Let’s start by summarizing what we’ve already covered about these common viral infections of the skin.

Herpes Simplex Type 1. Usually on the face. Transmitted by casual skin to skin contact. A cluster of sensitive small blisters/pustules. Frequently referred to as cold sores or fever blisters. Recurrent episodes in some people. Respond well to oral Acyclovir (Rx).

Herpes Simplex Type 2. Usually on the genitals. Transmitted most often by sexual contact. A cluster of sensitive small blisters or pustules. Recurrent episodes in some people. Responds well to oral Acyclovir (Rx). ANOTHER COMMON LOCATION is a recurring sensitive sore on the buttocks. This is also very common and responds well to oral Acyclovir (Rx).

Herpes Varicella/Zoster. The Chickenpox virus can remain dormant in the body for years after the initial outbreak. Reactivation usually only occurs once and is called shingles or Zoster. This is a sensitive blistering/pustular eruption in a unique distribution: in a narrow band on only one side of the body or face. This also responds well to oral Acyclovir, but requires twice the dosage of Herpes Simplex infections. Finally, immunization is available for children (Chickenpox) and for adults over 50 y.o. (Shingles). But remember, these are NOT 100% effective at prevention. The shingles shot is only 50% effective—so don’t be lulled to sleep. Still see your doctor EARLY—within the first three days of symptoms, in order to benefit the most from oral Acyclovir (Rx). Earlier intervention also helps prevent and/or minimize the most common complication—Post Herpetic Neuralgia. This is the feared nerve pain that can linger for months after the infection is healed.


This type of Herpes virus infects 90% of us sometime in life. Most of us are asymptomatic when we get the virus, although sometimes it causes Infectious Mononucleosis ( Mono). Extreme fatigue, sore throat, fever, lymph node swelling characterize this illness. It can mimic strep throat, but it lasts longer and can be diagnosed with a simple blood test (heterophile). Unfortunately, there is no specific treatment, only supportive—rest, nutrients—trying to build up the immune system. If it is allowed to smolder in the body for years with a weak immune system, it can lead to blood and immune failure, Lymphoma and even death. However, most healthy people handle this infection very well, often not realizing they were infected.

Cytomegalovirus (CMV)

This common viral infection is like EBV in that most healthy people don’t even know that they have it. However, it can cause birth defects if the mother gets it during pregnancy. No good therapy exists during pregnancy, although gamma globulin and antiviral medications are sometimes used. Other groups that can get serious CMV infections are the immunocompromised, like HIV+ and organtransplant or cancer patients. For these ganciclovir and other antiviral medications are helpful.


Roseola Infantum is a very common rash of infancy which is caused by this virus. Fever precedes the red rash which rapidly comes on after the fever is gone. This Herpes virus, like the others above, can go dormant and cause problems later in life if immune weakening occurs due to cancer, HIV or the use of immune suppressing drugs used in organ transplant and in severe autoimmune diseases such as Lupus.

Kaposi’s Sarcoma Virus (HHV 8)

This is another common viral infection that most healthy individuals never know that they have. It is much more common in the Mediterenean and Sub Sahara Africa countries. However, if immune compromise occurs—especially in HIV+, this virus can cause vascular (red) growths in the skin and/or mouth. This is Kaposi’s Sarcoma, a potentially fatal cancer.


Prevention is always the first step. If you feel that you may have been exposed to a virus, focus on good hygiene with frequent hand washing, as well as safe prophylactic sexual practices. Then see a doctor and get testing and/or treatment early in the process.

I hope this has been helpful and hopeful!

Remember, Healing Prayer is often the most helpful part!!

Steven A. Smith, MD, Dermatology

Psalms 103 Healing Prayers for You and Yours!!!