Herpes simplex is the physical symptom of a viral infection caused by the herpes hominis virus, HHV. Herpes simplex is commonly referred to as coldsores. When the infection is in or around the mouth, it is referred to as Oral Herpes. When it is on or near the sexual organs it is called Genital Herpes. At one time genital and oral herpes were split into two categories, type I and II, but, owing to the increase in oral-genital practises the distinction has been largely lost.

It is a viral infection of the skin that may occur once or return again and again. Once the external symptoms have been cured, the virus retreats into the nerves beneath the skin and will lay dormant until the next outbreak.

Herpes simplex begins as a group of small blisters at the site of infection. This is usually preceded by itching and burning of the area. The blisters begin to dry up after a few days and form a crust. The crust then falls off and the redness slowly goes away. The whole process take as little as five days and anything up to 14. Beyond this you should refer to your GP.

There are various types of the Herpes virus:

• 1 and 2 - Herpes

• 3 - Varicella Zoster virus (chicken pox/shingles)

• 4 - Epstein Barr virus (glandular fever, also some lymphomas)

• 5 - Cytomegalovirus (usually no effect except in the immunocompromised¹)

• 6, 7 and 8 - More recently discovered; carried by most of the population, but only cause problems in the immunocompromised

The Infection

Getting Infected in the First Place

It is frighteningly easy to get infected by HHV when the sufferer is displaying physical symptoms. The major causes of infection are:

• Kissing, especially parents kissing their children²
• Sexual contact
• Sharing eating utensils or drinking vessels
• Sharing toothbrushes or lipstick/gloss

Infection is very unlikely via the toilet seat.

Symptoms, if any, will usually appear two to three weeks after infection. However, there are no rules and it can be much earlier or later.

Always remember that prevention is better than cure.

The Recurrence

Unless you are very lucky, you will suffer from occasional outbreaks of coldsores. These can be triggered by a number of factors including:

• Stress
• Poor health, especially colds, chapped lips or trauma to the infected area
• Other infections
• Sunlight or sunburn
• Menstruation
• Sexual intercourse
• Lack of sleep

The coldsore will usually appear in the same place as the original infection.

Avoid Spreading Herpes

Herpes is not isolated to the mouth or genitals. Infections can occur anywhere on the body and you can have more than one infection.

• Don't touch the sores. If you do, wash your hands with soap.

• Wash your hands: after using the toilet, before rubbing your eyes, and before touching a contact lens.

• Don't wet contact lenses with saliva, especially if you have oral herpes.

• If you are suffering from an attack of oral herpes don't kiss anyone, do not engage in oral sex.

• If you are suffering from an attack of genital herpes don't have sex, even while using a condom.

Although coldsores are not dangerous but annoying in adults and older children, they can be very dangerous to babies. Any chance of infection should be avoided.

The Embarrassment

There are a number of ways to avoid the obligatory sense of embarrassment associated with an outbreak of oral herpes. The first is to lock the doors and windows and book a week off work/school/college. The second is to wear a face mask, à la Michael Jackson. The third is to ride it out as if that unsightly blister hanging from the corner of your mouth doesn't exist.

The first two methods are best avoided if one likes their friends. The third method is the most effective. Most people will not notice the blister or will know what it is and feel sympathetic towards you and not say anything. As a sufferer it will feel like the blister is bigger than your nose but it will only be around for a few days and it keeps would-be thieves off your pint.

Treatment

Coldsores will usually clear up in a few days, severe cases should be referred to your GP.

As a coldsore is a very visible symptom of the virus and in some ways embarrassing, it is worth knowing what can be done to reduce the time it takes to heal.

Aciclovir

Aciclovir (pronounced a'syclo'vear) is available over the counter as a cream. It's very expensive and is sold in small quantities, usually no greater than 2g. Aciclovir is best effective when used as soon as itching starts and will usually reduce the healing time. More severe cases will be treated with an oral solution which will be prescribed by your GP.

Hygiene

A highly infectious blister is the last thing you want to be poking at. But you must ensure that the area is kept clean to ensure that a bacterial infection does not take hold and greatly extend the healing time.

Cure

There is no known cure for herpes and the best course of action is to follow the advice above and sit it out. If you are in doubt at any point you should refer to your GP.