Herpes gladiatorum is a viral infection. Sometimes called mat herpes, it is common among people who play high-contact sports, such as wrestling. It may present as blisters on the chest, neck, and face.

Once the herpes simplex virus 1 (HSV-1) enters the body, it resides there for life.

While there is no cure for an HSV-1 infection such as herpes gladiatorum, the virus often lies dormant, so there are periods when the person has no symptoms.

When the virus reactivates and symptoms flare, the virus is more likely to transmit to another person via skin-to-skin contact.

In this article, we explore the symptoms of herpes gladiatorum, its diagnosis and treatment, and how to prevent transmission.

The symptoms of herpes gladiatorum vary from person to person. HSV-1 can enter any part of the body, and the infection can be particularly dangerous if it develops in the eyes.

Symptoms tend to become evident within 8 days of the virus entering the body. They can include:

  • a fever
  • swollen glands
  • a sore throat
  • sores or blisters, which can be painful
  • a tingling sensation in the affected area
  • a headache

Without treatment, the sores or blisters usually take 7–10 days to clear. While symptoms are apparent, the virus is more transmissible.

The pattern of flare-ups varies from person to person. Symptoms of herpes gladiatorum may flare once a month or once a year, for example.

When the virus is dormant, the person has no symptoms. This is no guarantee that the virus cannot pass on, but it is less likely to do so during this time.

Complications

HSV-1 commonly causes blisters, such as cold sores, to form on the skin. Bacteria may enter these blisters, causing a secondary infection. In this case, antibiotics may be necessary.

Without treatment, the bacterial infection may spread to other areas, such as the brain, eyes, liver, or lungs. If this occurs, it is a medical emergency, and the person needs urgent care.

HSV-1 transmits via skin-to-skin contact. Herpes gladiatorum typically passes between people participating in high-contact sports, such as wrestling, rugby, or basketball. For this reason, the condition is also known as mat herpes.

The virus can also transmit through:

  • kissing, if one person has a cold sore
  • sexual contact
  • sharing item such as drinks, utensils, and cellphones

Also, periods of illness and stress can cause herpes flare-ups.

While some people go for long periods without having any symptoms, flare-ups can happen at any time.

A doctor can recommend precautions to prevent transmission, and this is especially important for people who regularly participate in contact sports.

To tell whether a person has herpes gladiatorum, a doctor first visually examines any blisters or sores. This may be all that is necessary.

In some cases, they may also order a blood test. A person carrying the virus has specific antibodies in their blood that can indicate the presence of HSV-1.

In other cases, a doctor may take a sample of the affected skin and send it off for analysis.

If a person has other symptoms of herpes gladiatorum but no sores, it is still best to avoid skin-to-skin contact and see a doctor, who may order a blood test for the virus.

Symptoms of herpes gladiatorum may be unpleasant but mild. Without any treatment, blisters should resolve within 10 days.

It is important to avoid skin-to-skin contact and sharing objects such as cups, cutlery, and phones until symptoms have disappeared.

Also, try not to irritate the affected skin, such as by picking or rubbing the blisters.

If symptoms are more severe or are causing discomfort, the doctor may prescribe an antiviral medication to ease the symptoms and speed recovery.

To treat herpes gladiatorum outbreaks, doctors commonly recommend:

  • acyclovir
  • valacyclovir
  • famciclovir

Medication may also help prevent outbreaks from occurring.

There are many ways to prevent the transmission of HSV-1. For example, a person can use barrier protection, such as condoms or dental dams, during sexual contact with someone who has herpes symptoms.

Also, people can undergo testing for HSV-1 before sexual contact with new partners. Some people carry the virus without realizing it.

Another strategy is to adopt highly effective hygiene practices. Key prevention techniques include:

  • showering immediately after every game or coaching or practice session
  • not sharing personal care items, such as razors, deodorants, or towels
  • washing towels and sports gear often, on a hot wash with bleach, if possible
  • making sure equipment is regularly cleaned
  • avoiding skin-to-skin contact with people who have sores or other herpes symptoms
  • checking for sores regularly
  • covering any open skin, such as a cut, with a bandage or dressing
  • not picking, popping — or even touching, if possible — blisters

These precautions are especially important for people with a higher risk of infection, such as those who regularly play contact sports.

For people with this level of risk, it may be possible to get a prescription for antiviral medication. Taking this medicine a few days before exposure to the virus can help the body develop immunity to it.

An HSV-1 infection, such as herpes gladiatorum, stays in the body for life, and the virus is always transmissible.

Symptoms appear as the virus periodically reactivates. During these times, the likelihood of transmission is higher. However, medications can reduce the frequency and severity of outbreaks, and there are many ways to keep the virus from spreading.

Anyone who may have herpes gladiatorum, or who may have a high risk of it, should see a doctor.