Herpes is a viral infection caused by the herpes simplex virus. There are two common places the herpes virus can be found, near the mouth (oral herpes), which is also commonly known as a cold sore, and around the genitals (genital herpes).
A herpes infection typically starts with a change in sensation - pain or tingling in a particular area - followed by small blisters that burst and leave small painful ulcers. If they are near the vagina, they can cause really nasty pain when going to the toilet.
There are two forms of the herpes simplex virus, types 1 and 2. Type 1 is more commonly associated with oral herpes, and type 2 is more commonly associated with genital herpes. Although due to the fact the condition spreads via contact, and aided by oral sex, it is not uncommon to find either type in any location. There is no way to distinguish from symptoms, they present in the same way and require a test to see which type is causing trouble (although the type doesn't change anything clinically - treatment is given depending on where is infected).
Oral herpes is commonly acquired in childhood and passed on via skin-to-skin contact, or via contact with fluid in the blisters from the area of infection. Genital herpes is also spread through skin-to-skin contact, including vaginal sex, anal sex and oral sex.
The herpes virus cannot be eradicated from your system, once you have it, it can lie dormant in nerves for ages then erupts into an infection at different times. Some people get one episode, and then never again. Others find that certain things trigger an outbreak such as; contact with the area, or being tired and under the weather, or extreme cold or heat in the case of cold sores. While there is no cure, we can treat the symptoms and duration of a flare-up.
Herpes is contagious both to other people, but also to spread to other areas of your own body, so avoid touching the affected area. There is more chance of spreading the virus when sores are present, but it is also possible to pass on the virus from the affected area when there are no current symptoms.
If you have symptoms of genital herpes, you should avoid any sexual contact until you have seen your doctor for advice - it can spread even if you're using condoms.
Herpes can be very painful. The pharmacy can offer treatments to relieve pain, such as a numbing cream to the affected area or pain-relieving tablets. For cold sores, some early intervention at the initial tingling stage with an antiviral cream such as Zovirax may help to contain the breakout, and minimise blistering. You could also try a heat device such as Herpotherm to help.
If you have a cold sore, you are fit for work. If you have symptoms of genital herpes, you should prioritise seeing your doctor, as the sooner it's treated the better, and you might be in some discomfort. If pain is manageable and you're on a recommended treatment for genital herpes, you should be fit for work.
If you have genital symptoms, you should see your doctor as soon as possible, as treatment should be started within 48 hours after first noticing the symptoms. You should avoid sexual contact until treated and the symptoms are completely resolved, as the virus is spread by contact between partners.
The doctor will ask about your symptoms and, if you are comfortable, examine you. Depending on the possible diagnosis, a swab of the rash, blood tests, or urine tests could be carried out, or you may be referred to a specialist department. The doctor may recommend starting some antiviral medication (such as aciclovir), which will reduce the severity of your symptoms and how long the flare-up lasts. Painkillers are available from the pharmacy.
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