Better known as “fever on the lips,” Herpes labialis is the most widespread disease in humans .
In Italy, one in three claims to have suffered at least once in the life of this annoying problem and 15% of adults report having had a clinical recurrence last year.
The causative agent is the ‘Herpes simplex virus type 1 (HSV-1) and 90% of the population is a carrier of this variant of the virus, a second variant (HSV-2) is responsible only for a 2% of cases.
If the virus infects people who have never previously had the contract in primary herpetic infection, and after this infection the virus remains in the body in a latent phase and then, in the presence ofcertain conditions , it can reactivate and manifest in recurrent and circumscribed.
The incubation period is 10 days , the infection presents with fever and a sore throat erimatosa followed by vesicular eruptions in the mouth and the lip, followed vesicles join ulcerandosi aftoidi and forming patches of gray-yellowish . The pain is usually very intense and this makes it difficult to ingestion of any food. The healing occurs in 10 – 15 days in children and the infection can spread to other parts of the body.
The variant HSV-2 infection is manifested as genital and affects the sexually active population, the incubation period is 5 days and is followed by vesicular eruption on erythematous base located. At a later stage there is the breaking of the vesicles, in women can occur concurrently exudative vaginitis accompanied by fever and malaise. In general, the healing occurs in 15 to 20 days.
At the end of the primary infection the virus enters the nerve endings of the epidermis and remains there in a latent state.
Nell’infezione secondary gives the immune system to respond more quickly and effectively limiting the infection to a localized area around the end of the nerve involved: vesicles then appear on the lips and rarely inside the mouth.
It was found that the first contact with the HSV-1 virus occurs mainly in the first years of life by an infection called herpetic gingivostomatitis, which occurs with injury to the mucosa of the mouth and lips that cause pain and discomfort both physically and psychological, as the appearance is temporarily compromise is not uncommon for patients, especially adults who suffer from this problem are the symptoms of anxiety and feel the need to isolate due to a feeling of shame and embarrassment.
The primary infection with HSV-1 is often asymptomatic, most adults are in fact carry antibodies without having had episodes of apparent disease; in symptomatic cases the infection presents numerous clinical forms possible, however the most common that the herpetic gingivostomatitis occurs more frequently in children aged 2 to 5 years.
The key stages of herpes labialis applicant are essentially four.
- Prodromal phase, in which the subject may experience specific symptoms such as tingling, itching, burning and pain . This stage lasts from a few hours to a day and has already potentially infectious, even if they have not yet formed vesicles. Recognizing these symptoms is anticipating a great help as the application of topical preparations antiviral reduces the amplitude of the skin lesions .
- Phase of the vesicles, which can grow up from 2 to 5 mm filled with yellowish fluid.
- Step colitis, in which the pustules burst and confluisco to form one large ulcer sore gray color. The liquid is still very contagious.
- Phase of the hard crust where the crust springs already formed gradually becomes harder and takes on a deep red color. At this stage, the person may complain of itching and pain due to bleeding of the crust. At this point the person is no longer contagious .
The HSV-1 virus is very contagious and is transmitted by direct contact between people: either by herpes lesions, or through the saliva of healthy carriers.
So it can be done through the exchange of effusions between an infected person and an uninfected, through the exchange of infected items such as crockery, towels, razors, toothbrushes, etc.. Or a person can hit autocontagiarsi that transmit the virus to other parts of the body such as the nose or ‘ eye .
The person affected is recommended not to touch the blisters and careful follow general hygiene, wash your hands often, especially before handling shared objects.
Finally remember that the HSV-1 and HSV-2 can contaminate both the oral area that the area genital herpes labialis can be transmitted to the genitals through oral-genital contact , giving rise to secondary Genital Herpes and otherwise can be that genital herpes can be transmitted to the oral level, giving rise to secondary herpes labialis.
Herpes simplex eye is one of the most common causes of infectious blindness in the world.
The most significant risk of genital form is linked to pregnancy.
The healing period of secondary infection by HSV-1 usually has been around 9 – 11 days, sometimes persists a reddish stain which is attenuated with the passage of time, while HSV-2 has a healing time slightly longer and the lesion can be more accentuated especially for the female sex.
Care and treatment
The most effective treatment for this type of infection is constituted by an antiviral agent able to block the multiplication of the virus contributing to shortening the healing time. The two most commonly used drugs are acyclovir (as generic or as Zovirax, Cycloviran, …) and penciclovir (Vectavir), especially for topical use.
Aciclovir has proved effective when applied in the prodromal phase, while it is much less if only used in the vesicular stage. E ‘of fundamental importance for the purposes of a correct therapy the application of a layer of cream every 4 hours (night excluded) for at least 5 days up to a maximum of 10.
The penciclovir provides satisfactory results regardless of the stage of development of herpetic lesions. Topical application of penciclovir is also able to mitigate the pain, the cream should be applied on the infected area or every 2 and for 4 consecutive days.
If recurrences are frequent herpes is suggested to the administration of an antiviral for systemic on medical advice.
The vaccines are still under study.
Factors contributing to recurrent herpes appear to depend on the general state of the immune system, therefore, the following factors are the most incriminating:
- hormonal changes,
- colds or flu,
- trauma (dental surgery, cosmetic surgery, shaving),
- exposure to extreme temperatures,
- exposure to ultraviolet rays.
Avoiding these trigger factors can often prevent or decrease the severity of herpes labialis.
Scientific review and correction by Dr. Guido Distemper (pharmacist)
The information contained in this article should in no way replace the doctor-patient relationship, it is recommended as opposed to seek the advice of your doctor before you implement any advice or direction given.