Clinical Dermatology
Herpes Labialis
Information About Herpes Labialis
Herpes labialis is a transmissible autoimmune infection that occurs on the lips and sometimes involves cheeks and palate. It is caused by Herpes simplex virus type 1 (HSV-1) belonging to the herpesvirus family and rarely by herpes simplex type 2 (HSV-2), which occurs in the genitals but can be transported to the lips during sex contact. Extremely rarely, herpes labialis is due to a recurrence of the chicken pox virus (HHV-3), in people who have had chicken pox in their childhood.

A particular feature of the family of these viruses is the fact that once they are introduced into the body causing the first infection they do not recede. They remain latent in the nerve ganglia forever, causing the annoying symptoms on the lips and sometimes in the eyes when the defense of the immune system drops, for example in a period of high stress. Treatments deal with the symptoms and not the virus itself, since it remains inside the body.

Many patients mistakenly link herpes labialis to mouth ulcers. Although they cause similar ulcers in the mouth area, they are two completely different problems. Mouth ulcers appear inside the oral cavity and are not viral in nature, nor are they contagious, as opposed to herpes labialis that appears outside the mouth, is caused by a virus and is very contagious.
Why Does Herpes Labialis Appear?
Herpes labialis virus, when entering the body, initially attacks the epithelial cells of the mouth and is then transported into the nervous tissue and face where it is finally latent. In fact, the virus is largely asymptomatic. Two out of three patients do not know they have herpes labialis, because no symptoms are shown. The virus may, however, under certain circumstances be activated and displayed. It is estimated that 33% of people who have been infected with the virus for the first time will experience cases of reactivation. The main causes that can "wake up" the virus are:
  • low immune system
  • hormonal disorders
  • excessive exposure to the sun
  • poor diet
  • different psychological reasons such as anxiety and depression
Although herpes labialis most commonly appears on the lips and especially the corners of the lips, the virus can also manifest itself on the chin, nostrils or cheeks. In very rare cases and especially in individuals of weak immune system, it can occur in the mouth, gums and palate, but then the blisters are smaller and the symptoms milder.

The appearance of the virus begins with burning and itching in the area of the lips and sometimes the patient feels the lips swollen or numb. Bubbles are formed by the onset of virus break within 24 hours, usually, releasing the virus-containing fluid and creating a painful wound. The burning sensation continues, and rarely, the person may have a fever and feel unwell. After bubbling, the area begins to dry and a crust is created. This crust can burst or be removed and re-created several times until wound healing is completed.

In any case, healing is completed within 7 to 10 days of the onset of symptoms.

Ways of Herpes Labialis Transmission
Herpes labialis transmission can occur at any of the five stages of the disease, from the first symptoms to the healing of the wounds. Also, the fact that a virus carrier is asymptomatic does not mean that the carrier can not transmit the virus to another person who is not a carrier and has never suffered from the specific disease.

The most dangerous phase for viral transmission is when the bubbles break and the fluid is released. The transmission is through contact with the serum inside the bubbles, even though the virus does not survive much outside the body. For the transmission of the herpes virus, a kiss or direct exchange of items such as glasses, cutlery, towels, lipsticks, toothbrushes is sufficient. We also need to be careful when we touch the contaminated area with our hands. Normally we should not touch the infected area with bare hands, not only because we can transfer the virus to another part of the body, but we can contaminate it with bacteria as our hands are almost always carriers of germs.

How Is Herpes Labialis Treated?
Typically, the herpes virus is healed spontaneously within 7 to 10 days, depending of course, on each case. To reduce healing time and to deal with annoying symptoms, we use topical creams that usually contain asciclovir, valacyclovir, famciclovir. These ointments are applied to the lips, in the area of the infection, from the onset of the symptoms and require repeatitions several times a day. In recent years, patches are marketed, small transparent stickers containing the above substances. They are applied to the infection site by treating the symptoms while facilitating healing by creating an environment protected by external factors. This eliminates the risk of contamination of other parts of the body, and makes it easier to hide unsightly bubbles, especially for women, since they can put on the sticker. Usually these treatments are enough to alleviate and diminish the symptoms of virus manifestation and to recover a little faster. However, in more persistent cases or in patients with a proven weakened immune system, antiviral medicines may be administered orally.

Traditional herbal medicine contributes significantly to the natural treatment of herpes labialis virus symptoms, but also to the prevention, if not the virus itself, of at least its manifestation. An important aid is the B complex vitamins that are said to help the nervous system. A herb known for its anti-herpes virus activity is melissa, which is used as a base in ointments applied to the infection site in order to alleviate, rather than cure, the symptoms of herpes labialis.
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