Herpes infections are caused by herpes simplex virus (HSV) types 1 and 2. These viruses are contagious and spread from person to person through skin-to-skin contact. Kissing or touching is the leading cause of HSV-1 transmission, and sexual contact is the leading cause of HSV-2 transmission.
Herpes simplex viruses penetrate the skin and enter the nerves, where they usually do not cause problems. However, herpes can cause skin ulcers when viruses are activated.
HSV-1 is generally associated with infections of or around the mouth and lips, while HSV-2 is generally associated with genital infections.
Other areas of the body, such as the eyes or neck, may also be affected. Each of these two viruses can affect areas that are generally associated with the other virus.
There are other herpes viruses as well, but they are not associated with these problems. For example, chickenpox is caused by shingles. Infectious mononucleosis (also known as mononucleosis) is caused by the Epstein-Barr virus, which is also a herpes virus.
Transmission of infection
Herpes viruses are spread by contact with damaged skin or the mouth, vagina, penis, or anus.
Although herpes is most contagious when the sores are open or oozing, it can also spread when there are no sores and when the skin is completely intact due to a so-called asymptomatic rash. In other words, the virus exists and can be transmitted even if there is no clear indication of it.
Unfortunately, there is no way to detect asymptomatic discharge, so you should always consider herpes infectious, even in the absence of symptoms.
People can become infected again by touching the ulcer and then scratching or rubbing another area of the skin on the body.
Women who have vaginal HSV-2 infections can also pass the virus to their babies during labor through the vaginal birth canal. This type of transmission is more common if the mother has recently contracted an infection.
Infection and reactivation
Once in a human cell, the HSV virus enters the cell nucleus and the replication process begins. At this point, although the cells may be infected, you probably won't experience any symptoms.
During the initial infection, the virus is carried through nerve cells to nerve branch points known as ganglia. It is there that the virus will remain in a dormant, latent state, without replicating itself or showing any signs of its existence.
Sometimes a dormant virus can suddenly reactivate, restarting the replication process. When this happens, the virus travels back through the nerve to the surface of the skin. When this happens, many of the infected skin cells die and cause blisters. When these blisters form, characteristic sores form that are recognized as herpes or genital herpes.
What Causes Repetition?
Certain triggers can cause the herpes virus to reactivate. This is called relapse, and it can occur even if you have a healthy immune system.
There are a number of well-known triggers that can stimulate repetition:
- Physical stress, such as infection, illness, or injury.
- Constant emotional stress or anxiety for more than a week.
- Exposure to ultraviolet light, excessive heat or cold
- Hormonal changes, such as during menstruation.
Health risk factors
There are a number of health factors that can predispose you to a more serious or prolonged HSV infection if you already have HSV-1 or HSV-2. However, these risk factors do not increase the chance of infection.
- Immunosuppression: If your immune system is poor for any reason, you are at increased risk for a more severe or persistent HSV infection, as well as more frequent reactivation. Your immune system can be suppressed for a number of reasons, including autoimmune diseases, HIV, IgA disease, medical conditions such as bone marrow cancer, chemotherapy treatments, or organ transplants.
- Immunosuppressive drug use: You may have a more severe HSV-1 or HSV-2 infection or reactivation if you are taking immunosuppressive drugs such as steroids or chemotherapy drugs. This should not be the case if you stop taking the medicine and your immune system returns to normal.
- HIV: HIV infection, in particular, causes decreased immunity to viruses, and infections caused by the herpes virus can be more serious if you have HIV infection .
- IgA deficiency: While any immunodeficiency can predispose you to recurrent ulcers or a more severe attack of HSV infection, IgA deficiency is the immunodeficiency most commonly associated with HSV. IgA is an immune protein that specifically protects against infections of the mucous membranes, which are areas of thin skin protected by liquid mucus, such as the mouth and vagina.
Lifestyle risk factors
Herpes is a particularly common virus and there is a particularly high risk of infection associated with certain activities:
- Unprotected sex: HSV-2 is most often spread from person to person through sexual contact, including oral sex. HSV-1 can also be transmitted sexually, although not as often. Having multiple sexual partners and having unprotected sex with partners who may be infected increases your risk.
- Kissing: Kissing or other contact with the mouth is one of the common ways HSV-1 is transmitted.
- Sharing items: The HSV-1 virus can be spread by sharing items such as cups, toothbrushes, and even towels that have recently been in contact with the virus. Using someone else's lipstick, lip gloss, or lip balm is especially troublesome because these items are inherently moist, allowing the virus to easily linger.
- Prolonged skin-to-skin contact: Gladiator herpes, a type of HSV-1 infection, is characterized by sores on the face, head, and neck. This type of herpes infection is seen most often in wrestlers.
Frequently asked questions
HSV-1 is not classified as a sexually transmitted infection (STI). Although it can be transmitted sexually, it is not the most common method of transmission. In fact, oral herpes is often spread during childhood due to direct contact with sores (such as when a parent kisses their child) or contaminated objects.
There's no need. Herpes (oral herpes) is usually caused by HSV-1, which is usually spread through non-sexual contact. HSV-2, a sexually transmitted variant, can appear in or around the mouth if detected through oral sex. However, herpes is rarely due to HSV-2.
No, but if the virus is inactive in your body, stress can trigger an outbreak. It is possible to get HSV-2 without any noticeable symptoms and remain asymptomatic for many years.