Genital herpes

What Is Genital Herpes: Course And Complications, Infection, Symptoms, Treatment, Prevention

Genital herpes is an infectious disease caused by the herpes simplex virus ( HSV ). The infection causes skin lesions mainly located in the anogenital area.

The transmission of genital herpes occurs above all through unprotected sexual intercourse , but there is also the possibility of vertical contagion , ie from the mother with lesions or infection in progress to the child during delivery .

Within a week of infection, the infection can manifest itself at the entry point of the virus, which can be very annoying. In other cases, however, it may not cause any disturbance. A relevant factor in the propagation of this infection is precisely the unconscious transmission. In fact, it can happen that you are healthy carriers of genital herpes and you don’t know it.

Furthermore, the currently available treatment cannot permanently cure the infection. However, antiviral drug therapy is essential to reduce the consequences of the disease.


What Are The Causes Of Genital Herpes?

Genital herpes is the result of infection with the herpes simplex virus. The pathogen generally implicated is HSV-2 , although 10-30% of cases are caused by HSV-1 (i.e. the same viral strain responsible for cold sores).

Why Does Genital Herpes Recur?

Once the infection has resolved, these viruses have the peculiar characteristic of remaining in a latent state within the body (they evade the immune system and are not permanently eliminated).

Their permanence in the nerve ganglia corresponding to the affected areas allows short and generally less serious reactivation episodes compared to the first infection. Recurrences of genital herpes are favored by stress , excess alcohol , exposure to the sun or a decline in the immune system .


How Do You Get Genital Herpes?

The transmission of genital herpes occurs above all with unprotected sexual intercourse ( vaginal , anal or oral) and intimate practices involving contact with infected mucous membranes ( kissing , petting , mutual masturbation , etc.) between a person positive for the virus and a partner healthy

There is also the possibility of vertical transmission , i.e. from mother to child, during delivery. Precisely in order to prevent neonatal infection, caesarean delivery is recommended in pregnant women with ongoing infection and in the presence of lesions on the genitals .


Female And Male Genital Herpes: Sites Of Infection

Genital herpes lesions are mainly located on the foreskin , glans penis and shaft of the penis in men, on the labia majora and minora , clitoris , perineum , vagina and uterine cervix in women.

How To Recognize Genital Herpes?

4-7 days after the infection, the genital herpes simplex infection presents itself with small rounded papules or vesicles , often painful and gathered in a “cluster” . Generally, the appearance of these skin lesions is preceded by an annoying burning and tingling sensation at the point of entry of the infectious agent, i.e. at the level of the mucosa or skin of the genitals and surrounding areas.

The vesicles cause itching and discomfort ; over a few days, they can erode, spilling their contents and forming painful ulcers , which can coalesce. This moment coincides with the phase of maximum contagiousness .

Asymptomatic Genital Herpes

In some cases, genital herpes causes no noticeable discomfort; this factor is significant if unknowing transmission of the disease is considered.

As the disease progresses, the ulcers left by the rupture of the bullous lesions dry out . This is how scabs are formed which gradually heal, until they disappear, just like it happens to herpes lesions when it appears on the lips.

Genital herpes lesions usually regress after 3-4 weeks .

In some cases, however, the vesicles can appear repeatedly with a cyclical trend (ie they appear, disappear after 10-15 days, and then appear again).

Compared to recurrent genital lesions , primary vesicles are typically more painful and widespread. However, recurrent genital lesions can be associated with serious prodromal manifestations and can also affect the buttocks, groin or thighs.

Primary Infection And Recurrence Of Genital Herpes

The first Herpes virus infection, called primary infection , in fact, can be asymptomatic or manifest at the point of entry of the infectious agent. Once the primary infection has resolved, the virus becomes latent, localizing in the nerve ganglia, and then reactivated periodically over time. Recurrences are associated with the appearance of clear lesions or with the simple asymptomatic release of the virus. These episodes are favored by stress, fever , excess alcohol, exposure to the sun, menstruation or a decline in the immune system.

Male Genital Herpes: Male Genital Herpes Symptoms

In men, acute manifestations of genital herpes usually appear on the scrotum , the tip and shaft of the penis, or around the anus. Usually, the rash in humans is limited to the appearance of six or ten blisters .

These vesicles, like those of female genital herpes, contain many viral particles , so they are particularly contagious.

Herpes simplex vesicles which, in the case of genital infection, are typically localized on the vulvar (woman) or penile (man) mucosa

In men, acute manifestations of genital herpes usually appear on the scrotum, tip and shaft of the penis, or around the anus. Usually, the rash in humans is limited to the appearance of six or ten blisters.

These vesicles, like those of female genital herpes, contain a large number of viral particles, so they are particularly contagious.

Course And Complications

How Long Does Genital Herpes Last?

The course of the disease is similar to that of cold sores: the small and very annoying blisters burst turning into shallow ulcerations, which heal without leaving obvious signs within two or three weeks. However, local pain and itching may persist for up to a month after the blisters have disappeared.

Genital Herpes: What Are The Possible Complications?

Compared to cold sores, however, this type of infection is more subject to complications, especially following the first episode which we have seen to be generally more acute and painful than the subsequent ones. In addition to genital manifestations, primary herpes simplex infection can cause systemic symptoms , such as fever, headache , joint pain , general malaise, difficulty urinating , and constipation . Rarely, complications such as severe sacral radiculopathy or aseptic meningitis may occur .


How Is Genital Herpes Diagnosed?

To diagnose genital herpes we start from the observation of the vesicles that appear during the acute phase, recognizable even with the naked eye. However, the symptoms are not always present, especially in the recurrence phase.

In suspected cases, then confirmation of the diagnosis by means of some laboratory tests is necessary. In particular, to ascertain positivity to genital herpes, a blood test can verify the presence of specific antibodies directed towards HSV (the presence of IgM indicates an active primary infection, that of IgG a previous infection). These tests are also able to differentiate antibodies directed against herpes simplex type 2 from those directed against herpes simplex type 1.

Testing may also include looking for the virus in genital lesion material by PCR (polymerase chain reaction) analysis .


How To Cure Genital Herpes?

Currently available treatments cannot cure the infection permanently. However, therapy based on antiviral drugs is still effective in reducing symptoms and shortening healing times. In particular, the drugs recommended for the treatment of Herpes infection are those containing acyclovir , valacyclovir and famciclovir .

These active ingredients hinder the multiplication of the virus, thus reducing the duration and making the episodes of the disease less severe. However, antiviral drugs do not totally eradicate the presence of the latent virus, nor do they modify the intensity and frequency of relapses after the conclusion of the therapeutic cycle.


Is There A Vaccine For Genital Herpes?

As far as prevention is concerned, there is still no vaccine that can prevent genital herpes. For this reason, it is very important to adopt a suitable lifestyle to avoid the spread of this disease.

The only effective prevention is to take precautions during sexual intercourse (correct use of the condom and abstention from intimate contacts for the entire duration of the genital herpes episode). Certainly, condoms provide limited protection, as transmission is also possible through the skin .

As stated above, even therapy does not reduce the risk of transmitting the infection to sexual partners.

However, in order to prevent neonatal infection, cesarean delivery is recommended for pregnant women with active infection and genital herpes simplex lesions .

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