Infections Commonly Confused With Herpes

Genital herpes effects millions of Americans, but because up to 60 percent of people with the disease are asymptomatic, it can be difficult to diagnose the disease in order to prevent its further spread. Further muddying the issue are several other illnesses that can mimic the symptoms of herpes and cause infected persons to misdiagnose themselves and not seek the appropriate medical care for their illness. Health care professionals can also fail to perform the appropriate tests for herpes, and misdiagnose the disease as one of the similar illnesses.

Genital herpes is transmitted by direct skin to skin contact during sexual activity. The most common means of transmission is the skin of the uninfected person coming into contact with sores or blisters in the genital area of the infected person through oral, vaginal or anal sex. Genital herpes is caused by two variations of the herpes simplex virus, HSV-1 and HSV-2, although the vast majority of herpes cases are caused by HSV-2, whereas HSV-1 is more often associated with cold sores.Genital herpes affects nearly one-fifth of the U.S. population, while oral herpes affects up to 80 percent. The most commonly known symptom of herpes is periodic outbreaks of blisters and sores in the genital area, or the area of the anus. These outbreaks generally last 2-21 days, with the first outbreak after infection usually being the most severe.

As mentioned before, many people infected with herpes are asymptomatic, making diagnosis of the disease difficult. The more people who go undiagnosed, the more likely it is that they will spread the disease to other sexual partners unwittingly. Currently, there is no cure for genital herpes, but vaccines are under development.

Familiar symptoms, different problem

Making the diagnosis problem more difficult is the fact that some of the symptoms of herpes, particularly in mild cases of genital herpes, can easily be mistaken with other illnesses such as:

Lichen planus is an illness that causes lesions or rashes, usually in the area of the mouth, but also sometimes in the genital area. The lesions in the genital area can resemble herpes symptoms. The cause of lichen planus is unknown, but the disease is not contagious. It is treated with oral steroids, immunosuppressant drugs, aloe vera and other drugs.

Atopic dermatitis is another ailment that can resemble genital herpes. Atopic dermatitis, or eczema, causes blisters with oozing and crusting, much like herpes does. Eczema is caused by a variety of factors, including skin allergies. The number of cases of eczema have increased since the beginning of the 20th century, and now about 1 to 3 percent of adults are affected by it. There are a variety of treatments for eczema, including the frequent use of moisturizers. Corticosteroid treatment is also used in severe cases of the illness. There is no cure for atopic dermatitis, but with treatment and certain lifestyle adjustments it can be minimized to reduce impact on patients’ quality of life. Some lifestyle changes for people with eczema include wearing loose fitting clothing, avoiding stress and avoiding common food allergens such as nuts, milk, cheese and anything else your health care provider has found exacerbates your eczema.

Urethritis is a painful inflammation of the urethra. People with herpes can often have urethritis as a symptom of the disease. Urethritis can also be caused by a number of factors, however, including adenovirus, Reiter’s syndrome and Isotretinoin therapy. Urethritis can cause dysuria, painful or frequent urination, which is another symptom of herpes.

Uethritis can be diagnosed with a cotton swab test. Once diagnosed, urethritis can be treated with a variety of drugs that relieve pain and inflammation.

Because of the similarities between these ailments and herpes, it’s important to get checked by a doctor for herpes if you believe you may have the disease. Health care providers can perform a number of examinations, including blood work or a culture to determine whether you have herpes or another ailment.

Testing and identification is important to stop the spread of herpes, which can make it easier for infected persons to acquire HIV, or for persons already infected with HIV to have the virus turn into AIDS more quickly. By diagnosing herpes, steps can be taken to prevent the further spread of the disease by unprotected sex or risky sexual behaviors. Suppressive therapy using antiviral drugs can also reduce the likelihood of herpes transmission.

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Herpes Symptoms And Diagnosis

Herpes is so pervasive because many infected persons have no idea that they have this sexually transmitted disease. Identifying the symptoms of this illness and undergoing regular testing can help stem the spread of this illness, which affects millions of Americans.

Genital herpes is spread from direct skin to skin contact from an infected person to a non-infected person. The disease is usually spread when the infected person is going through an outbreak, which results in sores and viral shedding in the general area of the genitals, however the disease can also be spread when the infected person is asymptomatic, which can account for much of the unwitting transmission of herpes.

Genital herpes is a result of the herpes simplex virus, which comes in two variants, HSV-1 and HSV-2. HSV-2 is usually the cause of genital herpes, while HSV- 1 is more often involved with oral herpes, or cold sores as they’re commonly known. HSV-1 can also cause genital herpes, however.

While herpes symptoms can be quite severe in some patients, in others symptoms can be minimal or none. Some patients can have the disease for decades before finding out that they have herpes. This ability of the disease to “fly under the radar” contributes to the spread of herpes.

There are a variety of symptoms associated with genital herpes. Being able to identify them will better help people to determine if they have herpes, and if so, seek treatment for the disease.


The earliest, and most obvious, symptom of herpes is an outbreak of blisters or bumps in the genital area. The outbreak usually develops between 2 and 21 days after the initial infection of herpes. In some cases the outbreak can be so mild it goes unnoticed, while in others the outbreak is quite severe. The outbreak manifests as small red bumps or sores in the genital area. Pain or itching around the buttocks, thighs or genital area is also quite common. The first outbreak is usually the most severe, but in some patients the first outbreak is so mild that it goes unnoticed.

Once the initial outbreak has occurred, most infected persons experience recurrences of these symptoms of about two to six times per year. Once again, some infected persons are asymptomatic, and thus do not experience outbreaks.

Other early symptoms of genital herpes include:

  • Changes in appetite.
  • fever
  • flu-like or malaise symptoms.
  • aching muscles in the buttocks, lower back, thighs or knees
  • painful urination
  • vaginal or penile discharge
  • enlarged lymph nodes in the genital area

When an infected person is not experiencing an outbreak, the virus is said to be dormant. This means it is hiding within the nerve cells. Dormant periods can last for years.

Subsequent outbreaks tend to be much less severe than the original outbreak and last for a shorter period of time. There’s a variety of things that can trigger a recurrence of genital herpes symptoms including:

  • Stress
  • Trauma
  • Menstruation
  • Fatigue

As mentioned before, a large number of people with herpes exhibit no symptoms. Research indicates that up to 60 percent of genital herpes sufferers could be asymptomatic. That’s why a yearly STD check is encouraged, in order to reduce the number of unwitting infections that occur, and to encourage those with herpes to seek treatment.


Blood tests are the accepted general method of testing for genital herpes . The blood test can detect herpes, even if the patient is asymptomatic. When a blood test is done, a health care professional draws blood from the patient, and then examines the sample under a microscope for HSV antibodies. It’s important to note that if the infection was recent, the blood test might not pick it up, because it takes a few weeks for HSV antibodies to show up in the blood.

If you have sores on your genitals, health care professionals can take a sample from the infected area and perform a cell culture or direct fluorescent antibody test to determine whether you have herpes. These tests are also beneficial because they can determine whether you have the HSV-1 or HSV-2 variant of genital herpes.

New tests are being developed that will be able to detect the presence of herpes by means of a urine or saliva test. These tests will be helpful in providing quicker and more efficient means of testing for herpes, particularly in low-tech areas such as developing nations, where sexually transmitted diseases are a serious health problem.

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Risk Factors

Genital herpes is a disease that affects nearly a quarter of the population of the United States. It’s transmitted primarily through sexual conduct, and as a result, transmission of the disease can largely be prevented by responsible sexual habits. Two variants of the herpes simplex virus, HSV-1 and HSV-2, can cause genital herpes, although HSV-2 is the culprit in the vast majority of cases and usually causes more severe symptoms.

This disease is transmitted via direct skin to skin contact, meaning that its spread from the site of infection to a site of contact. For example, if you have gential herpes you can give your partner herpes through vaginal, oral or anal sex.

Genital herpes infections cycle between periods when the disease is active, resulting in sores and blisters in the genital area that remain present for two to 21 days, and when the disease lies dormant and no symptoms are present. It’s during the active period that the disease is most likely to be transmitted to another sexual partner, although the disease can also be transmitted when no symptoms are present.

Because a sizable number of people who are infected with genital herpes don’t know they have the disease because they are asymptomatic or because they’ve confused their symptoms with those of another illness, herpes is all too often unknowingly spread. The first line of defense from contracting herpes is knowing whether you or your partner have herpes. Sexually active individuals, particularly those who have multiple partners, should be tested annually for herpes. Knowing you and your partners’ status regarding herpes can help you make the right decisions regarding precautions that may be needed to prevent the further spread of the illness.

Condoms can offer some protection against the transmission of genital herpes for both men and women. People who are consistent in their use of condoms report a reduced risk of contracting herpes of about 30 percent. HSV-2 is unable to pass through a latex condom, but because other parts of the genital area beside the penis may have herpes-related sores or, in the case of an uninfected male, may come into contact with areas with herpes-related soresĀ  — such as the scrotum, upper thighs, anus, buttocks, or the general area around the penis, herpes can be spread in spite of condom use. To further prevent the spread of herpes, the use of garments that cover infected areas during sex can be a valuable preventative tool.

In oral sex, the use of dental dams can act much like condoms to help prevent transmitting herpes from the genital area of one partner to the mouth of the other.

Another way infected persons can help prevent the transmission of herpes is by using antiviral suppressive therapy. Antiviral suppressive therapy uses drugs that work to inhibit the replication of the herpes virus. Because outbreaks are reduced, blisters and shedding, which greatly contribute to the spread of herpes are also reduced, thus decreasing the chances of spreading the disease. The drug valaciclovir has been found to be effective in preventing the transmission of genital herpes when used as a suppressive therapy. According to a recent study in the New England Journal of Medicine, a once a day regimen of valaciclovir, commonly known as Valtrex, can help reduce herpes transmission rates by half.

Risk factors

Women are generally at greater risk of catching genital herpes than men. According to research, without the use of condoms or antiviral drugs, there’s about an eight to 10 percent transmission risk of spreading HSV-2 from infected men to women. The transmission risk from infected women to men is about four to five percent per year. Studies show that using condoms is more effective in preventing male to female transmission of herpes than female to male transmission of herpes.

Unborn children of mothers with herpes may be at risk of contracting herpes. The risk is more pronounced if the herpes infection was a recently acquired infection, with the first outbreak manifesting at or near the time of delivery. Antiviral drugs such as aciclovir can help reduce the risk of birth defects or herpes infection associated with the disease.

Persons with HIV are more likely to become infected with herpes than non-infected persons. HIV weakens the immune system, and makes a herpes infection more likely. Because herpes can contribute to the progression of HIV to AIDS, persons with HIV should take appropriate action to avoid being infected with this disease.

Herpes is a preventable disease if you’re armed with the appropriate knowledge and understand the right steps to take to avoid contracting the illness.

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