Nasal herpes is a common viral infection caused by the herpes simplex virus type 1 (HSV-1), manifesting as cold sores or fever blisters in or around the nose. The virus is highly contagious and spreads through direct contact with infected bodily fluids or skin lesions.
Identifying Nasal Herpes
Symptoms of nasal herpes follow a predictable progression. An initial tingling, itching, or burning sensation, known as the prodromal stage, often occurs before any visible sores appear. This sensation signals an impending outbreak.
Following the prodromal phase, small fluid-filled blisters develop. These blisters may emerge individually or in clusters, commonly found inside the nostril, on the nasal septum, or on the skin of the nose. The blisters rupture, leading to shallow sores.
Once ruptured, the sores weep clear fluid before drying out and forming a crust or scab. The scabs heal and fall off within one to two weeks. Differentiating nasal herpes from other common skin issues involves recognizing the characteristic blistering nature of herpes.
Causes and Transmission
Nasal herpes is caused by the herpes simplex virus type 1 (HSV-1). This virus is highly contagious and spreads through direct skin-to-skin contact or contact with infected bodily fluids. HSV-1 can also be transmitted even when no visible sores are present, though the risk is highest during an active outbreak.
A common way for the virus to reach the nose is through autoinoculation, which is the process of transferring the virus from one part of your own body to another. For instance, if an individual has an active cold sore on their lip and touches it, they can then transfer the virus to their nose.
While a primary infection can occur directly in the nasal area, nasal lesions are frequently a result of recurrent outbreaks. After the initial infection, HSV-1 establishes a latent, inactive state, residing in nerve ganglia. Periodically, the virus can reactivate and travel along nerve pathways to cause new outbreaks, including those in the nasal region.
Treatment and Management
Prescription oral antiviral medications are the primary medical approach to help speed healing and reduce the severity and duration of outbreaks. Common antiviral drugs used for herpes infections include acyclovir, valacyclovir, and famciclovir. These medications work by interfering with the virus’s ability to replicate. Topical antiviral creams, such as docosanol, are also available over-the-counter and can help with oral herpes symptoms, though oral antivirals are generally more effective for nasal infections.
At-home management focuses on hygiene to prevent spread and secondary infections. Keeping the affected nasal area clean and dry is important. Avoid touching or picking at the sores, as this can transfer the virus to other body parts or introduce bacteria, leading to a secondary bacterial infection. Consulting a healthcare professional for a proper diagnosis and personalized treatment plan is recommended, particularly for initial or severe outbreaks.
Potential Complications
While nasal herpes typically resolves without serious issues, certain complications can arise. A common concern is the development of a secondary bacterial infection in the affected sores. Open blisters and subsequent crusting can create an entry point for bacteria, especially if the area is not kept clean or if the sores are touched frequently. Symptoms of a bacterial infection might include increased redness, swelling, pus, or prolonged healing time.
A more serious, though rare, complication is the spread of the herpes simplex virus to the eyes, leading to ocular herpes. This can occur if the virus is transferred from an active nasal sore to the eye, often through contaminated fingers. Ocular herpes can cause symptoms such as eye pain, redness, irritation, and light sensitivity. If left untreated, recurrent ocular herpes can lead to scarring of the cornea and potentially permanent vision loss, requiring immediate medical attention if eye symptoms develop.