Herpes simplex infections are common, unsightly, and embarrassing. When they appear in their most common location, around the mouth and lips, people often refer to them as "cold sores" and "fever blisters." The herpes virus has two forms called - type I and type II. In general, type I infections occur above the waist, while type II infections occur below the waist. Type II infections are associated with genital herpes. However, the distinction between types I and II herpes is not absolute. Clinically, the distinction doesn't matter a great deal since a determination between the two types plays no role in diagnosing and treating people with herpes infections in everyday practice. The most striking characteristic of herpes infections, no matter where they occur on the body, is their tendency to recur in more or less the same place. Such recurrences may happen often (for example, once a month) or only occasionally (for example, once or twice a year). The tendency of this virus to establish itself in the nerve collections (called ganglia) under the skin is responsible for the recurrences. Repeated episodes occur when the virus is reactivated by: Fever; Systemic (body-wide) infection;, Ultraviolet radiation (like a sunburn); Stress; hanges in the immune system; Trauma.

Fever Blisters A small sore situated on the face or in the mouth that causes pain, burning, or itching before bursting and crusting over. The favorite locations are on the lips, chin or cheeks and in the nostrils. Less frequented sites are the gums or roof of the mouth. Fever blisters are caused by herpes simplex virus type 1. It lies latent (dormant) in the body and is reawakened (reactivated) by factors such as stress, sunburn, or fever from a wide range of infectious diseases including colds. Recurrences are less common after age 35. Sunscreen (SPF 15 or more) on the lips prevents recurrences of herpes from sunburn. The virus is highly contagious when fever blisters are present. It is spread by kissing. Children become infected by contact with someone who has a fever blister and then they spread the virus by rubbing their cold sore and touching other children. A person with fever blisters should be careful not to touch the blisters and spread the virus to new sites, such as the eyes or genitals. There is no cure for fever blisters. Medications that can relieve some of the pain and discomfort include ointments that numb the blisters, antibiotics that control secondary bacterial infections, and ointments that soften the crests of the sores. Acyclovir, an antiviral drug, prevents the herpes simplex virus from multiplying and, in pill form, has been reported to reduce the symptoms and frequency of recurrence. Fever blisters have plagued people for thousands of years. In ancient Rome, an epidemic of fever blisters prompted Emperor Tiberius to ban kissing in public ceremonies. Today, fever blisters still occur in epidemic proportions. About 100 million episodes of recurrent fever blisters occur yearly in the United States alone. Fever blisters are also called cold sores, labial herpes (herpes labialis, in Latin) and febrile herpes (herpes febrilis, in Latin).

Primary Herpes : The first time someone is exposed to herpes, the virus often infects the body without causing any noticeable problem. This process generates an antibody response in which the immune system produces specific proteins that are directed against the herpes virus. The antibody response usually makes recurrences mild. Sometimes, however, the first attack of herpes causes people to become very sick. It may cause fever, swollen glands, and bleeding gums, together with painful sore(s) around the mouth (gingivostomatitis). These signs and symptoms may last several days. Difficulty in eating and drinking may lead to dehydration. The viral infection typically lasts 10 to 14 days. The herpes blisters themselves may last anywhere from 2 to 6 weeks before they scab over and go away, usually without scarring. Primary herpes is typically contracted during childhood.

Treatment for Shingles : There are several effective treatments for shingles. Drugs that fight viruses (antivirals), such as acyclovir (Zovirax) or famciclovir (Famvir) can reduce the duration of the rash if started early (within 48 hours of the appearance of the rash). The addition of steroids may also limit the length of time that a patient has pain with shingles. However, the benefit of both of these drugs is limited. In addition to antiviral medication, pain medications may be needed for symptom control. The affected area should be kept covered and dry. However, bathing is permitted and the area can be cleansed with soap and water. An aluminum acetate solution (Burows or Domeboro's solution, available at your pharmacy) can be used to help dry up the blisters and oozing.