Viral Skin Infection: Herpes gladiatorum ('Mat Herpes')

What is herpes gladiatorum?

Herpes gladiatorum ("mat herpes") is a skin infection caused by herpes simplex virus type 1 (HSV-1), the same virus that causes cold sores on the lips. HSV-1 infections are very common. In the United States, 30% to 90% of people are exposed to herpes by adulthood, although many people never develop symptoms.

While herpes gladiatorum (HSV-1) can be treated, once infected with the virus, a person is infected for life. People with herpes gladiatorum can have periods where the virus is inactive and cannot be spread to others. However, the virus can reactivate at any time and be transmitted to others, even if there are no symptoms (such as sores). This is why prevention is so important.

Herpes simplex virus type 1 (HSV-1) on lip
Herpes simplex virus type 1 (HSV-1) on lip

What parts of the body can herpes gladiatorum (HSV-1 infection) affect?

Athletes with herpes gladiatorum may develop lesions anywhere on the face or body. HSV-1 infection of the eye can be serious and requires immediate medical attention.

Picture from the CDC of Viral Skin Infection - Herpes gladiatorum, the site is the eye
HSV-1 on and around eye

Is herpes gladiatorum only spread between athletes?

No. HSV-1, the virus that causes herpes gladiatorum, can be spread to others through direct skin contact with lesions -- this includes kissing or sharing beverage containers, eating utensils, cell phones, or lip balm with others.

What are the symptoms of herpes gladiatorum (HSV-1 infection)?

  • Symptoms usually begin about 8 days after exposure to HSV-1.
  • Fever (especially during the first episode).
  • Swollen glands (enlarged lymph nodes).
  • A tingling feeling at the affected area.
  • A cluster (usually more than one) of clear, fluid-filled blisters that may be surrounded by redness -- these blisters may or may not be painful.
  • Blisters and lesions usually heal within 7 to 10 days.
  • People with HSV-1 infection are infected for life, may have periodic outbreaks, and can transmit the virus to others.

Picture from the CDC of Viral Skin Infection - Herpes gladiatorum, the site is the arm
Herpes outbreak on arm

How is herpes gladiatorum diagnosed and treated?

  • If you suspect you have HSV-1 infection, inform your coach immediately -- early identification and treatment of skin infections is important for your health and the health of your teammates and opponents.
  • Some cases of herpes are mild and may not need treatment. However, athletes should not practice, play, or compete until a medical provider determines that the lesions are no longer infectious (contagious).
  • Athletes who have severe or prolonged outbreaks (especially if it is the first episode), immune system problems, or frequent outbreaks may be prescribed antiviral medications.

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