The herpes simplex virus comes in two forms: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Herpes simplex virus type 2 cause genital herpes that lead to breakouts of genital sores. Herpes simplex type 1 typically causes cold sores or blisters around the mouth but can be transmitted to the genital area by way of oral sex (oral to genital contact).
- HSV-2 (genital herpes) are commonly spread through sexual activity, such as anal, vaginal and oral sex.
- HSV-1 (oral herpes) can be spread through oral bodily fluids contacts like during kissing or with skin to skin contact with a cold sore.
Upon entry into the host body, the herpes simplex virus attach themselves chronically in the body through the nerves deep into the nerve centers (ganglia) part of spinal nerves and stays in a latent state until being “re-activated” again causing outbreak symptoms like painful blisters or sores.
What Triggers Herpes Outbreaks?
Medical doctors are still unclear why or how does the herpes virus decide when to reactivate but some studies have shown that certain factors such as trauma to the skin or various form of stress are possible triggers.
Common herpes outbreak triggers include:
- Physical stress, such as fatigue
- Emotional stress, such as depression, anxiety
- Immune suppression (can be triggered by sickness, infection, steroidal medications or surgery)
- Vigorous sex or friction to the skin during intercourse or masturbation
- Irritation or excessive sweating around the genital due to tight pants or riding a bike
- Excessive alcohol consumption
- Exposure of affected area to strong sunlight or ultraviolet light
In addition to the triggers common between both sexes, women may be at increased risk of a breakout due to the additional factors:
- Hormone fluctuations
Researchers have also found that foods or diets that are high in L-arginine, an amino acid can also aggravate the herpes simplex virus. This causes the virus to mutate, provoking more frequent herpes outbreaks.
Types of foods that are high in Arginine should be avoided to prevent recurrent outbreaks include:
- Nuts: almonds, walnuts, cashews and peanuts
- Grains: whole wheat, oats, brown rice and even flour products
- Caffeinated liquids or beverages
What Are The Symptoms And Cycles Of A Herpes Outbreak?
In most individuals who are infected with herpes simplex virus, first primary outbreak will occur between three to fourteen days after sexual exposure with an infected partner. Prodromal symptoms of mild tingling, itching and redness may precede the actual outbreak.
Other prodromal symptoms may also include:
- Flu-like symptoms, including fever, headaches, muscle aches and swollen lymph node glands
- Burning sensation or pain while urinating
- Vaginal or penile discharge
For some patients with herpes, the infection may not progress beyond the prodromal stage or the attack may be quite mild with just a few small red bumps.
For those who go on to develop active outbreaks, symptoms such as watery blisters or small fluid lesions will start to form.
Patients with infection of HSV-1 will have blisters, commonly known as cold sores in or around the mouth.
For genital herpes in women, the blisters will develop around the external genitalia as well as in the vagina and cervix. There is also vaginal discharge and pain during urination.
For men, singular or multiple blisters will appear on the scrotum, head, foreskin or shaft of the penis. There may also be penile discharge and pain in “passing water”.
Genital herpes can also form on the thighs, buttocks or around the anus for both genders.
After the appearances of the blisters, they break down into painful ulcers which tend to ooze fluid. During this stage, the herpes virus is the most infectious.
After a day or two, the open sores will then dry, crust over forming a scab and then heal without any scarring.
For recurrent outbreaks, the whole cycle from prodromal symptoms of an outbreak to healing can take about 10 days to 3 weeks. For individuals who are experiencing primary (first) outbreak, the outbreak will be the worst and the entire course of the infection may be longer and last from 3 to 6 weeks.
How Often Do Recurrent Herpes Outbreaks Occur?
Frequency of recurrent outbreaks vary for different individuals. For some lucky few, the body will build up an antibody tolerance and the disease will become perpetually asymptomatic, never to have an episode again, while others will continue to experience repeated chronic outbreaks for months and years.
Statistically, approximately 80% of the infected individuals will suffer from a recurrent (secondary) outbreak within the first 6 months of the first episode. On average, the number of recurrent outbreaks is 3 to 5 times a year depending on the general health of the patient.
Additionally, if the infection is herpes type-2, one is also 5 times more likely to experience a recurrent outbreak than a person who is infected with herpes type-1.
The good news is, over years, the frequency of outbreaks typically diminishes with time and the outbreaks become less severe. However, even if an outbreak has not occurred for a long period of time or a person become perpetually asymptomatic, the individual is still a carrier of the virus and may still be contagious to others.