Genital Herpes is primarily caused by strains of the Herpes Simplex Virus Type 2 (HSV 2) though some cases are also seen to be caused by HSV type 1 (through Oro-Genital contact). In any case, the features of Genital Herpes in both these types remain indistinguishable. Transmission of this virus is only through humans and no vectors are involved. Genital Herpes affects both the sexes, but females have a higher rate of complications. Almost 30% of adults in USA are affected by HSV 2 and 60-70% of these are asymptomatic carriers.

As mentioned above, HSV type 2 virus is the cause of Genital Herpes in most cases. HSV type 1 can also cause genital herpes in some cases especially if Oro-genital contact has been the cause of infection.

Transmission of the infection occurs mainly via the following routes:

• Sexually transmitted
• Homosexuality
• Cross-infection of type 1 and 2 viruses may occur from oral-genital contact
• Neonatal infection due to contact with infected vaginal secretions at the time of vaginal delivery
• It can be transmitted to the hands in health care workers, during finger-genital contact when they do not use protective gloves during examination
• Infection in a child by HSV 2 may indicate 'child abuse'

The incubation period is 3-7 days before the following constitutional symptoms begin:

• Fever, which may be high (102 -104 degrees F) and subsides after 3-5 days
• Bodyache
• Headache
• Loss of appetite
• Weight loss
• Listlessness
• Abrupt onset of complaints

Symptoms of the disease:

• Burning or tingling sensation before genital lesions manifest
• Vesicles around the vulva, vagina or cervix (female genitals) which may further progress to formation of ulcers
• Ulcers called as genital sores, on the penis (especially on the glans, foreskin and shaft) in males. There is soreness and burning pain that lasts for about 2-3 weeks if untreated
• Vesicles on the prepuce and scrotum
• Pain and difficulty in passing urine in both the sexes
• Discharge from the vagina and urethra
• Involvement of the perianal area and rectum in persons engaging in anal intercourse

After the acute infection subsides in about 2 weeks, the virus remains in a latent or inactive state and may become active again at a later stage. Reactivation of the virus may result in 'Recurrence' of the symptoms. This recurrence can be triggered by:

• Exposure to sunlight (ultra violet radiation)
• Fever
• Acute infections e.g. common cold, upper respiratory infections, etc
• Emotional stress
• Hormonal changes in pregnancy and during menstruation
• Minor trauma
• Systemic diseases that lower the immunity. E.g. AIDS, cancer etc
• Intake of drugs like corticosteroids that suppress the immunity

• The lesions of HSV have a characteristic appearance and so can be easily diagnosed clinically by naked eye examination.
• Antibody testing
• Tissue culture of the lesion
• Direct fluorescent antibody (DFA) test
• Tzanck test: To see the peculiar cytological changes of the HSV infection
• Punch biopsy for histological examination
• Examination of cerebrospinal fluid
• Brain biopsy and imaging in cases of HSV encephalitis

The following conditions may mimic Oral Herpes and have to be differentiated:

• Characteristic naked eye appearance of the lesions
• Antibody testing
• Viral culture
• Direct fluorescent antibody (DFA) test
• Tzanck test: To see the peculiar cytological changes of the HSV infection
• Punch biopsy for histological examination
• Examination of cerebrospinal fluid
• Brain biopsy and imaging

The following conditions may mimic Genital Herpes and have to be differentiated:

• Urinary tract infection, which may present as increased frequency of urination, burning, dysuria, fever with chills.
• Ingrown or infection of the hair follicles – In this, small areas of erythema develop around the hair follicle, which subsequently develops into pustule and eventually form scabs. There is no fever or blister formation.
• Abrasions, lesions due to violent sex, piles, insect bites and many more, which can be differentiated by eliciting the triggering cause of the ailment.

• Candidial vaginitis in women
• Herpetic whitlow
• Congenital anomalies in fetuses
• IUGR (Intra Uterine Growth Retardation) and prematurity
• Neonatal herpes
• Widespread infection and life threatening complications in debilitated patients, HIV patients and organ transplant recipients.
• Disseminated HSV 2 infection can result in HSV hepatitis, herpetic oesophagitis, adrenal necrosis, interstitial pneumonia, HSV cystitis, arthritis, ganglionitis, myelitis etc

• Do not scratch the lesions Wear loose cotton clothing Keep the affected area clean and dry
• Do not use deodorants, perfumes or other cosmetics
• Take a diet, which is rich in the amino acid lysine like beans, lentils, cheese, nuts, soya beans (tofu), fenugreek seed, meat (red meat, pork), poultry, eggs, fish (cod and sardines)
• Do not touch the lesions with a bare hand, or wash your hands cleanly if you do so
• Prompt relief of local pain can be transiently achieved by applying wrapped ice cube

• Improve general health and lifestyle
• Avoid sexual contact with many partners
• Avoid sexual contact if you have active lesions in the genital area
• Use condoms to lower the risk of transmission
• Abstain from oral sex or anal intercourse
• Abstinence and no skin-to-skin contact is the only full proof way to prevent HSV infection
• Advocate cesarean delivery instead of a vaginal delivery in a pregnant woman with an active infection
• Avoid sexual contact with a partner having active genital lesions during terminal stages of pregnancy

Homeopathy does not consider Herpes Simplex as a local affection of the skin but as something that has deeper roots within the system of the patient. Hence the treatment is not simply symptomatic; rather it is based on a detailed case study and endeavors to treat the disease from the root cause.

Homeopathic medicines work at two levels:

• Taking care of the acute symptoms
• Preventing recurrence of the infection

Overall, the medicines improve the immunity of the individual so that he doesn't fall prey to recurrent infections.

The homeopathic approach to treatment of Herpes Simplex (or any other disease) is called as the 'Constitutional approach'. In this approach, detailed study of the following aspects of the patient is done:

• Chief complaints
• Other associated complaints
• Evaluation of the causative factor
• Detailed study of the mind, temperament of the patient
• Detailed study of general features such as appetite, thirst, likes and dislikes about food, etc
• Study of past history of diseases
• Study of family history of diseases
• Examination of patient
• Investigations done

Based on the study of all these factors, a single Homeopathic remedy is selected which covers all the important features and helps in curing the disease in that patient. The medicine not only helps in alleviating the lesions, the pain and the discomfort associated with Herpes Simplex but it also helps in preventing future outbreaks of the same. An important aspect to be noted is that the medicines do not have any suppressive effects and they are without any side-effects whatsoever.