The number of STD patients coming to the dermatology clinic for genital herpes is quite high, and most of them have recurrence, which seriously affects their emotions and daily life. Let’s learn more about genital herpes.
1. What is genital herpes?
Genital herpes is a chronic, recurrent, incurable sexually transmitted disease caused by herpes simplex virus (HSV) infection of the genitourinary and perianal skin mucosa. Genital herpes can cause a range of complications including disseminated HSV infection, viral meningitis, pelvic inflammatory disease, and in pregnant women, fetal infection and neonatal herpes. Female genital herpes is also closely related to the occurrence of cervical cancer.
2. What are the ways of transmission of genital herpes?
The genital herpes virus is mainly found in skin lesion exudate, semen, prostate fluid, cervical and vaginal secretions and is transmitted through sexual contact. It is possible to get the disease when in contact with someone who has genital herpes infection. Patients with genital herpes, those with unexpressed detoxification and those with atypical genital herpes are the main sources of infection, and those with skin lesions are highly contagious.
Women are susceptible to infection because of the different genital structure, and herpes infection in newborns mainly originates from the mother’s genital tract.
3. What are the most common sites for genital herpes?
The most common sites of the disease are the sexual contact sites of men and women between the ages of 15 and 45 who are sexually active. In men, it is more common in the foreskin, glans, coronal groove and penis; in women, it is more common in the labia, mons pubis, clitoris and uterus; in men, it is more common in the perianal area, groin, buttocks and scrotum; in men, it is more common in the anus and rectum.
4, what are the symptoms of genital herpes?
There are three clinical types: primary, recurrent and subclinical. The severity of clinical symptoms and the frequency of recurrence are influenced by the virus type and the immune status of the host.
(1) Primary genital herpes.
That is, the first herpes virus. The incubation period is 2 to 14 days, with an average of 3 to 5 days; it manifests as clusters or scattered small blisters, which break down after 2 to 4 days to form vesicles or ulcers, and then heal spontaneously with crusting; pain is evident. It is often accompanied by inguinal lymph node swelling, fever, headache, malaise and other systemic symptoms. The duration of the disease is usually 2 to 3 weeks.
Some patients may develop aseptic meningitis, and the main symptoms include headache, photophobia, and difficulty in urination.
(2) Recurrent genital herpes
This refers to the recurrence of genital herpes within 1 to 4 months after the primary genital herpes lesions have subsided, and the lesions usually appear at the original site. The lesions are similar to primary genital herpes, but the disease is milder and shorter in duration, and there are often prodromal symptoms (such as local burning sensation, pins and needles or abnormal sensation) before the onset of the rash; the duration of the disease is usually 7 to 10 days; it can recur several times at intervals of 2 to 3 weeks or months.
In male homosexuals, the anus and rectum may be involved, manifesting as local pain, constipation, urgency, perianal ulcers, etc. Sigmoidoscopy may reveal mucosal congestion, bleeding and ulceration in the lower rectum.
(3) Subclinical genital herpes
Fifty percent of HSV-1-infected patients and 70% to 80% of HSV-2-infected patients lack typical clinical manifestations and are the main source of genital herpes infection. The atypical lesions can be manifested as tiny fissures and ulcers in the genital area, which can easily be overlooked.
5. How can genital herpes be treated?
If you are infected with genital herpes, you should keep the affected area clean and dry; pay attention to rest, avoid drinking alcohol and excessive sex; avoid sexual intercourse when there is pain and rupture; if genital herpes is active during pregnancy before delivery, a caesarean section should be performed.
Therapeutic drugs include antiviral and immune regulating drugs and topical medication, topical acyclovir ointment and interferon gel can be used on the skin lesions.
Treatment includes intermittent treatment such as acyclovir 3 times a day for 5 days; daily suppressive therapy: people who have more than 6 episodes per year need to take a small amount of antiviral drugs for up to 1 year or more, and the duration of medication can be assessed according to the condition; people with combined complications and severe infections can be treated with intravenous infusion.
6. How to deal with pregnant women during pregnancy?
Genital herpes during pregnancy can cause intrauterine growth retardation, miscarriage, premature birth or even stillbirth, and labor and delivery can also cause fetal infection. Pregnant women with genital herpes need to be evaluated for risk of transmission during delivery, and cesarean delivery can reduce but not completely prevent herpes virus (HSV) infection in the newborn.
Pregnant women with multiple recurrences of genital herpes before pregnancy are less likely to have a newborn with herpes infection. Patients with frequent recurrences during pregnancy or first-episode herpes are treated with acyclovir given near term to reduce active damage and decrease the rate of cesarean delivery.
7. Can genital herpes be cured?
Herpes virus infection can establish a latent state in the nerve root ganglion and cannot be cured, and the infection can last a lifetime. Recurrence of neuronal release of herpes virus (HSV) reinfects the epithelial cells of the skin and manifests as blisters, rupture and pain.
Daily life should be regular, strengthen exercise, avoid staying up late, less smoking and alcohol, and avoid factors that affect the body’s resistance to decrease.