Genital Herpes

Genital herpes (GH) is herpes simplex of the genital region, a viral contagious skin disease (TCM: hot sores). Unlike perioral HSV, it is mostly sexually transmitted.

Common Symptoms

Papulomacular rash; bleeding tendency; hepatosplenomegaly; tension; inguinal lymphadenopathy; toxemia; crusting

Causes and Pathogenesis

Etiology: HSV is a large DNA virus 150-200 nm with double-stranded DNA core, 20 icosahedral capsomers, lipid envelope. Route: enters via skin/mucosa/breaks, replicates in epidermis/dermis, then infects sensory/automatic nerve endings and travels up axons to ganglia (~2 days). HSV-1 (respiratory/GI/mucosal contact) latently infects trigeminal/cervical ganglia (oral herpes); HSV-2 (sexual) latently infects sacral ganglia (GH); serology positive; intermittent GU shedding lifelong. Cell-mediated immunity lowers recurrence; neutralizing/CFT antibodies appear at 4-5 days post-primary but cannot prevent recurrence. Reactivation: immunosuppression, fatigue, infection, mental/trauma triggers. Latent HSV DNA is circular; antisense ICP0 RNA may maintain latency. HSV-1 causes >99% oral/ocular/skin lesions; HSV-2 causes ~90% of GH (10% HSV-1). Heat-labile: killed 50-52°C water, survives weeks at 4°C, months at -70°C; dryness prolongs survival; sensitive to 0.5% formalin/1% Lysol/soap. Pathogenesis: HSV in lesions/saliva/feces; enters via respiratory/oral/genital mucosa and broken skin, replicates locally, then spreads via blood/nerves. After primary lesions heal, HSV persists in mucosa/blood/sensory ganglia (sacral for GH); viral reactivation on lowered immunity causes recurrent lesions.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Avoid promiscuous/unauthorized sex; active GH patients must abstain; no sex during treatment (check spouse); keep lesions clean/dry; prevent secondary infection; avoid triggers (cold/fatigue). No specific vaccine currently (oncogenic concerns with live virus; purified envelope glycoproteins under study). ACV prophylaxis; condoms reduce transmission (especially during asymptomatic shedding) but not when lesions are visible. Home remedies (emergency only): Ban Zhi Lian plaster; Ma Chi Xian plaster; fresh fig leaves + vinegar plaster; raw Dahuang/Huanglian/Huangbo 30 g + Ruxiang/Moyao 15 g ground + sesame paste. Health: cesarean for pregnant GH; wait for cure before marriage/pregnancy; disinfect household items; partners often asymptomatic shedders—examine/treat them; don't over-stress, regular life/exercise reduces recurrence; avoid alcohol/fatigue/sex during treatment; condoms do not fully prevent transmission.

Department to Visit

It is recommended to visit the STD department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.