Blisters on the mouth are not caused by heat! Be careful of this lifelong latent virus →

I believe many people have had this kind of "tragic" experience: small red and swollen blisters often appear at the corners of the mouth and around the mouth, which are hot, itchy and painful. Sometimes these small blisters will ooze yellow water, scab and crack at the same time. Moreover, these blisters often grow overtime and during menstruation. Some people even have repeated blisters from childhood to adulthood...

Many people think they are "getting angry", but in fact, these small blisters are herpes simplex. Once infected with the herpes simplex virus, it cannot be eliminated and will be carried for life, and it is also contagious.

So, how can we prevent and avoid infection in our daily lives? This article analyzes it in detail.

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What is herpes simplex?

"Herpes simplex" does not mean that herpes is simple, but it is a fixed disease name, referring to the disease caused by infection with the herpes simplex virus. The most basic type of rash is blisters, so the word "herpes" is mentioned in the disease name.

However, it should be noted here that herpes simplex can manifest in many ways, which is largely related to the type of herpes simplex virus that infects.

If it is herpes simplex virus type 1 infection, it is mainly transmitted through oral contact, causing infection in or around the mouth, and only in rare cases infecting other parts of the body. When herpes simplex appears on and around the lips, we also call it "cold sores." Herpes simplex virus type 1 is the most common type, and it is the cause of herpes simplex in most people.

If it is herpes simplex virus type 2, it is mainly transmitted through sexual intercourse, and the herpes simplex caused is called "genital herpes", and the medical community defines this herpes as a sexually transmitted disease. This infection is much less common in the general population.

What are the symptoms of herpes simplex?

Most people infected with the herpes simplex virus will not experience any symptoms or will only experience mild symptoms, but some people will experience more obvious symptoms.

1. Why do some people have no symptoms?

Asymptomatic situation means that being infected with the virus does not necessarily mean that you are sick. Since our human body has immunity, most people can "coexist harmoniously" with the virus in many cases.

It is for this reason that many people do not know that they are infected with the virus, nor do they know when and how they were infected with the virus. It is only discovered when they go for a special examination.

In fact, it is very common for viruses to not cause symptoms or diseases. In addition to herpes simplex virus, there are many other viruses, such as human papillomavirus on the skin, rhinovirus on the respiratory mucosa, and enterovirus on the gastrointestinal mucosa, which may not cause any abnormal manifestations, so there is no need to panic.

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2. What are the main manifestations if there are symptoms?

If symptoms occur, the common situations are the following (due to space limitations, rare manifestations will not be discussed here).

"Rotten mouth"

The "sore mouth" caused by the herpes simplex virus is more formally called "herpes simplex" or "cold sores".

However, it should be reminded that the so-called "sore mouth corners" is not a rigorous concept, and is sometimes used to refer to other problems, such as angular cheilitis, tongue licking dermatitis and even cheilitis.

Data show that after being infected with herpes simplex virus type 1, approximately 20% to 40% of people will have recurrent herpes simplex on the lips and perioral area.

This type of herpes simplex is relatively mild, rarely causing systemic symptoms such as fever and weakness. Generally, a small group of millet-sized blisters appear at the corners of the mouth, lips or around the mouth. About 24 hours before the blisters appear, there are often some signs of local outbreaks, such as pain, burning, tingling or itching. Once blisters appear, they may develop into damage, seepage and scabs in the later stage.

Many people mistakenly believe that this problem is caused by "getting angry". Although there may be a burning or burning sensation, this is not the so-called "getting angry", but an outbreak of herpes simplex.

In addition to being mild, it is also less harmful because it can heal without treatment. This statement is also supported by data - some scholars have found that if antiviral treatment (such as topical or oral acyclovir) is not used, the lesions caused by herpes simplex will progress from blisters to scabs and then heal within 5 to 8 days. In addition, symptoms such as pain will naturally subside after 24 hours.

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Private blisters and ulcers

The above discussion is about herpes simplex virus type 1. If it is herpes simplex virus type 2 infection, it is more likely to cause lesions in private parts, which is generally called "genital herpes." Common lesions are blisters and small ulcers in the private parts, which usually cause pain, and the blisters are also easy to rupture, leak water and scab. Similarly, more than half of the people will have prodromal symptoms before the onset of this herpes, such as mild local tingling and mild electric shock-like pain in the buttocks, legs and hips.

Unlike cold sores, genital herpes is much less common and is mainly transmitted through sexual intercourse. For herpes simplex virus type 2, data from the United States in previous years showed that 15.7% of people tested positive for serum (and most of them were asymptomatic), as shown in the figure below:

The seropositivity rate of herpes simplex virus type 2 in the U.S. population at different ages and periods (organized from reference materials)

Like cold sores, recurrent genital herpes can heal on its own without treatment, but it heals faster with prompt treatment.

To sum up, if you suspect you have cold sores or genital herpes, it is recommended that you seek medical attention promptly and actively undergo regular antiviral treatment without worrying too much.

The virus cannot be removed, what can we do?

We do have to accept the fact that herpes simplex virus is difficult to eliminate after infecting the human body. These viruses will enter a latent state, and there is a certain probability that they will be reactivated, causing lesions and leading to recurrence.

The idea of ​​"curing" does not work for herpes simplex virus, which does not respond to this approach. However, we are not helpless. If we can do some preventive work, we can actually reduce the risk of infection and recurrence to a great extent. So, what are some effective ways? You can refer to the following ideas.

1. Ideas to reduce relapse

If you have already had herpes, you can do the following to reduce the chance of it happening again:

Summarize the triggering factors before each attack;

Try to avoid triggers that are closely related to you in your life;

The more mainstream triggering factors include: excessive exposure to the sun, prolonged sun exposure, mental stress, fever, trauma/surgery, and illness (such as a severe cold);

Taking trauma/surgery as an example, some people have a certain probability of causing herpes recurrence when undergoing dental treatment or skin laser treatment. If you need such treatment, it is best to communicate with the doctor in advance and find ways to reduce the risk of recurrence.

If unfortunately, herpes attacks are very frequent, such as every month, you can take regular antiviral treatment under the guidance of a doctor to prevent recurrence.

2. Ideas to reduce infection

The herpes simplex virus is contagious. If the disease is active and symptoms are present, the risk of infection is greater. If there are no symptoms temporarily, it is still possible to transmit the disease, but the risk is much smaller.

The main route of infection is direct skin and mucous membrane contact, followed by indirect contact with virus-contaminated objects. In order to reduce the risk of infection, people who have had herpes simplex can usually do the following:

Avoid kissing others, especially on lips and broken skin;

Do not share personal items such as eating utensils, cups, water bottles, towels, lip balm, and razors with others, especially when you are ill;

Actively handle items that come into contact with herpes and saliva, such as cups and towels used during the illness, and wash or disinfect them;

If you have genital herpes, it is recommended that you stop having sex during the illness. If there is no recurrence, be sure to use condoms.

3. Ideas to avoid infection

Most herpes simplex virus infections come from close contact, so family members with herpes are the most at risk of infection. If you have never been infected, in order to avoid being infected with this virus in the future, you can do the following:

Actively avoid sharing personal hygiene items of family members, especially items that saliva and herpes may come into contact with;

When a family member is sick, try to minimize skin-to-skin contact. If you do come into contact, wash your hands immediately.

Protect your skin and avoid skin trauma, as the risk of infection will be greater after injury;

Urge your family to use medication to treat existing herpes in a timely manner and quickly get through the active infection period.

I hope that today’s popular science knowledge can help everyone understand the herpes simplex virus more objectively and rationally, eliminate some unnecessary anxiety and fear, face it correctly, and take active prevention measures.

References

[1]O'ConnellD,LiangC.Autophagyinteractionwithherpessimplexvirustype-1infection.Autophagy.2016;12(3):451-459.

[2]XuF,SchillingerJA,SternbergMR,etal.Seroprevalenceandcoinfectionwithherpessimplexvirustype1andtype2intheUnitedStates,1988-1994.JInfectDis.2002;185(8):1019-1024.

[3]BradleyH,MarkowitzLE,GibsonT,etal.Seroprevalenceofherpessimplexvirustypes1and2--UnitedStates,1999-2010.JInfectDis.2014;209(3):325-33.

[4]WHO.Herpessimplexvirus.https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus

[5]CDC.Rhinoviruses.https://www.cdc.gov/ncird/rhinoviruses-common-cold.html

[6]UpToDate.https://www.uptodate.com/contents/zh-Hans/epidemiology-clinical-manifestations-and-diagnosis-of-herpes-simplex-virus-type-1-infection

[7]UpToDate.https://www.uptodate.com/contents/zh-Hans/epidemiology-clinical-manifestations-and-diagnosis-of-genital-herpes-simplex-virus-infection

[8]UpToDate.https://www.uptodate.com/contents/zh-Hans/treatment-and-prevention-of-herpes-simplex-virus-type-1-in-immunocompetent-adolescents-and-adults

This article is a work of Science Popularization China-Starry Sky Project

Produced by: Science Popularization Department of China Association for Science and Technology

Producer｜China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.

Author: Tang Jiaoqing, attending physician of dermatology department

Review | Feng Jun, Deputy Chief Physician, Dermatology Department, General Hospital of Datong Coal Mine Group Co., Ltd.