that repeated cases of the appearance of herpes when using Fenistil-pencivir occur less frequently than when using other drugs. The minus of the drug: according to the instructions should be used in children over 12 years.
- Antiviral Tablets -
prescription, are used with significant skin lesions and red border of the lips. All tablets preparations can be divided into 3 groups:
1) Tab. Acyclovir (Fig.19) -
They have all the same drawbacks as creams: low affinity for the virus, up to 30% of herpes virus strains are resistant to acyclovir, plus low bioavailability when taken orally. Pros - no contraindications for age, worth a penny.
2) Preparations based on Valaciclovir (Valtrex) -
valacyclovir is a precursor of acyclovir, into which it turns, once in the body. Taking pills with valacyclovir allows you to create such a concentration of acyclovir in tissues, which is possible to achieve only with the intravenous administration of traditional acyclovir. What is achieved by greater bioavailability of the drug when taken orally (Fig. 20).
3) Famciclovir-based drugs (Famvir) -
It is the most effective remedy for herpes pills. Above, we talked about the cream "Fenistil-pentsivir" on the basis of penciclovir, which is applied topically. Famciclovir is essentially a tableted analog of penciclovir (Figure 21).
→ Acyclovir and its modern analogues
Important: tablets, as well as for intravenous administration, should be prescribed only by a doctor. For patients with a suppressed immune system, it is desirable to use only Famciclovir-based products (and, moreover, for both treatment and prevention of outbreaks). Tablets based on Valaciclovir can be used for patients with normal immunity (both for treatment and prophylaxis), but to monitor the effectiveness of therapy.
2. Treatment of herpes to the oral mucosa -
Treatment of herpetic stomatitis can be carried out at home, but you must be sure of the correct diagnosis. Most often, children are most susceptible to this localization of a herpetic infection, so parents often make their own diagnosis and start the wrong treatment. By experience, it can be said that often herpetic and aphthous forms of stomatitis are confused, which are treated completely differently.
How to distinguish aphthous form from herpetic -
With the herpetic form of stomatitis, numerous bubbles appear, which burst in 1-2 days, and in their place there appear multiple erosion of small sizes. In the aphthous form of stomatitis, the cause of which in most cases is an allergic reaction - only 1 erosion appears (maximum two or three), but of a very large size (Figure 22).
The most detailed information about the diagnosis of various forms of stomatitis and drugs that are effective in their treatment - read the article:
→ "Diagnosis and treatment of herpetic and aphthous forms of stomatitis"
Important: if you are at a loss in making the correct diagnosis even after reading an article with photos of various forms of stomatitis (the link to which we indicated above), you should contact only a dentist. If a child is sick, there is no point in contacting pediatricians, since from experience we can say that pediatricians do not even know that there are not one, but several forms of stomatitis, and that they are treated completely differently. Therefore, it is necessary to call only a pediatric dentist from a pediatric stomat. Polyclinics according to place of residence
Herpes Prevention -
The best prevention of herpes is the ability to avoid physical contact with a person who has active clinical manifestations of this disease. In addition, you can not use someone else's personal belongings of a sick person, such as: lipstick or lip balm, dishes, forks / spoons, a towel. If someone from your family members is sick, everyone needs to wash their hands with soap and water regularly.
You should also avoid such provoking factors as stress or excessive tanning. If you notice that herpes starts with you with enviable regularity after a long time in the sun - be sure to use sunscreen and special lipstick with UV protection. Abrasions and cuts in the mouth and red border of the lips are one of the predisposing causes of repeated outbreaks of herpes.
If you have damaged the skin or the rims of your lips, treat your skin with antiviral cream for prevention. If you often have colds, contact an immunologist to correct the immune system, and always support the body in the autumn and spring with vitamin preparations. We hope that our article: Herpes virus, symptoms and treatment - turned out to be useful for you!
Author: dentist Kamensky K.V., 19 years experience.