Herpes simplex infection

There are over a thousand entities in dermatology; it is difficult to understand all in just a few pages. We are going to describe a few common skin problems. This is purely educational; if you have a skin disease, please consult your dermatologist.

Herpes simplex is a very common virus that often affects the mouth. It can also affect the skin and the eyes. The type II virus affects the genitals, and is a sexually transmitted disease.

Herpes is extremely common. According to 1995 HK Government data, if you are 24 years old, you have a 80-90% chance of being infected by the type I virus previously; if you are 60 years of age, your chance of being infected by the type II genital virus is 20%.

Herpes type I infection often starts at a very young age. The symptoms include fever, mouth sore, vesicles and ulcers around the mouth. The virus will remain dormant inside our nerves, and will attack again when our immune system is weak.

Most people who have genital herpes remain asymptomatic. Some of us will feel stinging in the genitals. Some of us will have genital ulcer, similar to the symptoms of type I infection. Women tend to have more severe symptoms, and may have pain in urinating and cervicitis.

There is no permanent cure for this condition, and occasional relapse is the norm. Herpes type II infection relapses on average twice a year, while a quarter of those infected will relapse as many as six times per year.

Treatment aims to stop the virus from replicating, thereby halting the infection. For frequent relapsers, they may need long term prophylactic treatments.

Chickenpox is another herpes virus, commonly caught during childhood. It causes numerous vesicles all over the body with fever, which lasts a few days. Like Herpes simplex, it will reside in our nerves and may be activated again years later. When activated, it causes painful vesicles on the skin which the affected nerve supply. The treatment is again anti-viral medication and adequate painkillers.