Table of ContentsView AllTable of ContentsHow You Get ItWhat It Looks LikeRisk FactorsDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
How You Get It
What It Looks Like
Risk Factors
Diagnosis
Treatment
Prevention
Herpes gladiatorum is common among athletes like wrestlers who come into close physical contact, earning it the nickname “mat herpes.” As with cold sores, herpes gladiatorum causes episodic outbreaks of blisters that break open, crust over, and eventually heal. The sores tend to develop on the head, neck, shoulder, arm, or torso.
Once infected with HSV-1, the virus remains in your body for the rest of your life and can spontaneously reactivate at any time. Oralantiviral drugscan shorten the duration and severity of acute episodes (flares) if taken within 24 hours of the first appearance of symptoms.
Also Known AsWrestler’s herpesWrestlerpoxHerpes rugbiorumScrumpox
Also Known As
Wrestler’s herpesWrestlerpoxHerpes rugbiorumScrumpox
© Elsa / Getty Images
What Is the Cause of Herpes Gladiatorum?
HSV-1 is one of the most common viruses a person can get, affecting roughly 50% of the U.S. population.Many people get HSV-1 as children and experience it as a cold sore. Once infected, the virus will stay in your body for the rest of your life and can reactivate at any time, typically when yourimmune systemis weak.
While the most effective means of transmission is contact with a herpes sore or fluids from sores, you can also get it from someone who isasymptomatic(without symptoms). In cases like this, the virus is shed through intact skin at the site of reactivation, commonly the lip or mouth.
How Common Is Asymptomatic Herpes?Studies suggest that 90% of herpes reactivations are asymptomatic. In some cases, minor outbreaks may be confused for an ingrown hair or a pimple.
How Common Is Asymptomatic Herpes?
Studies suggest that 90% of herpes reactivations are asymptomatic. In some cases, minor outbreaks may be confused for an ingrown hair or a pimple.
With herpes gladiatorum, transmission can occur during close-contact sports when:
The virus commonly enters through the body through damaged skin, such as scrapes or abrasions. It will then penetrate cells on the surface of the skin, calledsquamous epithelial cells, and start replicating aggressively.
Herpes Gladiatorum Symptoms
Other than its location, the symptoms of herpes gladiatorum are no different than those of cold sores, typically causing:
With herpes gladiatorum, the outbreak most commonly affects:
Blisters usually form within four to 11 days of exposure to the virus and can take one to two weeks to fully heal, leaving no scars.
Complications
Herpes gladiatorum is rarely life-threatening but can cause complications if the virus gets into the eye due to hand-to-eye contact with a sore.
Referred to asherpes simplex virus keratitisor “eye herpes,” the infection can affect thecornea(the clear dome on the front of the eye),conjunctiva(the clear tissue covering the eyeball), and, in severe cases, theretina(the tissue at the back of the eye that detects light and color).
Symptoms of HSV keratitis include:
Severe cases can lead to corneal damage and permanent vision loss.
Potentially life-threatening complications are mainly seen in people who are severelyimmunocompromisedand lack the immune defenses to control the infection. This can occur in people withadvanced, untreated HIVin whom HSV can disseminate (spread) and causeAIDS-defining conditionslike:
If left untreated, these AIDS-associated complications can be fatal.
Herpes Gladiatorum Risk Factors
Playing a contact sport where bare skin touches bare skin is a major risk factor for herpes gladiatorum.
Wrestling is considered a major route of transmission. According to a 2020 study published inMilitary Medicine,nearly 72% of all herpes gladiatorum transmission occur among wrestling partners.
How Herpes Gladiatorum Is Diagnosed
The PCR test is highly accurate, with aspecificity and sensitivityof up to 99% and 98% respectively, and can usually return a result in 24 hours.
Herpes Gladiatorum Treatment
Herpes gladiatorum will almost invariably be treated preemptively. This is because the severity and duration of the infection can be reduced if treatment is started within 24 hours (and no later than 72 hours) of the first symptoms. Waiting only exposes you to a greater risk of a severe outbreak.
For the initial outbreak, referred to as the primary infection, the course of treatment is seven to 10 days. For subsequent outbreaks, referred to as recurrence or flares, the duration of treatment may be anywhere from one to five days depending on the severity.
How to Avoid Getting Herpes Gladiatorum
You can’t always avoid getting HSV-1 because the virus is not only widespread but infections are more often than not asymptomatic. As such, you can get herpes gladiatorum from someone who has no idea they have the virus or are infectious.
Is Asymptomatic Transmission Common?Studies suggest that people with asymptomatic HSV-1 can shed the virus from the mouth for around 4% of days (or roughly one day per month). However, people with recent primary infection may have asymptomatic reactivation up to 12% of days (or three days per month).
Is Asymptomatic Transmission Common?
Studies suggest that people with asymptomatic HSV-1 can shed the virus from the mouth for around 4% of days (or roughly one day per month). However, people with recent primary infection may have asymptomatic reactivation up to 12% of days (or three days per month).
This doesn’t mean there aren’tways to protect yourselffrom infection. If you are involved in close-contact sports, here are a few things you can do:
Summary
Herpes gladiatorum can be treated with antiviral drugs, ideally started within 24 hours of symptoms. People with frequent recurrence can take a daily antiviral drug to reduce the risk of flares and transmission to others.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wisconsin Department of Health Services.Herpes gladiatorum.Field RD, Taylor BM.Recurrent herpes gladiatorum: should we be screening our service members prior to close combat training?Mil Med.2020;185(5-6):e904-e908. doi:10.1093/milmed/usz317.MedlinePlus.Herpes simplex.Centers for Disease Control and Prevention.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.Johns Hopkins Medicine.Oral herpes.Ramchandani M, Kong M, Tronstein E, et al.Herpes simplex virus type 1 shedding in tears, and nasal and oral mucosa of healthy adults.Sex Transm Dis. 2016 Dec;43(12):756–760. doi:10.1097/OLQ.0000000000000522University of Utah.Herpes: the blistering facts.American Academy of Dermatology Association.Herpes simplex: overview.Saleh D, Yarrarapu SNS, Sharma S.Herpes Simplex Type 1.American Academy of Ophthalmology.Herpes simplex virus keratitis: a treatment guideline - 2014.U.S. Department of Veteran’s Affairs.AIDS-defining illnesses.Rajmohan R, Khoury D, Perez-Rosendahl M, Mnatsakanyan L, Groysman L.Polymerase chain reaction (PCR)-negative herpes simplex virus (HSV) encephalitis in a 62-year-old woman with p-ANCA vasculitis.Cureus. 2022 Jan;14(1):e21480. doi:10.7759/cureus.21480Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.Whitley RJ, Hook EW,Shedding patterns of genital herpes simplex virus infections.JAMA.2022;328(17):1710-1711. doi:10.1001/jama.2022.18930
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wisconsin Department of Health Services.Herpes gladiatorum.Field RD, Taylor BM.Recurrent herpes gladiatorum: should we be screening our service members prior to close combat training?Mil Med.2020;185(5-6):e904-e908. doi:10.1093/milmed/usz317.MedlinePlus.Herpes simplex.Centers for Disease Control and Prevention.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.Johns Hopkins Medicine.Oral herpes.Ramchandani M, Kong M, Tronstein E, et al.Herpes simplex virus type 1 shedding in tears, and nasal and oral mucosa of healthy adults.Sex Transm Dis. 2016 Dec;43(12):756–760. doi:10.1097/OLQ.0000000000000522University of Utah.Herpes: the blistering facts.American Academy of Dermatology Association.Herpes simplex: overview.Saleh D, Yarrarapu SNS, Sharma S.Herpes Simplex Type 1.American Academy of Ophthalmology.Herpes simplex virus keratitis: a treatment guideline - 2014.U.S. Department of Veteran’s Affairs.AIDS-defining illnesses.Rajmohan R, Khoury D, Perez-Rosendahl M, Mnatsakanyan L, Groysman L.Polymerase chain reaction (PCR)-negative herpes simplex virus (HSV) encephalitis in a 62-year-old woman with p-ANCA vasculitis.Cureus. 2022 Jan;14(1):e21480. doi:10.7759/cureus.21480Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.Whitley RJ, Hook EW,Shedding patterns of genital herpes simplex virus infections.JAMA.2022;328(17):1710-1711. doi:10.1001/jama.2022.18930
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Wisconsin Department of Health Services.Herpes gladiatorum.Field RD, Taylor BM.Recurrent herpes gladiatorum: should we be screening our service members prior to close combat training?Mil Med.2020;185(5-6):e904-e908. doi:10.1093/milmed/usz317.MedlinePlus.Herpes simplex.Centers for Disease Control and Prevention.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.Johns Hopkins Medicine.Oral herpes.Ramchandani M, Kong M, Tronstein E, et al.Herpes simplex virus type 1 shedding in tears, and nasal and oral mucosa of healthy adults.Sex Transm Dis. 2016 Dec;43(12):756–760. doi:10.1097/OLQ.0000000000000522University of Utah.Herpes: the blistering facts.American Academy of Dermatology Association.Herpes simplex: overview.Saleh D, Yarrarapu SNS, Sharma S.Herpes Simplex Type 1.American Academy of Ophthalmology.Herpes simplex virus keratitis: a treatment guideline - 2014.U.S. Department of Veteran’s Affairs.AIDS-defining illnesses.Rajmohan R, Khoury D, Perez-Rosendahl M, Mnatsakanyan L, Groysman L.Polymerase chain reaction (PCR)-negative herpes simplex virus (HSV) encephalitis in a 62-year-old woman with p-ANCA vasculitis.Cureus. 2022 Jan;14(1):e21480. doi:10.7759/cureus.21480Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.Whitley RJ, Hook EW,Shedding patterns of genital herpes simplex virus infections.JAMA.2022;328(17):1710-1711. doi:10.1001/jama.2022.18930
Wisconsin Department of Health Services.Herpes gladiatorum.
Field RD, Taylor BM.Recurrent herpes gladiatorum: should we be screening our service members prior to close combat training?Mil Med.2020;185(5-6):e904-e908. doi:10.1093/milmed/usz317.
MedlinePlus.Herpes simplex.
Centers for Disease Control and Prevention.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.
Johns Hopkins Medicine.Oral herpes.
Ramchandani M, Kong M, Tronstein E, et al.Herpes simplex virus type 1 shedding in tears, and nasal and oral mucosa of healthy adults.Sex Transm Dis. 2016 Dec;43(12):756–760. doi:10.1097/OLQ.0000000000000522
University of Utah.Herpes: the blistering facts.
American Academy of Dermatology Association.Herpes simplex: overview.
Saleh D, Yarrarapu SNS, Sharma S.Herpes Simplex Type 1.
American Academy of Ophthalmology.Herpes simplex virus keratitis: a treatment guideline - 2014.
U.S. Department of Veteran’s Affairs.AIDS-defining illnesses.
Rajmohan R, Khoury D, Perez-Rosendahl M, Mnatsakanyan L, Groysman L.Polymerase chain reaction (PCR)-negative herpes simplex virus (HSV) encephalitis in a 62-year-old woman with p-ANCA vasculitis.Cureus. 2022 Jan;14(1):e21480. doi:10.7759/cureus.21480
Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.
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