Genital herpes infection is most often caused by a virus called HSV-2. The virus that causes lip infection, called HSV-1, can also cause genital infections – albeit more rarely. Genital herpes is on the rise in the industrialized world. After entering the body, the virus can cause a first episode of disease which is usually the strongest and disappears within 15 days. The virus then remains in the body in a dormant state but, in 50-60% of cases, it can periodically awaken causing symptoms similar to the first time even if milder. The awakening of the virus is caused by stress, fever or can occur following menstruation, due to other infections, exposure to sunlight and through even minimal trauma caused by sexual intercourse. Fortunately, most infected people will never have an obvious clinical manifestation: however, not being aware of having contracted the infection, they can spread it.
It occurs both through sexual intercourse (vaginal, anal and oral) and through kisses or caresses. Items used for sexual pleasure and exchanged can also be a vehicle for infection. The virus can be passed on to the newborn during childbirth with serious consequences. In a couple where one of the two partners is infected, the odds of transmission are around 12%. The contagiousness is maximum during the symptomatic phases and tends to be greater in the first year after the initial infection. The contagiousness is very capricious and varies over time: there are periods in which the virus is eliminated on the skin and mucous membranes and periods in which it is dormant. Therefore, the presence of transitory moments of contagiousness between two acute episodes cannot be excluded, even if there are no symptoms or injuries and the individual is in full well-being. This alternation can last a lifetime.
Itching and burning precedes the appearance of round blisters in the genital area; blisters quickly break, giving way to small painful superficial ulcers. Subsequently appear yellowish-brown crusts destined to disappear in a few days. The first time the genital tissues also swell with urethral, vaginal or anal discharge. The glands in the groin area also swell, which become painful. The first infection can be accompanied by fever, headache, joint pain and – rarely – by complications such as inability to urinate, constipation, nervous irritation and in very rare cases meningitis (whose mortality rate is high). The subsequent episodes are instead much milder but always poorly tolerated due to local irritation. If the infection involves the anus, there may be anal pain, leakage and insignificant bleeding.
People with genital herpes risk 7 times more than contracting the HIV virus if they have unprotected relationships with an HIV-positive person during a herpetic episode.
Observation-based diagnosis can be confirmed by tests that can be performed at specialized centers. To determine if a person has already been exposed to the virus, a blood test can be performed to search for specific antibodies. Warning: not all tests are useful, so rely on the doctor and make sure that the laboratory is reliable.
There is no cure that definitively eradicates this virus. Depending on the situation, the doctor will be able to decide whether and how to use antiviral drugs. The effectiveness of local treatments with antiviral creams has never been scientifically established. Locally, baths with lightly salted water, or water containing a tea infusion, can be applied. Putting ice wrapped in a cloth can also give relief, as well as substances that “dry” the lesions, such as corn starch or alcohol (which, however, is extremely painful!). In severe cases, such as on the first episode, painkillers on prescription can be useful.
It is not safe to have sex when blisters are present on the genitals. The use of condoms reduces the risk of contagion by more than 50% in periods when there is the elimination of the virus from the skin but there are no acute manifestations. DAMs also help prevent infection, although the effectiveness percentage has not been established.