Clinical identification, home protection measures, and comprehensive antiviral treatment strategies for genital herpes

125. Clinical Manifestations of Genital Herpes Genital herpes is also a common sexually transmitted disease. It is widely distributed and spreads rapidly, often occurring in people with promiscuous sexual relationships after puberty or those with a history of unprotected sex. The sexual transmission rate is 30%–50%. This type of genital herpes is caused by type II viral infection, pathologically manifesting as an acute inflammatory skin disease of the male and female genitals. Its characteristics include recurrent attacks, with a recurrence rate of up to 60%, and the affected areas are often fixed. Besides causing suffering to the individual, it can also be transmitted to their spouse or sexual partners. If infection occurs during pregnancy, it can also infect the fetus. The main clinical manifestations of genital herpes are: The incubation period is 4–7 days. Fever, headache, and general malaise may occur before or after the rash appears, along with sensory abnormalities in the S2–S4 nerve segments. The virus enters the body through breaks in the skin or mucous membranes, grows and multiplies near the wound, and then spreads and diffuses through the bloodstream or nerve pathways. After the primary infection subsides, the virus remains dormant in the body, waiting for an opportunity to cause harm. When the body's resistance decreases, or when exposed to cold, fever, emotional excitement, menstruation, or mechanical stimulation, the latent, dormant virus can be activated and cause a recurrence of the disease. In men, genital herpes commonly occurs on the glans penis, coronal sulcus, scrotum, and foreskin, and occasionally affects the urethra, causing urethritis. Other symptoms are the same as in female patients. Homosexuals may also experience outbreaks in the anus and rectum. In women, the disease occurs on the labia majora and minora, clitoris, or cervix, presenting in clusters. It initially appears as red papules that can develop into small, translucent blisters containing yellow fluid. These blisters easily rupture and erode after scratching, causing burning pain and potential secondary infections. Inguinal lymph nodes may swell and become tender, but usually do not suppurate. This disease is self-limiting, meaning it can resolve spontaneously within 1-2 weeks without treatment. However, it recurs when the body's resistance decreases again, making it difficult to cure completely; this can be diagnosed as recurrent genital herpes. Herpes can occur in the mouth, skin, and eyes of newborns. Severe cases can lead to high fever, bleeding, and respiratory distress, with most resulting in death. Only 15% of survivors are healthy and fortunately, without long-term effects. Besides herpesvirus type II, there is also herpesvirus type I, which is not transmitted through the genitals and does not occur in the genital area. Instead, it is mostly found at the junction of the skin and mucous membranes above the waist and is primarily transmitted through the saliva of carriers. It can cause oral herpes, herpetic conjunctivitis, keratitis, etc. Generally, only 10% of infected individuals develop clinical symptoms.

Six Measures to Prevent Genital Herpes (1) Use Condoms: It was once thought that herpes was only contagious when the virus emerged from its hiding place and caused visible symptoms, or in the days before or after that. However, it is clear that many people can transmit the virus even when they are asymptomatic. One study showed that in 75% of cases, herpes is transmitted without any symptoms. The chance of transmission is greatest when there are obvious signs of organ damage, so it is important to avoid skin-to-skin contact. The risk of cumulative transmission through repeated contact is even greater during the asymptomatic period. Therefore, the Centers for Disease Control and Prevention (CDC) believes that this clearly indicates that condoms must be used during intercourse, as the virus cannot penetrate condoms. If you know that your sexual partner has had herpes, experts point out that to prevent infection during the asymptomatic period, condoms should be used during every sexual encounter, not just when herpes recurs. However, condoms are not 100% safe; they only protect the part they cover-the penis. If the herpes virus comes into contact with other parts of the body, infection can still occur through those areas. (2) Practice moderation in sexual activity: The Centers for Disease Control and Prevention's general recommendation for reducing all sexually transmitted diseases is to be selective in choosing sexual partners. The more sexual partners you have, the greater your risk of infection. (3) Be careful with oral sex: Experts point out that herpes can be transmitted to the genitals through the mouth. Oral sex can quickly turn your girlfriend's cold herpes into your genital herpes. (4) Avoid sun exposure: The only known cause of herpes recurrence is exposure of the affected area to ultraviolet light, a problem more common with oral herpes. If you are a hardcore nudist, you should be careful. (5) Reduce stress: Many people believe that stress can cause herpes recurrence, but there is no data to support this view. However, no one has said that reducing stress is harmful to the body. (6) Pay attention to nutrition: Although there is no reliable data to show that lysine and other nutrients can reduce herpes recurrence or make it heal faster, experts believe that, in general, people with good nutrition do heal faster. Therefore, paying attention to nutrition is also one of the measures for preventing and treating genital herpes.

Eight methods for treating genital herpes: (1) Correct medication: Although it is currently known that once the herpes virus enters the human body, it cannot be completely eliminated, scientists have discovered the best alternative – drugs that can shorten the course of the disease and almost completely cure recurrence. Therefore, once you are diagnosed with this disease, you should take medication in a timely, correct and sufficient manner according to the doctor's instructions. (2) Frequent bathing: When the disease first occurs, you should take a warm bath or shower 2 to 3 times a day. Gently press (but do not rub) the affected area to let it dry. Excessive rubbing can easily irritate the affected area and expand the infected area. (3) Keep dry: Apply a drying agent directly to the ulcerated area, such as zinc oxide or calamine lotion. (4) Heat or cool the affected area: Ice cubes, infrared heating lamps or hair dryers set to cool or warm air can relieve pain. However, do not overdo it, and stop immediately if there is a slight irritation. (5) Wear loose clothing: Wear loose, well-fitting underwear, as air circulation helps prevent irritation to the affected area and accelerates wound healing. (6) Do not use viscous medications: Avoid using viscous ointments with a petrolatum base, as they do not keep the affected area dry, thus prolonging healing time and the time for virus shedding. Zinc-containing topical ointments, which can be purchased without a doctor's prescription, may have some antiviral effects. (7) Wash nails thoroughly: Wash hands thoroughly with soap after touching the affected area. Viruses can survive on the skin surface for 30 minutes and are easily transmitted through contact between the hands and other parts of the body, especially the face. (8) Seek mental health support: If you experience depression, consider consulting a psychologist or participating in group therapy.