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Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery

Written by Dr. Ringpfeil

Herpes simplex

Synonyms: cold sores, fever blisters, herpes simplex

Overview

Herpes simplex, a common viral disease, is caused by two strains of the herpes simplex virus (HSV). The strains are referred to as herpes simplex virus-1 (HSV1) and herpes simplex virus-2 (HSV2). HSV can infect all areas of the body but most commonly the cavity of the mouth and the genital area. HSV1 causes most breakouts around the mouth and HSV2 causes the majority of genital or buttock lesions. The signs and symptoms of HSV differ between oral and genital infections.

Oral Herpes

Herpes treatment

The initial infection (primary stage) of oral herpes is generally asymptomatic and is acquired through person-to-person contact such as kissing. The virus then lies dormant in a nerve root. Reactivation of the virus may be caused by a number of events such as a fever, intense sunlight, intense cold, or stress.

In the active (secondary) stage, individuals with oral herpes have "cold sores" around the mouth or on the face that may become painful ulcers. The early period immediately before the outbreak is referred to as the prodromal period and from this time to the end of the outbreak, the virus can be transmitted to another person by direct contact.

Genital Herpes

The stages of genital herpes are very similar to oral herpes with an initial stage that manifests with few symptoms and is less contagious. The secondary stage, which can occur unpredictably but is usually mediated by stress or sickness, shows lesions on the vulva or penis.

The lesions are often painful and itchy may also be accompanied by difficulty urinating, lymph node enlargement with tenderness, and puss-like discharge. The herpes virus is most contagious during the active periods but can spread immediately before the outbreak occurs.

For both genital and oral herpes, the dormancy period involves the virus "resting" within the nervous tissue around the initially infected area.

Diagnosis

Herpes is commonly diagnosed based upon the symptoms described above paired with frequent recurrence in the same area. Rapid tests have been developed to detect antibodies to the herpes virus. Positive results reveal that you have been exposed to HSV1 or HSV2 in the past.

However, 90% of inner-city populations carry HSV1 antibodies and about 35% carry HSV2. The presence of antibodies does not diagnose a current outbreak. In some instances, samples of representative lesions are taken and tested for the presence of the HSV1 or HSV2 virus.

Management

Once diagnosed with herpes, managing the disease includes caring for sores during outbreaks as well as preventing their recurrence. Several medications and dietary guidelines are outlined below as well as advice on how to prevent the spread of the disease.

Treatment and Medication

While there is no cure for herpes, a few medications are available for control. Famvir™, Valtrex™, and Acyclovir are currently used to treat and prevent cold sores and genital herpes. None of these drugs cure the disease but all help alleviate or prevent symptoms. In addition to medication, you should keep lesions as dry as possible to speed healing.

Your diet can also play an important role since the amino acid lysine, found in fish, chicken, beef, lamb, milk, cheese, and beans, has been shown to reduce the recurrence of outbreaks. Some people feel that they can stop outbreaks by daily lysine supplementation. Condoms help prevent the spread of herpes among individuals.

Coping

Remember, if you have been infected with herpes, you are not alone. The disease affects many people who live normal lives. Especially with genital herpes, the ulcers are concealed and do not affect any daily activities. Open communication with partners is important so that both of you can practice safe intercourse. In the middle of an outbreak, you should avoid contact, and medications can mitigate symptoms.

Support Groups and References

Since genital and oral herpes is extremely common in the United States, with an estimate of 45 million people or one out of every five infected, there are many places to turn for support.

The website: http://www.herpes.com contains more information regarding the disease. A list of support groups organized by state is found on http://www.herpes.com/supportgroups.shtml. The Center for Disease control also contains information on herpes and other genital diseases at http://www.cdc.gov/std/herpes. If you think you have genital herpes speak to your physician about treatment options.

How can we help you?

SKIN

# of surveys: 4008
Last updated: 3/15/2023 9:53 PM

PATIENT RATINGS

Would you recommend us?

definitely
93.1%
probably
6.16%
maybe
0.58%
not likely
0.08%
no
0.02%

Compare our service to other similar practices

excellent
87.9%
very good
10.1%
good
1.8%
poor
0.06%
very poor
0%

Overall doctor performance

excellent
94.2%
very good
4.89%
good
0.80%
poor
0.03%
very poor
0%

The doctor listened to you attentively

excellent
93.9%
very good
4.97%
good
1.05%
poor
0.05%
very poor
0%

The doctor took time to answer your questions

excellent
94.0%
very good
4.66%
good
1.27%
poor
0.02%
very poor
0%

The doctor explained treatment options

excellent
94.3%
very good
4.16%
good
1.25%
poor
0.14%
very poor
0.02%

The doctor explained treatment options

excellent
92.0%
very good
5.69%
good
2.18%
poor
0.11%
very poor
0.0%

Front desk performance

excellent
85.6%
very good
10.2%
good
3.66%
poor
0.31%
very poor
0.08%

Aesthetician performance

excellent
88.6%
very good
7.61%
good
3.39%
poor
0.24%
very poor
0.08%

Office comfort

excellent
90.9%
very good
6.93%
good
2.08%
poor
0.05%
very poor
0.05%

Parking

excellent
66.4%
very good
14.4%
good
15.7%
poor
2.49%
very poor
0.9%

Friendliness of the staff during appointment

excellent
90.9%
very good
7.23%
good
1.85%
poor
0.05%
very poor
0%

What WE DID WELL

(Answers:674)

The friendliness of the staff, their attitude, their orange uniform..yessssss.

#12023-01-21

After meeting the doctor I felt very comfortable. When I first came in I was very nervous

#22022-09-04

Everybody was friendly and helpfull.

#32023-03-15

The attention Dr. Abraham gave to me.

#42012-07-24 12:29:37

The friendliness with the staff kept me comfortable.

#52023-02-06

Dr. Ringpfeil is extremely knowledgeable about her field. She also put me at ease immediatley and made me feel quite at home. I will definatley return once a year for her to check me. Her assistant and the receptionists were most helpful and very nice and more than happy to comply with their patients' wishes. Should anyone be searching for a dermatologist, I highly recommend Dr. Ringpfeil.

#62023-01-01

all people very nice.

#72022-05-24

The knowledge, helpfulness, and friendliness of every person in this office has made me decide to have my daughter and me be seen here instead of by a doctor in the area in which we live (more than half an hour away). Thank you.

#82022-04-27

Knowledgable and friendly staff.

#92022-06-26

Technologically advanced office made it much easier to register all information as a new patient.

#102022-12-24

What can we do better?

(answers:373)

I checked off compimentary consultation with aesthetician on the intake forms, but it wasn't mentioned and I forgot to ask during the examination.

#12022-05-06

My only complaint is that I work and live (1 mile from) Center City, PA and I wish the office (Dr. Ringpfield) had weekend or later hours. Dr. Heckman was great but she cannot assist me with my cosmetic issues. Overall - like the office and professionalism.

#22011-08-10 18:44:27

I have an unusual challenge getting to and from the office. Your practice is doing a great job; I will deal with the transportation issues.

#32011-03-21 10:03:43

beethoven & mahler symphonic music pumped N2 waiting area* squash magazine & velonews & roleur periodical*(my wish list JK)

#42022-03-29

I think the service provided fulfilled my expectations so at this time I do not have any suggestions for improvement.

#52022-04-14

Maybe directions as "across from the Lexus place." Have the assistant say there may be a name recall test later, as she introduces herself.

#62010-12-07 10:07:04

keep doing what u doing keep up the good work!!!!

#72022-08-13

frankly, everything was excellent

#82011-08-01 16:26:25

I'm speechless!! I make a living at answering this very question but I can't recommend anything you can do to provide better service. You deserve a high score in all aspects of the practice. One minor detail - I have not yet seen the aesthetician and I have limited experience with you. Maybe patients could complete a survey after they've had a couple of appointments and contact with others. Some valuable feedback may be provided. Oops....I just heard an administrator use the word "cancellation" with a patient. May I suggest other terms like "change in the schedule" or "we'll make time for you". Wouldn't want to give patients the idea that it's ok to cancel. :-) Can you recommend a vascular specialist closer to the area than in Center City?

#92011-06-02 14:18:32

Be on time for our appointments

#102011-11-16 13:56:14

Customer Rating : 4.6

Based on 402 ratings
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