Herpes (Genital herpes, Herpes Simplex Type 2)

The herpes simplex virus infects skin and mucous membranes, causing painful, recurrent outbreaks of sores. There are two major strains: Type 1 generally causes cold sores and fever blisters; type 2 commonly affects the genital and anorectal area. Genital herpes is usually spread through sexual contact, and some 500,000 Americans contract it each year.

Symptoms of genital herpes usually appear two to seven days after contact with an infected sexual partner. Typically, the first sign of infection is itching and irritation in the genital area, followed by especially painful blisters, which rupture in a few days. These then turn into painful, shallow skin ulcers that last from one to three weeks. In women, sores may be present in the vagina, cervix, and urethra. Blisters may also develop on the hands or mouth if these were used during sexual activity. Other possible symptoms are painful urination, enlarged lymph nodes, fever, and general malaise.

Although the sores and other symptoms disappear in a few weeks, the virus lingers in the body and may flare up from time to lime. The frequency with which it recurs varies widely, but stress and lowered immunity can lead to more flare-ups.

Diagnostic Studies and Procedures

A doctor can usually diagnose genital herpes by reviewing the symptoms and inspecting the blisters. Examining cells from one or more of the lesions under a microscope usually confirms the presence of type 2 herpes. A laboratory culture of a tissue sample from one of the blisters is sometimes needed.

Medical Treatments

At present, there is no cure, but the symptoms can be alleviated. The first attack is likely to be the most severe, and a doctor may prescribe acyclovir (Zovirax), an antiviral drug that is taken orally or used as a topical cream. Acyclovir reduces the intensity and duration of the symptoms but does not prevent recurrent herpes outbreaks.

A woman who is pregnant and has had herpes or contracts it during pregnancy should inform her obstetrician at once. Although it is not life threatening to adults, an active infection in the mother at the time of birth can be transmitted to the baby. Herpes in a newborn can cause blindness; systemic herpes can cause retardation, neurological damage, and even death. These complications can be prevented by a cesarean delivery or other precautions.

Alternative Therapies

Although alternative therapies cannot cure genital herpes, some may alleviate pain and other symptoms.

Aromatherapy. A daily bath in water containing six drops of geranium oil of 2 percent strength is recommended. The treatment should be continued until the skin ulcers disappear.

Herbal Medicine. Herbalists recommend aloe vera gel to soothe and dry the sores. An alternative is a poultice made with comfrey root. Make a paste, put it between layers of gauze, and apply it to the sores.

Visualization. This technique is said to help prevent recurrences. The patient learns to visualize the immune system successfully fighting off the virus.

Yoga and Meditation. Because stress can precipitate an attack, practicing these and other relaxation techniques may help prevent recurrent flare-ups.

Self-Treatment

For generalized pain, take aspirin or acetaminophen. To soothe localized pain and itching, use compresses soaked in cool milk or water. Vitamin E oil or A and D ointment applied to the sores may also alleviate pain, though some experts believe these remedies slow healing by keeping sores moist; they suggest cornstarch instead. You can also try taking several salt baths a day; use tepid water and add 1 cup of baking soda per gallon. Pat the sores dry or use a hair dryer set on low.

Women can reduce pain during urination by relieving themselves in the shower or urinating through a tube to keep the urine stream from contacting the lesions. A small plastic cup with the bottom removed can serve the purpose.

Keeping the sores dry and exposed to air speeds healing. Wear cotton underclothes and avoid nylon pantyhose and tight-fitting jeans. Also, do not douche without consulting a doctor.

To avoid passing on the virus, abstain from sexual contact for at least one month after recovery, to prevent further attacks, do not engage in oral, genital, or anal sex if one partner has sores in the genital area or on the mouth. When either partner has had genital herpes, a rubber condom should always be used.

Other Causes of Genital Sores

Type 1 herpes can cause lesions similar to those of genital herpes if the virus infects this area. Blistering and ulceration can be due to gonorrhea, syphilis, and genital warts.