Getting rid of herpes - how to treat colds on the lips during pregnancy

Every mother dreams of giving birth and raising a healthy baby. Unfortunately, there are many dangers along the way of pregnancy, and one of them is the herpes virus, which is familiar to many. The virus can manifest itself in different ways: from itchy sores on the lips, poisoning a comfortable life, to the development of serious health-threatening conditions. In pregnant women, relapses can occur especially often, which is due to a natural decrease in immunity during pregnancy. During this difficult period, the expectant mother's immunity levels decrease. This condition is called physiological immunosuppression, which, on the one hand, helps to bear a child without rejecting him, and on the other, makes the body susceptible to various infections. Despite the fact that herpes on the lips is not considered a serious disease by most, herpes viruses can have an adverse and even fatal effect on the course of pregnancy and childbirth, leading in some cases to damage to the fetus.

• Herpes on the lips during pregnancy
• Why is herpes dangerous during pregnancy?
• An important aspect of protecting the body from viruses and germs
• Herpes during pregnancy. Is it possible to resist him?
• How to behave if the disease manifests itself
• How does the virus enter the body and why is it activated?
• Herpes zoster during pregnancy
• Who needs a herpes diagnosis?
• Herpes treatment regimen
• Effects of therapy with VIFERON

Herpes on the lips during pregnancy

The herpes simplex virus (Herpes simplex virus) of the first and second types is constantly present in the body in most people after infection in early childhood and under unfavorable conditions can be activated. It is known that by the age of fifteen, 80% of children and adolescents are infected with one or another herpes virus, and by the age of 30, 90% of people have antibodies to different types of this virus. The most common sites for infection are the genital area and surrounding skin, such as the buttocks, perineum, and face. Single or grouped itchy blisters appear on/on the nose, lips, cheeks, mouth, and on the mucous membrane of the eyelids. Recurrences of herpes during pregnancy are a very common occurrence, since a woman’s immune system during this period may not be able to cope with the virus that has once settled in the body.

Symptoms (manifestations)

The two types of herpes described above give rashes in different places of the body. But the symptoms are similar:

• rashes that look like blisters
• burning and itching of the mucous membranes of the genital organs
• headache
• muscle pain
• weakness in the body
• temperature is about 38 - 39 degrees

In the place through which the pathogen entered the woman’s body, burning and itching first begins. But only after a while a rash appears. Blistering rashes are called "vesicles." They are filled with serous contents that have no color. The blisters of labial herpes are found mainly on the lips, sometimes on the nose. With genital herpes, accordingly, the rash will be on the labia, in the vagina, on the cervix and even in the anus area.

Several days pass before the bubbles open and their contents come out. Small ulcers remain at the site of the rash. If you touch them, pain will occur. Wounds take a long time to heal. With genital herpes, pregnant women may experience vaginal discharge of a watery consistency for 5-7 days. This is one of the symptoms of genital herpes.

Recurrent genital herpes during pregnancy is clinically similar to primary herpes, but the symptoms are not so obvious. As we know, during pregnancy a woman’s immunity decreases (so that she can carry a child without the body rejecting it), so the disease recurs. Doctors call such relapses relapses. After an exacerbation, a stage of remission usually follows.

Remission means that the pathogen remains in the body, but there are no longer typical obvious symptoms. Relapses are similar in symptoms to the clinical picture of primary herpes.

Why is herpes dangerous during pregnancy?

The greatest danger is posed by primary infection with herpes during pregnancy. Due to the absence of antibodies protecting against herpes in the mother’s body, the situation is characterized by more pronounced manifestations. For the fetus, the risk is especially high when infected with genital herpes in the first and third trimesters. Infection of the fetus in the first trimester leads to severe consequences, but such cases are extremely rare, since with the primary infection of a pregnant woman up to 10 weeks, as a rule, spontaneous termination of pregnancy occurs. The situation is considered extremely unfavorable in the case of primary infection in the second and third trimesters. However, primary infection in the second half of pregnancy almost always has a clear manifestation, which allows immediate action to be taken. HSV, while in the body, certainly reduces the “reserve” of health originally provided by nature. However, in the process of interaction with the virus, antibodies are formed that are passively transmitted to the newborn from the mother. With recurrent herpes or carriage of the virus, the risk to the fetus is assessed as minimal, since maternal antibodies help cope with the infection even in the event of an active relapse. With this form of infection, the virus is released less than with the primary one.

Diagnostics

Enzyme immunoassay is a very reliable diagnostic method. It allows you to detect both labial and genital herpes in a woman. ELISA detects immunoglobulins G and M in the patient’s blood. After infection, Ig M first appears in the blood. And after 2-4 weeks, Ig G can be detected (after primary infection or resumption of a pre-existing disease).

Types of ELISA:

• qualitative
• quantitative

The last of these provides information about the titer of immunoglobulins, that is, their quantity. Quantitative ELISA allows you to assess whether the patient has immunity to the herpes pathogen.

In addition to ELISA, diagnosis is carried out using PCR or virological culture. The fact that a woman has herpes is indicated to the doctor by symptoms that point specifically to this disease.

Laboratory diagnostic methods:

• serology
• culture method
• immunofluorescent reaction
• microscopic examination

In 80 women of reproductive age out of 100, antibodies to the causative agent of herpes simplex type 1 are detected during testing. Antibodies in the same patients to the second type virus are found in 30 women out of 100. Those who want to conceive a child, and those who are already pregnant, worry when ELISA detects herpes in the body. But there is no need to worry, because a herpes test shows whether there are protective antibodies in the blood.

If you have IgG, then the fetus is not in danger. This is even good, because herpes will not be passed on to the child, because the mother has immunity. If (IgM) is detected, this may indicate a recurrence of herpes, which the woman was once infected with and which was latent.

IgM remains in the body for only one or maximum two months. IgG antibodies will remain in the blood throughout your life, which in medical language is called seropositivity. If a primary infection has occurred, then IgM and a 4-fold increase in IgG are detected, which are detected during studies with a break of 12 days.

A relapse of the disease in a woman is indicated by a large amount of IgG and the appearance of IgM. If questionable results regarding IgM were obtained, you need to take the test again after 10 or 12 days.

An important aspect of the body's defense system against viruses and microbes

In the process of evolution, humans have developed various defense mechanisms that allow them to resist various infections. Thus, the interferon system IFN is one of the most important factors of the body’s resistance, participating in various immunological reactions. Interferons are a group of biologically active proteins or glycoproteins synthesized by the cell in the process of a protective reaction to foreign agents, which include viral infection. Currently, the concept of “interferon system” (SI) has emerged. It does not belong to any specific organ, but exists in every cell, so all of them can be infected with a virus and must have a system for recognizing and eliminating foreign genetic information. SI is configured to recognize “self and foe” and is “built-in” into almost all cells of the body, which allows it to actively influence the entire cascade of the body’s defense reactions from phagocytosis to inflammation, which makes it an important factor in nonspecific resistance. As a result of the study of interferons, their role was determined: control and self-regulation of processes in the body. The main effects of interferon protection: antiviral, antimicrobial, immunomodulatory, preventing excessive cell proliferation, protection against radiation and others. Herpesvirus infections cause an imbalance in the interferon system, inhibit the cellular and phagocytic reactions of the body (prevent the detection, absorption and removal of viral particles). Restoration and normalization of the body’s defense mechanisms is the preventive task of antiviral therapy.

Give me some kind of alcohol tincture for colds on the lips - maybe calendula or boric alcohol

Applying alcohol solutions to lesions is a very controversial method. On the one hand, they, of course, dry and have an antiseptic effect. However, not a single tincture, as well as boric or salicylic alcohols, are active against the causative agents of “colds on the lips” - herpes simplex viruses. Moreover: these drugs contain ethyl alcohol in a fairly high concentration - up to 70%. When applied to damaged skin, irritation and even burns may occur, which will only worsen the situation. The pharmacy's assortment today includes products that act directly on herpes viral particles, preventing their reproduction and accelerating recovery. It is these drugs that are considered the “first line” for the treatment of herpes on the lips.

Herpes during pregnancy. Is it possible to resist him?

What can be advised to those who, with the help of approved medications, seek to stop herpes during pregnancy? VIFERON is an antiviral drug that can be taken by expectant mothers. One of its properties is a wide range of antiviral activity due to the presence of interferon in the drug. That is, you can start using it already at the beginning of symptoms. This can stop the disease at the very beginning, while the virus has not yet multiplied and affected healthy cells. Doctors prescribe VIFERON for herpes during pregnancy to compensate for the lack of its own interferon and enhance antiviral protection. Already from the 14th week of pregnancy, VIFERON Suppositories are allowed in a dosage of 500,000 IU. It is prescribed for primary or recurrent herpetic infection of the skin and mucous membranes, with a localized form, mild and moderate course, including the urogenital form of infection.

Recommend something effective to get rid of this herpes once and for all

Unfortunately this is not possible. Once entering the body - most often this happens in childhood - herpes simplex viruses never leave it. They penetrate the nerve ganglia of the trigeminal nerve and migrate from them only during relapses, and then return again to the zone of permanent “dislocation”. Activation of the infection occurs against the background of a number of risk factors, or triggers. They can be: fever, stress, fatigue, hormonal changes, respiratory infections, etc. By the way, with age, the frequency of relapses of orolabial herpes decreases.

There is no remedy that would allow you to get rid of herpes infection at once. However, there are drugs that alleviate the condition during the activation of the disease and speed up recovery. These are primarily acyclovir-based products that block the proliferation of herpes viruses. Acyclovir ointments and creams are the drugs of choice for recurrent colds on the lips, having an optimal balance of effectiveness and safety.

How to behave if the disease manifests itself

Speaking about household habits, it is worth noting that hand hygiene during a relapse of herpes is very important. Do not touch the affected area with your hands, because the infection can be transferred from the face to the genital area. Infection of the birth canal before childbirth may lead to a caesarean section. Herpetic infection in pregnant women requires mandatory treatment under the supervision of a specialist. If a pregnant woman is surrounded by someone with signs of infection, close contacts should be avoided: kissing, sex, and you should not share dishes, linen, or towels with the patient.

How does the virus enter the body and why is it activated?

Of the eight types of herpes viruses known today, the cause of rashes on the lower part of the face and genitals are usually HSV-1 (mainly herpes labialis) and HSV-2, which has more dangerous consequences. Transmission of HSV-2, as a rule, occurs through sexual intercourse, but vertical transmission is also possible - from mother to child during childbirth. Moreover, if a pregnant woman is infected for the first time, then the risk of neonatal herpes in the baby is 50 to 50, and in case of relapse, only 3-5% of children are born with signs of herpes infection. With the vertical mechanism of infection, the fetus is infected through maternal blood during childbirth, or the virus enters the pregnant woman’s uterine cavity from the cervix. At the same time, a high level of immunoglobulin proteins in the blood (antibodies) can protect the fetus from intrauterine infection. Cellular immunity also plays an important role in preventing the recurrence of herpes. In turn, the frequency and intensity of relapses depends on the state of local (mucosal) immunity. When there is a malfunction in the immune system, there are exacerbations of herpes infection. Injuries, surgeries, cosmetic procedures, sexual contacts that injure the mucous membrane, and taking certain medications can trigger a relapse. With reduced levels of T-cell immunity, conditions are created for the virus to multiply in cells. Interferon deficiency plays a significant role in the pathogenesis of herpes. In foci of herpetic lesions, local suppression of interferon formation is noted. VIFERON for herpes during pregnancy in the form of Suppositories can be taken starting from the 14th week, however, local forms such as Gel and Ointment have no restrictions on the duration of pregnancy. They are used directly on the affected areas: skin and mucous membranes.

Ways of spreading the disease

HSV-1 is transmitted in the following ways:

• contact-household
• airborne

Airborne transmission means that the virus is transmitted from an infected person to a healthy person through touching (only through those areas where there are rashes), kissing, etc. By using the personal belongings of an infected person, you have every chance of becoming infected. Therefore, a pregnant woman should only use her own cosmetics, toothbrush, body washcloth, towels and dishes.

HSV-2, that is, the genital type of herpes infection, is transmitted through sexual contact (coitus). In half of the cases, a woman becomes infected from a partner who currently has no significant symptoms, but may only have a small rash, mild pain and a slight burning sensation, nothing more. Such symptoms often seem not to threaten a man’s health, and he does not go to the doctor, infecting his partners through kissing, touching and unprotected sexual intercourse.

If a pregnant woman becomes infected with herpes for the first time, the fetus will become infected in 50-60 cases out of 100. These are very high chances of getting sick. Vertical transmission of genital herpes is also possible (through the placenta or during childbirth). During the birth process, the baby passes through the birth canal, where the virus is localized and there are rashes. His immunity is still too weak to resist such an infection, and infection occurs literally in minutes.

Most of the population suffers from herpes due to the fact that it is very easily transmitted. Therefore, those who are expecting a child need to be tested before pregnancy and monitor their immune status for all 9 months.

Herpes zoster during pregnancy

Herpes zoster (herpes zoster, herpes zoster) is a viral disease of the skin and nervous tissue that occurs due to reactivation of the herpes virus type 3. Primary infection with the Varicella-zoster virus usually manifests itself as chickenpox. People with immunosuppression have a much higher risk of getting the disease than those with normal immunity. The main symptom is severe, prolonged pain, which may precede the rash. Pregnant women may experience severe complications. Infection in the first trimester will most likely lead to primary placental insufficiency and miscarriageii.

Avoiding illness

To ensure that herpes infection does not become something unexpected, it is necessary to adhere to certain preventive measures, and they must be started before conceiving a child. These rules include:

1. Donating blood for analysis and detection of herpes.
2. Constant observance of personal hygiene rules.
3. The right approach to planning a child, given that both parents must undergo a full examination.
4. Maintaining immunity at a high level.
5. Timely treatment of infectious and viral diseases.
6. Hardening.
7. Minimizing bad habits or completely abandoning them.

Diagnosis of herpes, who needs it

When planning a pregnancy, it is recommended to be tested for this infection, which is dangerous for the fetus, since herpes can have an atypical form, in which there is no itching and burning, and there are no vesicles. The reason for diagnosis may also be a history of herpetic rashes of any localization, erosive or vesicular rashes on the skin, buttocks, thighs, mucopurulent discharge from the vagina, or sexual contact with a partner who has this disease, as well as frequent changes of partners. Particular attention is required for women with a burdened obstetric history, those who have already suffered perinatal losses or have given birth to a child with congenital defects. Pregnant women with signs of intrauterine infection determined by ultrasound should undergo testing.

Complications of herpes

The worst thing is that a herpes infection brings not only unpleasant symptoms. This virus causes many terrible complications. The most obvious ones are:

• Irritation and dryness of the skin and mucous membranes of the genital organs;
• Cracks in the genitals caused by metabolic disorders in tissues caused by herpes;
• Adhesive and cicatricial deformities of the labia, vaginal opening, perineum, urethra and rectum. The complication arises due to the specific feature of herpetic rashes appearing on the same areas of the skin and mucous membranes
• Cervical erosion leading to cancer of the reproductive organs.
• Lacerations during childbirth caused by poor distensibility of inflamed perineal tissue.
• Infection of ulcers due to microbes entering tissues not protected by the mucous membrane;
• cicatricial deformities of the penis, provoked by constant inflammatory rashes and ulcerations.
• Chronic herpetic lesions of the genitourinary area, spreading to the urethra, bladder and kidneys.
• Herpetic proctitis is inflammation of the rectum.
• Erectile dysfunction and male and female infertility.
• Neurological symptoms caused by a viral infection of the nervous system. Patients complain of pain in the sacrum, lower back, and groin. With recurrent lesions on the inner surface of the thighs, hypersensitivity of the skin occurs, manifested by a burning sensation, crawling “goosebumps”, tingling.

In severe cases, with a pronounced weakening of the immune system, viremia occurs - viral infection of the blood leading to damage to the brain, liver, lungs, adrenal glands, and intestines. This condition, even with adequate treatment, is often fatal.

Treatment regimen:

Pregnant women from the second trimester of pregnancy (starting from the 14th week of gestation) are recommended to use the drug VIFERON® 500000 IU, 1 suppository 2 times a day every 12 hours for 10 days, then for 9 days 3 times with an interval of 3 days (on the fourth day) 1 suppository 2 times a day every 12 hours. Then every 4 weeks until delivery VIFERON® 150,000 IU, 1 suppository 2 times a day after 12 hours every day for 5 days. If necessary, before delivery (from the 38th week of gestation), the use of the drug VIFERON® 500,000 IU, 1 suppository 2 times a day after 12 hours every day for 10 days. Ointment for local and external use (interferon content 40,000 IU) is applied in a thin layer to the lesions 3-4 times a day and rubbed in gently. Duration of therapy – 5 – 7 days. You can also use Gel (interferon content 36,000 IU). A 0.5 cm strip is applied using a spatula or a cotton swab/cotton swab to a previously dried affected surface 3–5 times a day for 5–6 days; if necessary, the duration of the course is increased until the clinical manifestations disappear. It is advisable to start therapy at the first signs of relapse: tingling, redness, itching.

How to treat herpes in a pregnant woman?

It is impossible to cure a cold on the lips once and for all. However, if therapeutic measures are started in a timely manner, the intensity of the pathological manifestations of the disease can be minimized.

It is possible to prevent the appearance of herpetic rashes on the lips only if specific treatment begins at the first stage of the disease (at the first appearance of discomfort). Delayed initiation of antiviral therapy accelerates the healing process, promoting faster healing of affected skin areas.

Pregnant women cannot use conventional antiherpetic medications.

Effective and at the same time safe treatment for herpes for the child can only be prescribed by a gynecologist who is seeing the expectant mother.

Today there are many ways to get rid of pathological rashes during an exacerbation of the infectious process and prevent the patient from developing severe complications.

When treating labial herpes, the most effective and fast-acting is the use of pharmaceutical ointments, gels or creams. To eliminate rashes on the lips of a pregnant woman, the doctor may prescribe:

• Panavir is an antiviral agent of plant origin (the active ingredient is potato shoot extract). Available in the form of a 0.002 percent gel or aerosol for external and topical use;
• Penciclovir is a synthetic antiviral drug with a prolonged action (more than 12 hours). Available in the form of a 5% ointment and 5% cream for external use;
• Oksolin is an antiviral agent produced in the form of 0.25 percent and 3 percent ointment. The active substance of the drug has a local effect and does not accumulate in the patient’s body.

The most common and most effective antiherpetic drug is Acyclovir ointment and its analogues. This medication may be prescribed by a doctor to treat cold sores in a pregnant woman only if the expected benefit to the mother outweighs the potential risk to the fetus. The same applies to Zovirax 3% ophthalmic ointment, which is used to treat keratitis caused by the herpes simplex virus.

In the absence of individual contraindications, pregnant women during an exacerbation of herpetic infection can resort to the help of alternative medicine, having previously agreed on this issue with their doctor. The following traditional medicines are effective for treating colds on the lips:

• treating the affected area of ​​skin with aloe or garlic juice;
• applying egg film located on the inside of the shell to the lesions;
• lubricating the bubbles that appear with vegetable or essential oils (sea buckthorn, fir, almond, tea tree oil);
• spot application of Forest Balm paste or earwax to the vesicles;
• applying ice cubes to the affected area of ​​the skin;
• lubricating lips with hygienic lipstick containing tea tree or calendula extract;
• cauterization of blisters with propolis tincture or Corvalol.

The use of alternative medicine when a cold appears on the lips helps a pregnant woman reduce the intensity of pain and speed up the healing process of erosions.

In case of exacerbation of herpetic infection, close attention is paid to the diet of the expectant mother. HSV-1 is activated if the body lacks vitamins E and C, as well as zinc and the amino acid lysine.

To compensate for the lack of these elements, pregnant women should include in their usual menu:

• products containing protein (eggs, meat and dairy dishes);
• fish;
• legumes;
• sprouted wheat;
• potato broth;
• fresh fruits and vegetables;
• herbal decoctions.

Fatty foods should be excluded from the diet and sugar consumption should be limited.

Effects of therapy with VIFERON

“The use of the drug VIFERON® from the 14th week of pregnancy contributed to:

– exclusion of signs of hematogenous infection;

– reducing the frequency of ascending infection by 4.5 times;

– reducing the incidence of pathology in newborns (infectious and non-infectious);

– exclusion of structural changes in the central nervous system in newborns;

– increasing the frequency of births of healthy children by 2 times [1];

According to available data: “The inclusion of the drug VIFERON® in complex therapy helps reduce:

– threats of termination of pregnancy 2 times;

– polyhydramnios and oligohydramnios by 3 times;

– gestosis by 2.5 times;

– the frequency of replicative forms of the virus is 2 times (HSV from 79.3% to 45%, CMV – from 62.2% to 33.3%);

– the frequency of relapses of concomitant bacterial vaginosis is more than 1.5 times (mycoplasma and ureaplasma);

– the total number of non-infectious complications of the perinatal period by 2.5 times (from 28.6% to 12%)

– the total number of cases of IUI in newborns increased 5 times (from 26.7% to 5.2%);

– the incidence of severe forms of IUI doubled (from 25% to 11.3%) [2].

Reference and information material

Author of the article

Belyaev Dmitry Alexandrovich

General doctor

Sources:

1. Bocharova I.I., Novikova S.V., Malinovskaya V.V., Vyzhlova E.N., Parfenov V.V. Perinatal aspects of herpesvirus infections // Medical Advisor. Gynecology. 2022.1/(41).
2. IN AND. Krasnopolsky, T.G. Tareeva, V.V. Malinovskaya. Monitoring of pregnant women with viral infections of the herpes family // Medical technology. – M. 2016. – 40 p.

i https://www.lvrach.ru/

ii https://medi.ru/

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