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About cold sores There are two types of HSV – HSV-1 and HSV-2. Oral herpes is easy to diagnose when a patient has visible sores or ulcers, but early stages of herpes on the face and mouth as well as on the genitals are harder to diagnose.
Herpes should be distinguished from herpes zoster, chicken pox, impetigo, and drug eruptions.
Herpetic sores are classified as heat sores in TCM because the lesions are red and follow febrile disease conditions. As with all treatment protocols, be sure to tailor and modify the basic treatments below to fit your patient's specific constitution, root cause, and symptoms. Treatment principle: Drain Spleen and Stomach damp heat, nourish yin, drain deficient heat . Cash, checks and credit cards are also gratefully accepted if you prefer to donate in person. Pain, emotional upheaval, fatigue, people who are burned out, folks who want to try esoteric acupuncture.
Genital HSV is the most common sexually transmitted infection (STI) in both men and women, but as many as 90% don’t know they are infected because their symptoms are too mild to notice or mistaken for another condition. Symptomatic genital herpes is characterized by a burning and itching sensation in the genitals, followed by blistering. HSV skin lesions usually appears as small blisters or sores around the mouth, nose, genitals, buttocks, and lower back, though infections can develop almost anywhere on the skin. This photo shows HSV-1 lesions on the buttock of a five-year-old girl — also called sacral herpes simplex. Herpetic whitlow is an intensely painful infection of the hand involving 1 or more fingers that typically affects the terminal phalanx. Serologic testing for HSV has limited value in acute clinical diagnosis because of the time delay for seroconversion following initial infection. Acyclovir, valacyclovir and famciclovir are the most commonly used agents for treating HSV infections.
A wide disparity exists between the public and medical community regarding the significance of herpes infections. The majority of recurrent oral herpes cases are caused by herpes simplex virus type 1 (HSV-1) and the majority of genital herpes cases are caused by HSV-2.


Differentiating between the two types of infection using either type specific swab testing, preferably PCR, or type specific IgG antibody testing, is very important because HSV-1 genitally recurs less, is shed less, and presents far less risk of transmission to others than HSV-2. Fifty seven percent of Americans between 14 and 49 have HSV-1, and 16% of the same group has HSV-2 infection.
Most cold sores are caused by HSV-1, whereas most genital sores (genital herpes) are caused by HSV-2.
During active disease phases there are blisters on the skin which contain the infectious virus. In women who contract the disease, the cervix is infected 80% to 90% of the time during primary infection.
This photo shows a close-up of lesions on the upper eyelid in a 20-year-old male patient due to HSV-1.
Of patients who develop seropositivity, 65% do so within six weeks, while approximately 20% do not make antibodies for six months. While all three drugs decrease the duration and severity of illness and viral shedding, they have no effect on nonreplicating viruses, nor do they eliminate the virus from the ganglia.
Although treatment options exist, respondents in one survey considered contracting herpes as worse than breaking up with a significant other, getting fired from a job, or failing a course in school.
HSV infection is a persistent and chronic infection of the sensory ganglia with a varying, unpredictable degree of skin expression.
Accompanying symptoms may include high fever and swelling of tenderness of the lymph nodes.
Primary infections can range from subclinical to severe, with fever, headache, malaise, anorexia, pain, lymphadenopathy and edema. Clinical recurrence occurs on average 3 to 4 times a year, but some patients experience monthly outbreaks. Cervical infection alone is rarely symptomatic, but because the cervix is not sensitive to pain, infection may pass unnoticed.
Be sure to provide adequate counseling to help patients put their diagnosis in perspective.
This slideshow will highlight variations in presentation and provide more information about diagnosis and treatment.
Crusting of the lesions begins after three to four days of onset and complete healing within three weeks.


Viruses are transported along the sensory nerves to the nerve cell bodies where they go dormant and reside as long as the host is alive. They may come out of dormancy because of a variety of triggers (one of which is immunosuppressant drugs).
When it becomes active the virus multiplies, travels along the axon of the neuron to the nerve terminals in the skin and releases the virus particles.
However, if they get worse, don’t improve within seven days, or you have recurrent outbreaks, see your GP for advice. This is a condition that can develop if the sores become infected with bacteria, causing them to become crusty and yellow. HSV can spread into broken skin (for example, eczema or dermatitis) and cause a serious skin infection. The infection is passed on through skin-to-skin contact, for example by kissing someone who has the virus or by sharing objects that have been in contact with the virus, such as a razor or a lipstick. If you have any pain or discomfort, you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice. If you wear contact lenses, it’s particularly important to wash your hands before you touch them. If possible, you should also try to discourage your child from sharing anything that may have come into contact with the cold sores, such as cutlery. If, and when HSV becomes active again, your son is unlikely to have severe blistering in his mouth and on his gums again.
Young children can develop herpetic whitlow from sucking their thumbs or fingers when they have a cold sore. If your child has a cold sore, it’s good to try and encourage him or her not to touch it, or if they do, to wash their hands with soap and water straightaway.



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