Genital herpes - symptoms, relapses, how to treat?

Herpes in the intimate area is an unpleasant pathology not only for aesthetic reasons.

The disease, if it makes itself felt, is often accompanied by a number of unpleasant symptoms that can greatly reduce a person’s quality of life.

Naturally, if a patient cares about his health, he will seek help from a doctor to overcome the disease.

What are the causes of pathological rashes in the intimate area, patients want to know, and what characteristics of the disease occur in the stronger sex and in women.

What are the ways the infection spreads?

Which doctor will provide assistance, conduct diagnostics and select the optimal method of treatment if the symptoms have made themselves felt and are reducing the quality of life?

Herpes in the intimate area: features of viral infection

The reasons for the development of herpes in the genital area are well known.

The main factor is the entry into the body of a small virus, which is called in medical practice the herpes virus of the second type.

It is characterized by damage to the genital area with the appearance of characteristic rashes on the skin.

The disease affects both men and women equally often.

Moreover, as doctors note, today it is quite difficult to meet a person who has not been in contact with this infection throughout his life.

Herpes has one significant feature.

It begins to actively manifest itself if a person’s immunity decreases.

This can happen, for example, against the background of other infectious diseases, due to congenital or acquired pathologies of the immune system, or with HIV.

Once the virus has entered the body, it will no longer be possible to destroy it.

The person’s task in this case is to suppress the activity of the pathogen with the help of special medications.

Then maintain immunity at a high level to avoid relapses in the development of pathology.

The average incubation period for infection is several weeks.

However, if the immune system of a sick person is strong, the virus may not appear for years.

Prevention of genital herpes virus infection

To prevent infection, you must remember to use a condom during casual sexual intercourse, as well as the use of antiseptics to treat areas of the skin where the virus can get. Relapses of the disease are observed with a decrease in immune defense, various diseases, stress, and even with frequent overheating and hypothermia. Therefore, in order for the clinical signs of herpes to make themselves felt as rarely as possible or not to appear at all, you must try to lead a healthy lifestyle, eat well and get enough rest, as well as regularly take vitamin supplements recommended by your doctor.

To prevent self-infection, in order to prevent the virus from being transferred from the face in the presence of rashes on the lips to the genital area, it is necessary to adhere to the rules of personal hygiene and wash your hands more often. Each family member should have separate towels for different parts of the body.

After unprotected sexual intercourse, during sexual relations with a carrier of the herpes simplex virus, and when planning pregnancy, it is necessary to undergo regular examinations with a doctor.

Reference and information material

Author of the article

Belyaev Dmitry Alexandrovich

General doctor

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Options for the spread of herpes in the intimate area

Many patients are concerned about the question of why herpes appears in the intimate area.

The main reason is infection with a corresponding pathogenic microorganism.

Its spread in the environment is possible in several ways:

• through sexual intercourse, especially if the couple does not bother to use condoms as the only barrier protection against STDs
• through household contacts, for example, when using shared towels, linen, washcloths
• perinatally, that is, at the moment when the child, during birth, passes through the mother’s birth canal, coming into contact with her mucous membranes affected by the disease

Doctors note that it also happens that herpes on the lips and in the intimate area is caused by one type of infection.

This happens when the inoculation route is implemented, i.e. transfer of pathogens from one place to another, during combing or other manipulations.

This route of infection is quite rare in medical practice, but it still cannot be ruled out.

How can you get infected?

Causes of the disease:

• unprotected sexual contact with an infected partner;
• oral sex with a person who has herpetic blisters on the lips or face;
• self-infection with common herpes due to non-compliance with personal hygiene rules.

Treatment can drive the virus deep inside the body, but some factors provoke a re-exacerbation. Reasons for relapse:

• frequent colds and immunity problems;
• stress;
• lack of adequate nutrition;
• overwork and exhaustion;
• diabetes;
• alcohol or coffee abuse.

Also, this type of herpes can be transmitted to a child during childbirth from a sick mother if the disease is in the active stage.

Typical symptoms of genital herpes

During the incubation period, while the virus increases its power in the body, the person does not make any complaints.

Symptoms first appear after the pathogen has multiplied sufficiently.

It has already caused enough damage to the body to cause clinical symptoms.

The infection then proceeds in several stages.

• Manifestation . Symptoms during this period do not differ from any infectious disease. The patient complains of weakness, fever, fatigue and other nonspecific signs of changes in the body.
• Primary manifestations . The genitals turn red, severe itching appears, causing serious discomfort, sometimes preventing normal sleep at night. Pain syndrome may occur.
• Progression. The redness is covered with specific blisters, which are well known to any person who has ever had herpes. The blisters are filled with transparent contents and often continue to itch.

• Permission. After a few days, the blisters burst, leaving ulcers in their place. The ulcers may also be itchy and painful. Also during this period there is a high probability of secondary infection. The infection makes its way deep into the body.
• Healing . The ulcers begin to heal, completely disappearing after an average of 1.5-2 weeks. Itching and other unpleasant symptoms subside.

Asymptomatic course of the disease

The first infection with the herpes simplex virus is often called the primary infection. Such an infection can cause symptoms of the disease, but this does not occur in all cases. After the primary infection, the virus is not eliminated from the body; it lives in it in the form of an inactive form (in sleep mode).

In some people, the virus “wakes up” from time to time and enters the surface of the skin. This, in turn, causes a relapse of the viral disease on both the genitals and lips.

For most people, infection with the herpes virus in intimate areas is not a cause for concern. At least 8 out of 10 people with genital herpes don't even know they have it. Sometimes only very mild symptoms may appear that are difficult to associate with genital herpes. Such symptoms may include a slight burning sensation or slight redness that quickly disappears.

In such people, the virus remains dormant and never causes a wave of symptoms to return. However, even those who develop the disease asymptomatically are dangerous to their sexual partners. It is in such cases that infection with the herpes virus occurs.

Features of herpes in the intimate area in women

The appearance of herpes in the intimate area of ​​the fair sex rarely goes unnoticed.

This happens due to vivid symptoms, which greatly reduce the woman’s quality of life.

Often the pathology is accompanied by severe swelling of the genital organs and a feeling of heaviness in the perineum.

Disturbances in the process of urination are practically not encountered, but the itching is felt especially strongly.

Many representatives of the fair sex note that sexual intercourse at the time of exacerbation becomes painful.

It is also worth considering that ulcers can be located not only outside the genital organs, but also directly in the vagina.

As a result, during sex, rubbing may occur, followed by bleeding.

Herpes can be quite common, also affecting the buttocks and thighs.

In rare cases, if the infection is severely advanced, abdominal pain and disruptions in the menstrual cycle may occur.

Herpes rarely affects fertility, but can increase the likelihood of infertility if other infections are present.

The causative agent of the disease

Herpes (from the Greek ἕρπης - creeping, spreading skin disease). Genital herpes is a viral infection that affects the penis in men (penile herpes) and the external genitalia and vagina in women (herpes vaginalis, labia), as well as the area around the genitals, usually the perineum. Infection is manifested by the appearance of blisters on the skin. Sometimes they can occur on the buttocks and anus.

The causative agent of the disease is the human herpes virus. There are two types of AI virus: herpes virus type 1 and herpes simplex virus type 2.

• AI virus type 1 most often leads to the appearance of herpes on the lips. Causes half of the cases of genital herpes.
• AI virus type 2 is responsible almost exclusively for the development of genital herpes. Very rarely it can also cause herpes on the lips.

Herpes on the lips

Features of herpes in the intimate area in men

The herpes virus in the intimate area in men is usually not as pronounced as in the fair sex.

Basically, the stronger sex complains about the involvement of the glans penis, its main body, in the pathological process.

The symptoms are typical, the itching is quite noticeable.

The process can spread to the pubic area and scrotum.

In some cases, ulcerations are localized directly in the urethral area.

Such localization is accompanied by frequent secondary infections that can develop during the passage of urine through the urethra.

The man also complains of typical symptoms of urethritis, such as itching and burning when urinating, and other unpleasant sensations.

Symptoms incl. common ones in men are often almost completely absent.

Or they are so weakly expressed that a representative of the stronger sex simply does not go to the doctor with them, ignoring the unpleasant manifestations.

It is men who often experience episodes of self-healing.

When the body copes with the infectious process on its own, without the help of medications.

True, even in this case, the virus remains in the body and can at any time again remind of its presence with a relapse of symptoms.

Genital herpes - relapses

Some people experience recurrences of genital herpes symptoms. Scientists cannot explain why an inactive virus wakes up from time to time. Relapses are often milder and last shorter than the first wave. In case of relapses, symptoms usually occur within 7-10 days.

Most people do not complain of fever or malaise. Mild tingling or itching of the genitals for 12–24 hours may indicate a recurrence of symptoms of the disease. The intervals between individual relapses vary.

Over time, relapses of genital herpes appear less frequently. Relapse rates may vary among people already dealing with them. Some people experience them 6 or more times a year, while others experience them much less frequently.

As a rule, in the first 2 years after the first wave of symptoms, relapses occur 4 to 5 times. Some people do not relapse at all. Sometimes it is possible to identify factors that cause symptoms to recur. These could be: sunburn, physical illness, excessive alcohol consumption, stress.

Which doctor should I go to if symptoms of herpes appear in the intimate area?

Sick people often want to know which doctor will help cope with the infection.

Especially if its severity is quite strong, and there is neither the strength nor the desire to wait for the rash to disappear on its own.

In most cases, you should contact a dermatovenerologist.

This doctor treats diseases that are transmitted from one person to another during sexual intercourse.

And genital herpes just belongs to this group of infections.

In addition to a dermatovenerologist, a urologist or gynecologist, if we are talking about a woman, can provide assistance to the patient.

These doctors who work with the genital organs know the symptoms of herpes, and also understand the principles of diagnosis and subsequent treatment of the pathology.

In rare cases, consultation with an immunologist or infectious disease specialist is required.

Patients want to know where to go if specific rashes appear.

First of all, you should visit a skin and venereal disease clinic or clinic.

This is where you can find the specialists needed to prescribe and monitor treatment.

A private medical center can always serve as an alternative to government institutions.

There you can undergo any necessary examinations and then be treated for infection.

Forms of the disease

There are two forms of genital herpes: primary and recurrent. Primary genital herpes is said to occur when clinical signs appear for the first time after infection, which can happen after a couple of weeks or in some cases months. Recurrent herpes is a periodic exacerbation of the disease with the slightest weakening of the immune system. Depending on the number of exacerbations of relapses of genital herpes throughout the year, 3 degrees of severity are distinguished:

• mild degree – the number of relapses is 3 or less per year;
• moderate – exacerbations occur 4–6 times a year;
• severe - relapses occur monthly.

During the course of the disease:

All factors that suppress immunity in genital herpes are also causes of exacerbation.

Herpes in the intimate area: features of diagnosing the disease

In a significant number of cases, effective treatment of herpes in the intimate area without preliminary diagnosis is how it differs from other STDs.

The picture of the disease is quite clear.

It is not typical for other pathologies, which makes it possible to make a diagnosis based only on complaints.

However, there are difficult cases when you still have to resort to additional research.

First of all, you can donate blood for antibodies.

This will help determine whether there is an infection in the body at all, or whether the appearance of complaints is caused by any other factors.

Blood is taken from the patient from a vein according to a standard protocol.

No special preparatory measures other than standard ones are required.

You can also conduct PCR from the surface of the rash.

This will help to reliably determine the type of virus and select the most optimal therapy depending on what infection caused the pathological symptoms.

In some cases, even sowing is done using special equipment and special nutrient media.

But in most cases this is not necessary.

Viral culture is difficult and expensive, and therefore it is prescribed only in complex diagnostic situations.

Genital herpes: clinical questions requiring clear answers. Marchenko L.A.

Larisa Andreevna Marchenko , professor:

– Today we will talk about genital herpes, about the use of modern drugs that have appeared on our market for such a pathology as genital herpes infection. I will express my opinion, and, of course, I will rely on documents that are fundamental today. These are European recommendations for the treatment of genital herpes infection, which have been extended until May 2013, and, unfortunately, the extension period has expired, but there are no new recommendations. And why do we rely more on these recommendations? Because our friend, Raj Patel, who has been to Russia twice, is leading these recommendations. And it’s nice to say that Professor Gomberg Mikhail Aleksandrovich, a friend of our clinic and a friend of all obstetricians and gynecologists in Russia, he is an expert from Russia, and also the creator of these recommendations, and therefore today we are working on these recommendations.

First of all, I must say that 2013 was such an epochal year, because 100 years have passed since the discovery of the herpes virus, and virologists have well studied the morphology, antigenic structures, replication mechanisms, and all virological properties. And we are clinicians, and we need to treat, be able to treat patients suffering from genital herpes. And until actually 1974, the thesis that the number of drugs used for genital herpetic infection was inversely proportional to their effectiveness worked well. And only in 1974, the nucleoside analogue acyclovir was created, and about 10 years later Gertrude Elion received the Nobel Prize for the creation of this antiviral drug. You understand, the herpes virus is a virus that affects not only the epithelial cell, but also the nerve cell, and they created drugs and gave the Nobel Prize, because the mortality rate from herpetic meningitis and encephalitis was more than 80%. However, having received the Nobel Prize for the creation of this drug, the companies did not stop, and due to the fact that the bioavailability of the drug was relatively low, 15-30%, the affinity for thymidine kinase was not very high, and also relatively short-lived the drug was in the cell, addiction to the drug occurred, and acyclovir-resistant strains appeared.

After 10 years, the valyl ester of acyclovir appears, and another 10 years pass, and in 1994, famciclovir is created, the last drug in this group, a derivative of penciclovir. And researchers have already managed to achieve 77% bioavailability. The drug is well bound by thymidine kinase for a long time, remains in the cell for up to 20 hours, and practically no addiction to this drug has yet appeared. But the infection is serious; today, it is known that every fifth woman on our planet suffers from genital herpes after the age of 12 years. Dramatic situation in Africa. And in all developed countries, including Russia, the indicators are approximately the same. 20% of women in Russia suffer from genital herpes infection. And the features of epidemiology, the key position in this pathology is that every fifth patient suffers from genital herpes, but you, as a clinician, remember the very small number of patients who have this infection, before your eyes, out of 20 patients who theoretically suffer from genital herpes , before your eyes there are these 4 red little men who have a typical form of herpes with a classic fever, which repeats depending on whether the woman suffers from type 1 or 2 of herpes, monthly or once a year.

You do not know at all about four women who suffer from asymptomatic herpes, but in whom, unfortunately, in 70% of cases with the asymptomatic form, children will die from intrauterine herpetic infection, and the mother will go to be examined for genital herpetic infection after the fact, because morphologists will give an opinion that the fetus was infected with herpes. And the rest of the 20 patients, here we have 12, they will suffer from an atypical form of herpes, who will come to the doctor with complaints of itching, burning, discomfort, leucorrhoea. And if you do not examine them for the presence of the herpes virus, the DNA of the herpes virus in the genital tract, you will be in the dark and will not know how to treat these patients. But, unfortunately, for a long time it was believed that genital herpes affects women who are infected with type 2 of the virus. But today, almost every fifth and third patient is infected with type 1, which was not the case literally 20 years ago, because orogenital contacts are widely developed.

And so we, studying our patients in the Covance laboratory in Switzerland, showed that in the structure of infection with genital herpes, every third patient is infected with type 1. Yes, of course, 50% are type 2, and it is necessary, of course, to type patients from the very beginning, typing is mandatory, because it is known that if the clinic is severe, there are exacerbations every month, 6 or more exacerbations per year, and there are patients who They have 12 exacerbations per year, it is already known in advance that this is the 2nd type of herpes, and there is no need to treat them episodically, treat each exacerbation, but still need to switch to therapy that is suppressive in relation to the causative agent of this infection, and carry out long-term 6 -8-month courses of treatment in order to obtain a positive effect and not discredit the drugs that are part of the line of drugs that received the Nobel Prize. It is very rare in our specialty to give a Nobel Prize for drugs. Therefore, the question arises: is it generally necessary to type if the classic fever is herpetic? Maybe you can make a diagnosis based on appearance? A survey of a fairly large group of women and men showed that it is difficult to sufficiently suspect a diagnosis based on clinical symptoms, and the diagnosis was made using type-specific antibodies; in Russia there are no such antibodies, when a diagnosis can be made by blood.

But according to the anamnesis, as the patient tells us, the onset of the disease, the clinical manifestations, it is quite difficult to make a diagnosis, and yet, of course, every case must be suspected of genital herpes, and genital herpes is a sexually transmitted sexually transmitted disease , this is a great tragedy for our patient, we must understand that family relationships can change. And if a woman or man is not yet married, they have some restrictions on sexual intercourse. Of course, we must clearly diagnose them that it is genital herpes, especially since there are diseases that are similar, also accompanied by ulcerative manifestations and similar to herpes, but this is not herpes. So as not to confuse herpes with syphilis and lichen planus, and Behcet's disease (this is a very interesting disease, but there is no time to talk), with recurrent candidiasis. By the way, in patients with genital herpes in 30% of cases this is the cause of recurrent candidiasis infection. Therefore, if a patient has 4 or more exacerbations of candida during her life, she must be examined for genital herpes. It is also necessary to carry out a differential. diagnosis with scabies, and with a banal injury, and with pemphigus. By the way, I didn’t diagnose it once, I don’t know, dermatovenerologists sometimes have to show these patients, because we don’t encounter pemphigus. And with streptococcal impetigo, which, in general, is well known to dermatologists, so sometimes you have to turn to our colleagues.

Therefore, today the diagnostic method is, of course, a clear method. It is necessary to find the DNA of the herpes virus type 1 or 2 using real-time PCR. With high specificity and sensitivity, this method is in no way inferior to the classical cultural method. But, if you use the immunoenzyme method or immunofluorescent method in your clinics, then you should avoid such methods, because they have very low specificity. I want to say right away that here are bacterial infections, when we correctly perform oncocytology on patients, or, more correctly, a PAP test, then at the same time we determine how many leukocytes are in the smear, what type of cells, then the recommendations clearly state: the PAP test method is not can never be used to diagnose genital herpes because you won't see anything on the smear. This must be remembered. Today in Russia, unfortunately, we detect mixed antibodies in the blood to both type 1 and type 2. And 95% of our population are carriers of types 1 and 2 of herpes, a combination of these types. Therefore, it is impossible to diagnose genital herpes based on blood, because 20% suffer, and you will unwittingly increase the number to 95%.

Using mixed antibodies, we identify only a group of patients, especially pregnant women, when we look at TORCH infections that are seronegative for genital herpetic infection... - for herpetic infection, sorry, not genital, but simply for herpetic infection in general - and then in During pregnancy, we monitor whether seroconversion to the causative agent of a simple herpes virus infection has appeared, and we monitor precisely the 5% of women who do not have antibodies to herpes. Therefore, today it is impossible to make a diagnosis using blood tests, either in Russia or in the world, because these type-specific IgG2 antibodies are very expensive, and they are not used for clinical practice in the West. They are resorted to in the West, we don’t have them, because they are very expensive, only in cases that are difficult to resolve in Russia, when you see herpetic rashes, classic herpetic fever over and over again, take a smear from the cervical canal, and do not find the pathogen , do not find viral DNA. In this case, they resort to serological studies.

The question arises: maybe infection, if the genital herpes virus can be excluded with the help of a seronegative antibody test, and this is also incorrect. Antibodies are an additional method. In Russia they really like to focus on antibodies. It’s impossible, because they should theoretically form by the 22nd day from the moment of infection, but in 20% they do not form within the next 3 months. That is why a woman who is seronegative in the first trimester of pregnancy should take it in the second and third trimester and monitor the appearance of seronegativity. There is another very important point. Why are there so many genital herpes infections? People do not want to infect each other in the acute period, when the maximum number of rashes is on the genitals. But no one, unfortunately, knows that 7 days before the rash and 7 days after the rash has healed, there is a severe reproduction of the virus, the virus is isolated from the intended focus, and at this moment our patients remain sources of infection.

How can you reduce the risk of transmission? Of course, using condoms is a must. Of course, in the first year of the disease, it is clear that the highest percentage of infection is in a sexual couple. Of course, during exacerbations, of course, you cannot be sexually active. But there is also a method that allows people who are in discordant couples to live peacefully, that is, if one sexual partner suffers from genital herpes, and the second is either an asymptomatic carrier, but he thinks that he is healthy, or is actually healthy. If the patient, by the way, is a woman, suffering from frequent severe forms of genital herpes, she should use famciclovir as a suppressive therapy, and in 95% of cases she will not secrete the virus, and the risk of transmission of the infection is reduced by 48%. These were international studies using the example of valacyclovir, but only 48%. But this is of great importance, of course. Does genital herpes cause complications? I'm talking now about genital herpes. Complications? Yes unfortunately. Especially during the initial episode, during pregnancy. Aseptic meningitis also happens; they are more common in women; they are three times less common in men. Sporadic encephalitis may occur.

Ellsberg syndrome may develop. This is a syndrome characterized by radiculoneuropathies, when the patient cannot even urinate, she has temporary paralysis of the lower extremities, and severe radicular pain. Fortunately, they are treated with nucleoside analogues, and neuropathologists, in particular, must be involved in this treatment. Bell's syndrome, when neuritis of the facial nerve occurs with genital herpes, is very common. Much less often - damage to internal organs, there may even be hepatosis and pneumonitis. And it should be remembered that in all cases when there are exacerbations, it is imperative to start with specific therapy with nucleoside analogues, and it is mandatory to use it, treatment must be carried out together, it is imperative to involve specialists in neuropathologists, dermatologists, and so on. As for how we should interpret our laboratory results, and how we should treat our patients. Today, there is only one strict approach in the world - to use nucleoside analogues for genital herpetic infection. Unfortunately, Russia is a special country where they use either immunomodulatory therapy - perhaps immunomodulatory therapy is the future in the treatment of genital herpes, but immunomodulators have not yet been found - or combination therapy. But, from the point of view of pharmacotherapy, this is generally absurd.

If the effectiveness of nucleoside analogues is 95%, why increase it to 98, perhaps using or adding immunomodulators? This is unrealistic. Therefore, we must still adhere to international recommendations, which state that genital herpes should be treated with nucleoside analogues. And today we are discussing Famvir, a drug derived from penciclovir, and the mechanism of action of the drug is that, for this, the Nobel Prize was given, that this drug, if the patient does not have acute reproduction of the virus in the body, and when virus reproduction begins, it is released the enzyme thymidine kinase, which generally does not appear in any situations in the human body, except acute infection with genital herpes or extragenital herpes. Therefore, under the influence of thymidine kinase, famciclovir begins to transform from its inactive form into mono- and triphosphate, and the triphosphate has an active effect. But I want to tell you right away that famciclovir, according to FDA recommendations, like valacyclovir, is not approved for pregnant women. Therefore, today we will not touch upon pregnancy, and we will discuss the treatment of our patients with famciclovir outside of pregnancy.

And I emphasize once again why we are talking about this drug today - because the drug has high bioavailability, good affinity for thymidine kinase, and no mutant strains are formed. Because I have extensive experience using drugs, both acyclovir and valacyclovir, and in some cases patients receive drugs and say that there is no effect. We now have a new drug that will help us in these situations. We ourselves unwittingly form mutant strains, and international recommendations state that genital herpes is a disease of the whole body, and therefore today no one uses acyclovir cream for this pathology, because it is believed to be responsible for the development of mutant strains. What are the modes of using famciclovir? For an acute episode, for a primary episode of genital herpes, we use famciclovir 250 milligrams 3 times a day for at least 5-7 days, so the drug exists in two doses - 250 milligrams and 125 milligrams. Moreover, we begin treatment with the drug immediately upon suspicion.

If we diagnose a patient with genital herpes, having received a positive response from the DNA probe, the presence of genital herpes, then we begin treatment as soon as the patient comes to us, and we suspect only this pathology. Because if she does not have genital herpes, if she has this ulcer due to trauma, then there will be no thymidine kinase in the body, and the drug will not have any effect, and non-activated famciclovir has no effect on uninfected cells, there will be no negative effect on the body, and it will be positive if we start treating early. The slide shows that, unfortunately, and you must understand this, not a single nucleoside analogue today can cure a patient of genital herpes, because over the next 48-72 hours the virus enters the nerve ganglia, and there has been in the form of naked DNA for 64 years. Then, as soon as some provoking factor acts, for women this is often menstruation, so an exacerbation of type 2 infection is often associated with menstrual days, the virus again takes an ascending path to the place where it first arrived. But, if a patient in a suppressive mode receives a drug, it is in her body all the time, she does not yet know that she has an exacerbation, and the secreted thymidine kinase activates the drug, and a kind of hidden treatment occurs.

Therefore, a suppressive therapy regimen for severe forms of herpes is necessary. But if the patient no longer has a primary episode, but a repeated exacerbation, then the dose can be halved, and it is 125 milligrams, and no longer 3 times a day, but 2 times a day for 5 days. Who is given such regimes? Our patients, who have few exacerbations, have 1 exacerbation or 2 exacerbations per year. If there are 6 or more exacerbations per year, then this regimen does not give anything. With such severe exacerbations, the exacerbation can be sharply shortened, if you take 4, 4 tablets 2 times a day at a time during the day, then even this exacerbation in every fourth case will be stopped very quickly within a few hours. If our patient, as I told you, suffers from frequent exacerbations, 6 or more exacerbations per year, this is a severe form of herpes, we give famciclovir 250 milligrams 2 times a day. And how long? Up to 12 months. After this, you need to take a break and see what kind of exacerbation regime the patient will have. And you say: “What kind of drug is this that we have to give to our patients for 12 months? What will happen to their liver, kidneys, and so on?” Nothing will happen. Because within 12 months, in fact, there is an exacerbation, maybe the drug works, maybe 20 days, because he understands that the virus has been assembled, thymidine kinase has appeared, within a few hours the reproduction of the virus is blocked, and again the drug is just like is suspected to be in the body without causing any pathological effects on uninfected organs and systems.

So, the effectiveness of famciclovir is high, 90%, and therefore we think that there is no point in changing the regimens for the use of drugs that are currently proposed by International recommendations, in particular European ones. Let me emphasize once again that the creators of these recommendations are our domestic professors, in particular, dermatovenerologists. And here is such a beautiful slide. This is how Salvador Dali imagined genital herpes. But in fact, he has a completely different appearance. But imagination is perhaps more important than knowledge, said Einstein. And maybe on this basis we will create new drugs. Thank you for attention.

Antiviral agents for the treatment of herpes in the intimate area

Many patients, noticing symptoms of herpes in the genital area, resort to the use of antibiotics.

This is a common mistake that is caused by little awareness of what the nature of the infection is.

It is worth remembering that antibacterial agents are not helpful in the fight against herpes.

It refers not to bacteria, but to viruses.

Therefore, antibiotics may not only not kill it, but also increase its activity, which patients often forget about.

To cope with the infectious process in the body, the patient is recommended to give preference to drugs with antiviral activity.

Medicines in this group are divided by method of use, active ingredients and a number of other indicators.

Because of this, you should not make a choice of therapy on your own.

Moreover, frequent herpes in the intimate area should be treated exclusively under the supervision of an experienced doctor who can select effective combinations of drugs.

Naturally, therapy is not limited to the use of antiviral drugs.

In each case, the doctor can supplement the recommendations depending on how complex the case is.

Immunomodulatory therapy

Another stage of complex treatment is immunomodulatory therapy aimed at strengthening the body's defenses. For this purpose, interferon preparations (Viferon, Genferon) are prescribed, as well as interferon inducers (Amiksin, Cycloferon), which have an antiviral effect and promote the production of interferon in the body.

A good effect is achieved by the use of vitamin therapy, in particular the prescription of calcium, zinc, vitamins B, C, E. In order to reduce the frequency of relapses, the patient may be prescribed subcutaneous administration of immunoglobulins. This treatment regimen helps restore the body's defenses and direct them to fight the viral infection.

Oral preparations for herpes in the intimate area

Acyclovir is the best-known and most common medicine used if it is necessary to start fighting viral rashes that appear in the intimate area.

The drug has proven itself to be an effective remedy that stops the multiplication of the virus.

Helps cope with the main symptoms that cause the most inconvenience.

Contrary to popular belief, Acyclovir is available not only in ointment form, but also in tablet form.

If the infection cannot be controlled for a long time, the drug can be used to defeat the virus.

In addition to Acyclovir, there are other tablet drugs intended for oral use.

Among them, for example, Valacyclovir, Famciclovir.

These products also have high antiviral activity and have proven themselves to be effective in the fight against genital herpes.

Doctors note that the regimen for using antiviral drugs should be selected individually.

It must be adjusted depending on how severe the symptoms of the disease are in a particular case in a particular patient.

Treatment of genital herpes with ointment - how effective is it?

A number of medications are used to treat and relieve symptoms of genital herpes.

Over-the-counter painkillers such as paracetamol and ibuprofen can help relieve pain. If there is pain when urinating, it is recommended to take a warm bath.

Anesthetic ointment for genital herpes with iceocaine relieves itching or pain. You can lubricate the skin with ointment 5 minutes before urinating to relieve pain. Some patients may be allergic to the pain-relieving ointment, and using such a drug may worsen symptoms. Instead of anesthetic ointment, you can rub Vaseline into the skin before urinating.

External preparations for herpes in the intimate area

Ointment for herpes in the intimate area is the most popular option for a drug that helps cope with the infectious process.

With the help of external means, it is possible to defeat the multiplication of the virus in foci, reduce the feeling of itching, and reduce the severity of pain, if present.

It is important to keep in mind that many doctors prefer to initially prescribe ointments or creams in the fight against the virus.

This reduces the burden on the body and helps protect the body from the side effects of drugs that occur when taken systemically.

There are many names for ointments for herpes in the intimate area.

As with tablets, the most popular drug is Acyclovir.

In the form of an ointment, it does not lose its effectiveness, quickly relieving unpleasant symptoms and contributing to the disappearance of rashes on the lips.

Levomekol is also successfully used for herpes in the intimate area, as doctors note.

The drug easily copes with the disease if it is possible to catch it in the early stages of development, and the virus itself does not show very high activity.

In addition to Levomekol and Acyclovir, for example, Panavir, Herpferon can be used.

Ointments can be combined with systemic therapy if such a recommendation is given by the attending physician.

Often, local treatment enhances the effect of the systemic drug, helping to quickly defeat the disease.

Topical antiviral drugs for the treatment of HPV (papillomavirus)

Some topical antiviral drugs active against papillomaviruses, in contrast to a number of drugs that help against the herpes virus, have a strong evidence base and are used throughout the world to treat manifestations of HPV - in particular, condylomas.

Imiquimod

An immune response modifier that does not have an antiviral effect. It exhibits activity due to the ability to induce the production of interferon-alpha and other cytokines. Indicated for the treatment of genital warts in the urogenital area [5].

Release: by prescription.

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Solid evidence base. The drug definitely reduces the viral load. The use of imiquimod cream 5% 3 times a week at night for 16 weeks has been proven to be effective and safe for the treatment of condylomas. The relapse rate is estimated to be low [8]. Imiquimod is recommended for the treatment of genital warts by the authoritative American regulator FDA [8].

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When applying imiquimod, itching and pain are observed in more than 10% of cases [5], which the buyer should be warned about.

Immunomodulators for herpes in the intimate area

When answering the question of why herpes often appears in the intimate area, doctors place special emphasis on the fact that the disease is often provoked by a decrease in immunity.

To support the patient’s immunity and force him to adequately respond to negative external influences, it is recommended to use immunomodulators.

These medications help activate the immune system, allowing it to act more aggressively on pathogenic microorganisms that enter the area of ​​their work.

Among the immunomodulators, the most commonly used are, for example, Viferon, Genferon.

These drugs, in combination with the main antiviral treatment, have proven to be quite effective.

They do not have a direct effect on the development of the disease, but can significantly reduce its duration.

Symptoms under the influence of immunomodulators also do not decrease in severity.

However, it is possible to reduce the duration of the course of taking drugs internally or externally if immunomodulators are used correctly.

Folk remedies

Herpes in an intimate place is treated with folk recipes in combination with medications. It is imperative to coordinate the chosen treatment with a specialist.

1. Compresses with arnica. A decoction of arnica inflorescences is prepared from 12 g of herb and 400 ml of water. The product is infused for an additional 2 hours, pieces of natural fabric are soaked in it and applied to the inflamed areas.
2. This recipe is for women. Candles made from beeswax with the addition of aloe and kalanchoe are very useful. Making them at home is not difficult. The plants are crushed, vitamins are added in ampoules B1 or B12, poured with molten wax and mixed thoroughly. The resulting product is laid out on a piece of bandage and a small candle is formed. Inserted into the anus or vagina. Depending on which organs the rash has formed on: in the back of the perineum or on the labia, you need to approach use specifically for each place.
3. Infusion of birch buds. The drug is prepared from 25 g of phyto-raw materials and 1 glass of 70% alcohol. It is infused in the dark for 2 weeks, then filtered and used to rub herpes blisters.
4. There is an effective folk method to strengthen the immune system. You need to extract juice from apples and onions. The proportions are taken 1/1. Dilute the liquid with pumpkin juice and consume a tablespoon 3 times a day. These products contain vitamins that have a positive effect on the immune system.

The simplest and most affordable recipe at home is aloe juice. The plant leaf is washed, cut and applied to the areas of infection. If there is a rash on the labia. You can grind aloe into a paste, apply it to the affected area, secure it with a bandage, and put on underwear on top. Compresses are changed after 1-3 hours.

Treatment of herpes in the intimate area in pregnant women

During pregnancy, the herpes virus poses a particular danger, since the lives of two people are at risk.

Moreover, as doctors say, pregnancy is always an immunosuppressive condition, which can be one of the triggers that triggers the activation of pathogens in the body.

So it is not surprising that pregnant women seek medical help for rashes in the genital area.

It is worth keeping in mind that herpes is a pathogen that can lead to the formation of various abnormalities and deformities in the fetus.

Its activation poses the greatest danger in the first weeks of pregnancy.

When the child’s body is just at the stage of formation, and the main organs and systems have not yet been formed.

Patients whose pregnancy is combined with genital herpes should only be treated by a doctor.

At the same time, when choosing medications, the doctor will be able to take into account not only the effectiveness, but also the potential harm to the fetus.

Acyclovir preparations in any form are almost never used in pregnant women.

Preference is given to Panavir, Vivorax and other more harmless medications.

Immunostimulating therapy is also prescribed with great caution.

Since there is a possibility of harming the pregnancy process.

Diagnostics

Diagnosis is mainly based on the clinical picture. But in uncertain cases, they turn to laboratory tests.

Materials are taken from those infected with genital herpes for various tests:

• determination of virus culture;
• polymerase chain reaction to determine the genetic material of the virus;
• carry out tests using antibodies to the genital herpes virus to confirm the presence of the disease.

The doctor or laboratory worker takes a sample from the rash, sometimes the patient's blood, to confirm the immune response to the presence of genital herpes. To identify antibodies, a test product is taken from the rash, mucus, urine, tear fluid, and rarely, cerebrospinal fluid are also collected.

Possible complications of genital herpes

Patients are often interested in the question of why herpes in the intimate area is dangerous.

After all, it would seem that the disease occurs in many people and is tolerated quite easily.

However, treating pathology carelessly is a serious mistake.

Herpes can cause complications in some cases.

They are most often caused by inadequate functioning of the immune system.

For example, the virus is tropic not only to mucous membranes, but also to nervous tissues.

If left untreated, it can cause neurological diseases, the severity of which can vary greatly.

Herpes itself is also an immunosuppressant, reducing the already poorly functioning defense even more when activated.

As a result, the risk of developing other infectious diseases increases.

In particular, one should not exclude the development of secondary infections directly on the rash.

Since they are a violation of the integrity of the skin.

Often, herpes leads to an exacerbation of the human papillomavirus.

As a result, a person develops papillomas and condylomas, which can cover not only the intimate area, but also other parts of the body.

Synthetic antiviral topical drugs

This group of drugs can be roughly divided into drugs used for genital herpes infection and antiviral drugs prescribed for the treatment of papillomas and condylomas associated with papillomavirus infection.

Local medications for genital herpes

Several drugs registered in the Russian Federation are used for the treatment and prevention of relapses of genital herpes.

Tromantadine

An antiviral drug for herpes, an adamantane derivative (similar to the well-known antiviral drugs rimantadine and amantadine). Inhibits the attachment of the virus to the surface of the cell membrane, preventing the pathogen from penetrating into the cell. Prevents cell fusion and makes it difficult for the virus to spread by changing the synthesis of glycoproteins [5]. Available in the form of a gel for external use, which can be applied to mucous membranes during exacerbation of HSV infection [5].

Vacation: without prescription.

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There is evidence of the development of a contact allergic reaction when using the drug [7].

Sodium aminodihydrophthalazindione

An immunomodulator capable of regulating the activity of innate and acquired immune cells, including macrophages, neutrophils and natural killer cells. At the same time, this antiviral drug against herpes increases the body's resistance to bacterial, viral and fungal infections, reducing their frequency, severity and duration (5). In addition, the drug normalizes the formation of antibodies and regulates the production of interferons, and also blocks the excessive synthesis of pro-inflammatory cytokines and reduces the level of oxidative stress (5).

Vacation: Without prescription

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High safety profile (5).

Azoximer bromide

A Russian drug supposedly exhibiting an immunostimulating effect. According to the instructions [5], it directly affects phagocytes and natural killer cells, stimulates the formation of antibodies and the synthesis of interferon, and exhibits antioxidant and detoxifying properties. In domestic practice, it is used for a wide range of diseases - from influenza to malignant neoplasms.

Azoximer bromide vaginal suppositories are used to prevent recurrence of genital herpes.

Vacation: without prescription.

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High safety profile. According to the manufacturer [5], no side effects have been reported.

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Azoximer bromide suppositories are not indicated for the treatment of active herpes!

Treatment of herpes type 3

Herpes simplex virus type 3 (HSV-3) is the cause of infectious diseases such as varicella (chickenpox) and shingles.

Most people experience a viral infection during preschool age, but cases of infection in adulthood are also not rare. Herpes zoster most often occurs in adulthood and old age.

This type of herpesvirus is also characterized by a lifelong existence in the human body: it is impossible to completely recover from the virus; throughout life, the virus “dormants” in the tissues of the nervous system.

Symptoms of chickenpox include fever, rash on the skin and mucous membranes, itching; in mild forms of the disease, a small amount of elements may form on the skin; body temperature does not rise.

Shingles is also characterized by skin rashes, general weakness, itching, and fever.

Treatment of viral herpetic infection type 3 is multi-stage, complex. Since it is not possible to get rid of the virus, the goals of therapy are as follows:

• Reduce pain during acute illness
• Shorten the regeneration period of skin manifestations
• Reduce the likelihood of complications such as postherpetic neuralgia

1. Etiotropic (directed at the cause of the disease) therapy: antiviral drugs are used in the first three days from the onset of symptoms. These drugs can suppress the spread of the virus; they reduce the activity of viral particles. The duration of treatment is on average 7–10 days.
2. Symptomatic therapy: due to severe pain, itching and discomfort accompanying skin manifestations of HSV-3, analgesics and non-steroidal anti-inflammatory drugs (ibuprofen-based drugs) are prescribed; At elevated temperatures, antipyretics are recommended. Anticonvulsants prescribed for acute HSV-3 (carbamazepine) also reduce the severity of pain. Treating skin rashes with antiseptic solutions prevents the risk of developing infectious complications.
3. Increasing the body's defenses with the help of interferon inducers and immunomodulators.
4. Specific immunotherapy: it is necessary for infection with HSV-3 during pregnancy; such therapy consists of the administration of specific immunoglobulin in the early postpartum period.
5. Antidepressants: this component of therapy is aimed at reducing discomfort and correcting the psychological state.
6. Physiotherapy: successfully used due to positive treatment results. Methods of influence such as electrical neurostimulation, magnetic therapy, laser therapy, hyperbaric oxygenation, and reflexology are used.

The duration of treatment for herpes zoster is from 7 to 14 days for an uncomplicated process and up to 3-4 weeks for a process complicated by pustular infection or neuritis.

Complications

Genital herpes itself does not cause serious illness. However, its complications, which are often observed in people with weak immune systems (especially those with HIV infection), can pose a serious threat to health and even life.

1. Herpetic eczema is a skin lesion that leads to the appearance of a rash similar to that of eczema;
2. Herpetic keratoconjunctivitis is a lesion of the cornea and mucous membrane of the conjunctiva of the eye. Manifested by photophobia, burning, lacrimation, redness of the eye. Small white spots appear on the surface of the cornea, causing itching and pain. Without treatment, vision loss is possible;
3. Herpetic encephalitis is an inflammation of the brain caused by the HSV type 2 virus. Without treatment, the complication leads to death. The virus infects nerve cells in the cerebral cortex, leading to focal and general brain symptoms. Complete cure is possible with adequate and timely therapy;
4. Intrauterine herpes is the transmission of infection from mother to child. Primary infection is dangerous, which leads to damage to the fetal nervous system;
5. Herpetic meningitis is an inflammation of the meninges caused by the HSV type 2 virus. A severe complication leading to a number of neurological symptoms, including convulsions, severe headaches, and disturbances in the circulation of cerebrospinal fluid.

In people with normal immune status, complications are rare. On average, the acute phase of infection during primary infection lasts several weeks. During this period, the infected person releases a large number of viral particles with biological fluids. Carriage lasts up to 1 year. In most cases, the immune system controls the infection and suppresses its activity. This occurs due to the production of antibodies directed against the virus. During the period of remission, the virus remains only in the nerve cells of the sensitive nerve plexuses.

In patients with immunodeficiency, the herpes simplex virus often causes complications. Infection is especially dangerous in patients with AIDS. Herpetic lesions in such patients are extensive and often occur in the form of severe meningoencephalitis with a fatal outcome.

Treatment of herpes type 1

Herpes virus type 1 (HSV-1) is a type of herpes virus that affects the trigeminal nerve. Most people know this common virus as a cold sore. Manifestations of the virus appear on the skin around the lips and directly on the red border and wings of the nose. They look like bumps against a background of redness, which then transform into blisters, erosions, and crusts. The course of the infection consists of periods of exacerbations and remissions; the virus is constantly located in the nervous tissue and is activated under favorable conditions (hypothermia, weakened immunity, various diseases, stress). Complications of a viral infection are possible, such as damage to other areas of the skin and internal organs.

Treatment of herpes type 1 during exacerbation

1. The use of drugs whose action suppresses the further development of viral infection. Both external (creams, ointments) and internal (tablets, injections) and combined treatment are possible. Therapy with antiviral drugs is necessary during exacerbation of the disease.
2. The use of immunomodulators, prostaglandin inhibitors, interferon inducers: this is necessary to activate the immune defenses to fight the virus.

Treatment during an exacerbation period lasts on average no longer than 10–14 days.

Treatment of herpes after remission

After the disappearance of external manifestations of infection, immunomodulatory drugs, physiotherapy, ozone therapy, and plasmapheresis are used. The patient is advised to reconsider his lifestyle, give up bad habits, and eat right. When 2–3 months have passed after recovery, vaccine therapy is carried out in order to form an immune response. Special vaccines used:

• live weakened
• inactivated (“dead”)
• split vaccines (“divided” into proteins and nucleic acids)

Due to the proven oncogenicity of the herpes simplex virus, the use of vaccines is a rather controversial method of treatment. Thus, live and inactivated vaccines are considered dangerous in terms of the risk of developing cancer pathologies, and split vaccines, despite their apparent superiority and novelty, may have low effectiveness.

Based on the above, it is obvious that the herpes simplex virus type 1 must be suppressed during exacerbations, and it is better to prevent the development of exacerbations as such.

Treatment of herpes type 4

Among herpes viruses, type 4 is extremely widespread, also known as the Epstein-Barr virus. Just a few years ago they didn’t write about him as much as they do now; Meanwhile, the diversity of its manifestations should not give reason to take this type of herpesviruses lightly. The virus is the cause of diseases such as infectious mononucleosis, multiple sclerosis, lymphogranulomatosis, Burkitt's lymphoma, oncological diseases of the gastrointestinal tract, nasopharynx, etc.

Treatment of herpes type 4 can be called multi-stage, complex, individual: everything depends on various factors, such as, first of all, the course of the disease, the severity of symptoms, as well as the state of the immune system, the presence or absence of diseases.

It should be noted that the course of the infection can be both latent and pronounced. Mild forms of viral infection, reminiscent of a common acute respiratory viral infection (often even without a rise in temperature) are subject to outpatient treatment and do not require medication, with the exception of symptomatic remedies.

If the disease occurs with a rise in temperature, deterioration of condition and general well-being, hospitalization is often required.

Therapy can be described as follows:

1. Bed rest, drink plenty of fluids.
2. Mobilization of the body's immune forces with the help of immunomodulators (Viferon, Cycloferon), alpha interferon (Roferon, Reaferon). The administration of immunoglobulin (Sandoglobulin, Polygam, etc.) is also indicated.
3. Nonspecific antiviral treatment with abnormal nucleotides, acyclovir (in severe cases, administered intravenously).
4. Symptomatic remedies: painkillers, antipyretics, vasoconstrictor drops, gargling.
5. Antibiotics for infectious complications.
6. For swelling of the pharynx, hormones (corticosteroids) are prescribed.
7. Adaptogens, B vitamins, and nootropics are also used. In some cases, the prescription of antidepressants and psychostimulants is indicated.

The infection is not completely cured, so improving health is of great importance to prolong the period of remission. You should give up bad habits, including food habits, treat diseases in a timely manner, and get rid of foci of chronic infection.

Epidemiology

Genital herpes, being a special case of herpetic infection, is one of the most common sexually transmitted diseases, and differs from other diseases of this group in the lifelong carriage of the pathogen in the human body, which determines the high percentage of formation of recurrent forms of the disease.

Transmission routes

Transmission usually occurs through close contact with a sick person or a virus carrier. The virus penetrates through the mucous membranes of the genital organs, urethra, rectum or microcracks in the skin.

In couples where one partner is infected, the probability of infection of the second partner within a year is 10%. In most cases, infection occurs when the infected partner has not had a clinically significant recurrence of genital herpes. Asymptomatic and unrecognized forms of infection play an important role in the spread of the virus. The virus can be excreted in sperm; cases of infection of women during artificial insemination have been described. Speaking about the routes of transmission of the virus, it is necessary to note the important epidemiological significance of oral-genital contacts, which are associated with an increase in the frequency of isolation of herpes type 1 from the genitourinary system.

Who gets sick more often?

Among college students, antibodies to the herpes virus type II are detected in 4% of those examined, among university students - in 9%, among representatives of the middle strata of society - in 25%; among patients in dermatovenerological clinics with heterosexual orientation – 26%; among homosexuals and lesbians – 46%, among prostitutes – 70–80%. Antibodies to genital herpes are more often detected in representatives of the Negroid race than in whites. Women are infected more often than men, with the same number of sexual partners during their lifetime. In developed countries, the virus affects 10–20% of the adult population.

Numerous studies on the general population have shown that the incidence rate increases with age: isolated cases are detected in a group of patients aged 0–14 years; the highest incidence is recorded in the age group 20–29 years; the second peak incidence occurs at 35–40 years of age.

The main risk factors for developing the virus are a large number of sexual partners throughout life, early onset of sexual activity, homosexuality in men, belonging to the black race, female gender and a history of sexually transmitted infections.

Mandatory registration of genital herpes was introduced in the Russian Federation in 1993. During the period 1993–99, the incidence of this virus in Russia increased from 8.5 cases to 16.3 per 100 thousand population. The incidence in Moscow increased from 11.0 to 74.8 cases per 100 thousand population and almost reached the level of European countries.

Herpes: questions and answers

Is it possible to treat teeth with herpes?

Dentists say that it is possible to treat teeth with herpes, but they strongly advise against doing so. If it is possible to postpone the procedure, it is better to postpone it for 1-2 weeks, when the blistering rashes completely disappear. If the toothache is mild or moderate, specialists will help relieve it with safe medications, and the therapy itself will begin after the exacerbation of herpes has passed. In critical cases, if you need urgent surgical intervention, you will be helped in any dental clinic, despite the presence of concomitant diseases.

We recommend monitoring the condition of your teeth and undergoing regular preventive examinations so that in the future there is no reason for urgent dental treatment during the period of herpes. We advise the same regarding viral infections. This pathology is difficult to control. Often its symptoms appear at the most inopportune moment. If you are tired of discomfort on your lips, spoiled appearance and constant itching, contact our medical center and get rid of this problem.

Can you drink alcohol if you have herpes?

In this case, alcohol does not have a negative effect directly on the affected area. However, drinking it during an exacerbation of herpes is still not recommended, since alcohol has a bad effect on the body as a whole. When it is consumed, the body begins to spend energy on eliminating alcohol and turns on compensatory mechanisms, which leads to even greater fatigue and a decrease in protective reactions. Medicine has long recognized that there are no safe doses of alcohol. There are no direct contraindications to drinking alcohol during an exacerbation of herpes, however, specialists at our Private Practice clinic strongly do not recommend this for the following reasons:

1. Alcohol can worsen existing allergic reactions or provoke new ones in response to one of the medications you are taking.
2. Alcohol increases the load on the liver, which at this moment is already working on the biotransformation of drugs and the removal of infectious toxic products.
3. The likelihood of developing side effects with any treatment regimen for alcohol intake increases significantly.
4. Alcohol further suppresses the immune system, which complicates the treatment of herpes and delays the moment of recovery.
5. Alcoholic drinks retain fluid in the body, which slows down the removal of toxins and cleansing of the bloodstream.

Of course, if there is an important reason, drinking alcohol in small quantities is allowed even while treating herpes. In the absence of abuse, the possible risks are minimal. At the same time, we try to convey to each patient the importance of following the prescribed treatment regimen and the need for dedication, since the patient himself is primarily interested in a successful result.

Thus, our medical doctor takes the position that you can drink alcohol if you have herpes, but you shouldn’t do it. Following a correct lifestyle and a competent treatment regimen drawn up by our specialists guarantee the achievement of the desired and quick result.

Is it possible to wet herpes?

The common belief that herpes cannot be wetted is incorrect. The water itself does not have a negative effect on rashes and damaged skin. It does not increase the symptoms of the disease and does not contribute to its progression. On the contrary, it is recommended to keep the skin affected by blisters clean to prevent secondary infection and speed up healing.

You can wash your face if you have blisters on your lip, and you can also take a shower if you have rashes on your body. In this case, you should follow some precautions:

• during an exacerbation, take a shower rather than a bath;
• the water temperature should be comfortable, and prolonged bathing and the use of hot water should be avoided;
• It is better to simply wash off dirt and sweating with water using the palm of your hand, rather than using a washcloth. During the period of exacerbation, the use of hygiene products that contain added dyes and fragrances is also subject to restrictions;
• After swimming, it is better to pat your skin with a towel rather than dry yourself with it. We recommend using two towels, one of which should be in contact with the affected areas of the skin, and the other with healthy areas.

Is it possible to take baths if you have herpes?

We do not recommend taking baths if you have herpes. To maintain hygiene, it is enough to take a shower every day. Hot baths and prolonged swimming can reduce the skin's protective properties and also contribute to the spread of infection to neighboring areas. The exception is short-term therapeutic baths after the acute stage of the disease with the addition of agents with bactericidal properties.

Is it possible to go to the pool with herpes?

Herpetic blisters periodically burst, and the affected area of ​​skin turns into an open wound. This area should be protected from possible infection and any damaging factors. We do not recommend going to the pool if you have herpes, as the likelihood of skin damage increases. The main reasons are the addition of aggressive disinfectants, as well as prolonged exposure to water. In addition, you must remember that during the period of exacerbation of herpes infection you are very contagious and should not attend open groups.

Is it possible to give birth with herpes?

The birth process is quite complex and is accompanied by rupture of blood vessels and bleeding. Open blood flow significantly increases the likelihood of the baby contracting infections that the mother has. When preparing for the upcoming birth, the question becomes relevant: is it possible to give birth with herpes and what is the best method to do this. According to American studies, herpes during pregnancy is transmitted from mother to child in less than 1% of cases. If a woman had relapses of herpes before pregnancy, then the child is reliably protected from infection by maternal antibodies to the virus. The woman chooses the method of delivery together with the gynecologist, and natural childbirth is also possible.

Is it possible to breastfeed if you have herpes?

Everyone knows that during an exacerbation of herpes, it is better for the patient to protect himself from any contact with others - shaking hands, using common household items, etc. This is due to the fact that the blistering rash contains a high concentration of the virus and there is a high risk of infecting other people. Considering this, the question arises whether it is possible to breastfeed with herpes, because this process involves the closest possible contact between the child and the young mother.

According to American studies, breastfeeding during exacerbation of herpes virus infection is possible. Specialists at our Private Practice clinic recommend not interrupting breastfeeding even if there is a relapse of a viral infection in the mother, since breast milk is the best nutrition for a newborn. In addition, antibodies to the virus enter the child’s body with mother’s milk, thereby providing the baby with stable antiherpetic immunity.

Is it possible to smear herpes with brilliant green?

Zelenka is not an antiviral agent. Its benefits for herpetic rashes include drying the wound, accelerating cell regeneration and preventing bacterial infection. You can smear herpes with brilliant green, but this should be an addition to the main treatment, and not monotherapy. Our Private Practice clinic offers everyone to undergo a detailed diagnosis of virus carriage, as well as receive an individual treatment regimen to reduce the frequency of relapses.

Is it possible to smear hydrogen peroxide on herpes?

Peroxide is an antiseptic that, when it gets into a wound, causes virtually no pain, unlike iodine and brilliant green. Thanks to this, the remedy has become quite popular, including in the fight against herpetic rashes. In their practice of treating herpes, our doctors do not discourage the use of peroxide externally, but we need to clarify why this should be done. Peroxide is used for its intended purpose (as an antiseptic) and is not an antiviral agent. Free oxygen, which is released from the peroxide when interacting with the virus, has a detrimental effect on the cell wall of the pathogen. An additional benefit is the ability to expel dead organisms and cleanse the wound. However, modern medicine, which is followed by highly qualified specialists at our clinic, suggests using antiviral drugs with proven effectiveness instead of peroxide. We will select an individual treatment regimen for each patient and help avoid relapses.

Is it possible to smear herpes with iodine?

We can confidently answer: only two methods are effective in the fight against viral infections. The first is the use of antiviral drugs, the second is an increase in the immune response. Iodine is an antiseptic and acts as an oxidizing agent. The popularity of its use for herpes is explained by its ability to dry out blisters, destroy cells damaged by the virus and prevent secondary infection. The product can be used to accelerate wound healing and cell regeneration. It is possible to cauterize herpes with iodine, but you need to understand that the procedure is not done to kill the virus, but rather is a way to prevent bacterial infection. It is strictly not recommended to use concentrated iodine solutions to cauterize herpes with iodine if rashes appear in the genital area, since these areas of the skin are very sensitive.

Can you treat herpes with toothpaste?

Toothpaste is one of the popular folk remedies for combating herpetic rashes. If you smear toothpaste on herpes, unfortunately, you will not be able to kill the virus. It lives inside the body, and symptoms of the disease appear only when immunity decreases. The secret to the effectiveness of toothpaste is its fluoride content (other toothpastes are not suitable for such purposes). This element destroys the membranes of damaged cells, accelerates tissue renewal and wound healing, which leads to faster disappearance of symptoms and recovery. Our medical center offers a more modern approach to the treatment of herpes viral diseases. If you believe in the power of toothpaste, try to choose products based on herbal ingredients, as they will additionally have an anti-inflammatory and drying effect.

Is it possible to cauterize herpes?

When characteristic rashes appear, many patients try to immediately cauterize the blisters with iodine, brilliant green or alcohol. However, a virus is an infectious agent that penetrates inside a human cell and, thanks to it, continues to live and multiply. It is possible to cauterize herpes, but it is recommended to do this to prevent the development of a secondary infection, and not to destroy the virus. Our Private Practice clinic advises all patients to use non-alcohol-based antiseptic solutions for these purposes to avoid unnecessary injury and burns to the skin.

Sex and herpes

Herpes is a chronic viral infection. Once HSV has entered the body, it will never leave it. How then can you have sex if you or your partner have this disease? Is it possible to have sex with herpes?

It is reliably known that the herpes virus can be present in the mucous membrane of the genitals or oropharynx and lips even in the absence of rashes. That is, infection is possible without exacerbation of the disease.

Transmission of the herpes simplex virus occurs when the mucous membranes of a healthy person come into contact with an infected person. This happens both during classic vaginal contact and during oral and anal sex.

The chief physician of the Private Practice clinic, urologist-dermatovenereologist, doctor of the highest category, Evgeniy Aleksandrovich Volokhov, talks about herpes on the penis.