What is facial herpes?
Facial herpes is very common and is also known as cold sores, fever blisters, sun blisters, orofacial herpes,herpes labialyherpes febril. Facial herpes is characterized by clusters of fluid-filled blisters that appear on inflamed red areas of skin or mucous membranes. A burning sensation usually occurs just before the skin lesions develop. The areas can be sensitive and painful. Blisters heal without scarring but tend to recur.
These episodes are caused by a very common viral infection known as the herpes simplex virus (HSV), of which there are two types:
- HSV-1, the most common type, which causes facial and genital herpes.
- HSV-2, which commonly causes genital herpes.
Although cross-infection can occur, it is more common on the route from the face to the genitals (causing genital HSV-1) than from the genitals to the facial area.
How do you get facial herpes?
Facial herpes is transmitted by a person infected with the herpes virus and a person who has not been previously infected. HSV-1 infection is most often acquired during infancy or childhood as a result of contact with family members (eg, kissing). The source does not always show the typical symptoms of facial herpes at the time of transmission. For example, the herpes virus is usually cleared from the lips before blisters appear, and it is also possible to shed infectious particles from the herpes virus without noticeable symptoms.
Most people will come into contact with the herpes virus between the ages of three and five, but only one in three will have a first episode of herpes with symptoms.
What the virus does: initial infection and recurrences
HSV invades the cells of the epidermis, the outer layer of the skin, causing fluid-filled blisters to appear. The herpes virus travels from the epidermis along nerve pathways to the trigeminal ganglion, a bundle of nerves near the inner ear, where it remains hidden until reactivated. Possible triggers for herpes include fever (for example, a common cold), ultraviolet radiation (exposure to sunlight), extreme tiredness, or decreased immune function.
The initial herpes infection
When a person is infected with herpes for the first time, the episode is calledprimary infection. The primary infection can progress in different ways. Some people have only very mild symptoms or no symptoms of herpes at all, but others may experience considerable discomfort. Sores can develop inside and outside the mouth and this is commonly called gingivostomatitis. Initially, this can take the form of painful sores that affect the mouth, gums, throat and lips, and can last for more than 14 days if left untreated. Gingivostomatitis should be treated with antiviral medications. Most patients also require pain relievers or even local anesthetics applied directly to the area to ease the discomfort of the canker sore and to be able to eat and drink.
This first outbreak starts one to three weeks after the herpes virus has invaded the skin and disappears within a few weeks.
The herpes virus remains hidden in the nerves for the rest of a person's life and becomes active again from time to time. Some people have few or no outbreaks of herpes, while others have regular recurrences. They seem to become less frequent with age.
A facial herpes outbreak has four stages:
- Tingling sensation on the skin.
- Mild swelling and development of a series of fluid-filled blisters, often painful
- Blisters burst and form clumps, leaving fluid-filled sores (cold sores)
- Canker sores eventually dry out, form scabs, and heal without healing after 8 to 10 days.
The virus can spread until the cold sore is completely covered in scabs and the infection is usually external.
Most commonly, herpes simplex affects the lips or nasal area and causes cold sores. Recurrences can affect the eye region or even involve the eye itself. HSV eye infection is also known by other names includingherpetic keratitis,herpes conjuntiviteyherpetic stromal keratitis. Deep eye infection is very rare, but it can cause a syndrome called acute retinal necrosis. In children, the herpes virus can infect the mouth and throat. The infection may be accompanied by fever and general aches and pains.
What triggers facial herpes?
The factors that can trigger herpes outbreaks differ from person to person. Menstruation, trauma, fever, exposure to sunlight, extreme weather conditions, or anything that weakens the immune system, such as a cold, flu, or general illness, can cause cold sores to reappear in some people. In others, there is no definite cause.
facial herpes transmission
People who have a herpes episode, whether facial or genital, should be considered infectious from the onset of the herpes episode until the last sore heals. During this time, the herpes virus can be transmitted to other people, and in rare cases it can be transferred to other areas of the body. Increasingly, genital herpes (genital HSV-1) is being caused by face-to-genital transmission. Remember, most of us get facial herpes within the first five years of our lives.
To help prevent the transmission of herpes, you should avoid:
- Kissing someone or sharing drinking utensils when you have a cold sore.
- Having oral sex when you or your partner has facial or genital sores.
- Sharing of towels and facial tissues.
- Use saliva to moisten contact lenses if you have sores around your mouth.
Hygiene is important for people infected with the herpes virus. Try to avoid direct contact with cold sores, but if you do, wash your hands with soap and water and dry them thoroughly. Avoid picking at cold sores, as this can spread the virus to other parts of the body or lead to a bacterial infection in the sores. Avoid using strong detergents on the skin.
The body's defenses can be strengthened with a healthy lifestyle. Try to eat a varied diet, exercise regularly and get enough sleep. Using sunscreen can help prevent cold sores from recurring in some cases.
How to Diagnose Facial Herpes
Accurate diagnosis of facial herpes is most easily and accurately done at the time of an active herpes infection. A combination of the patient's medical history and the appearance of the sores are usually sufficient to identify facial herpes. A swab of the lesion or a specialized blood test can be used to confirm this.
Possible complications and treatment
Cold sores can be infected by bacteria. If the condition spreads to the eyes, in severe cases it can impair vision.
In patients suffering from atopic dermatitis, in rare cases, cold sores can spread to larger parts of the body.
Massive cold sores can be a sign that another disease, pneumonia or HIV, for example, has weakened the body's defenses.
Facial herpes can be treated, and sometimes even prevented, with an antiviral drug, valacyclovir, available in pill form (prescription needed). There are also over-the-counter treatments for cold sores that your pharmacist can advise you on. Pain relievers and a pain-relieving mouthwash can also alleviate symptoms. Treatment should be started as soon as the first symptoms appear. Each herpes outbreak can be treated with pills or cream to speed up the healing process. If the episodes are very frequent or troublesome, taking antiviral pills daily can help prevent outbreaks.
Free download of genital herpes resources
You can also download our guides in pdf format:
Genital Herpes - The Facts
Genital herpes: myths and truths
herpes and relationships
herpes and pregnancy
Summary of Genital Herpes Guidelines
New Zealand residents only
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