Herpes Gladiatorum, or Mat Herpes: What to Know

Herpes gladiatorum is a type of herpes virus spread by skin-to-skin contact. It's a prevalent problem in close contact sports like wrestling, earning it the nickname "mat herpes" for the surface wrestlers perform on.

Like most types of herpes, herpes gladiatorum will stay in your body once you are infected. You'll also go through periods without active infection and other times when the infection flares up. Transmission increases during flare-ups.

This article will provide an overview of symptoms, causes, and treatments for herpes gladiatorum and discuss treatments and coping strategies for people diagnosed with this disease.

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What Is Herpes Gladiatorum?

Herpes gladiatorum is a viral skin infection caused by herpes simplex type 1 (HSV-1) virus. This virus is one of many in the herpes family and can affect the skin on the face, mouth, or genitals. It is the same virus type that causes cold sores and some forms of genital herpes, although herpes simplex type 2 is more commonly associated with sexually transmitted genital herpes.

Herpes Gladiatorum Symptoms

HSV-1 infections are diagnosed based on associated symptoms and the areas of the body most affected. Many types of herpes result in the formation of blisters, but specific characteristics of a herpes gladiatorum infection set this type of herpes apart from other HSV-1 infections.

Symptoms

Herpes gladiatorum infections are distinguished from other types of HSV-1 infections based on where and when symptoms appear. A rash with blisters or lesions that form over the top of a red rash is the most common visible symptom. This rash often appears on the:

  • Back of the neck (lateral neck)
  • Sides of the face
  • Forearms

Blisters usually form within four to 11 days of exposure to the virus and can take one to two weeks to heal. Sometimes, these infections can be confused with a bacterial infection called bacterial folliculitis.

Other symptoms include:

Complications

Severe complications are most common when the virus affects the eye or enters the central nervous system. Either of these complications could lead to blindness.

HSV-1 infection in the eye can result in scarring of the cornea (the clear dome in front of the eye) or rupture of the globe (eyeball).

When the herpes virus enters the central nervous system, it can cause HSV encephalitis or inflammation of the tissues in your brain. If left untreated, this complication can be fatal.

Herpes Gladiatorum Causes and Risk Factors

Viruses can spread through the air or through direct contact. Direct contact is the most common form of transmission for viruses in the herpes family.

Causes

Herpes gladiatorum is caused by direct contact with HSV-1, meaning skin-to-skin contact with an infected person. Some types of herpes, like genital herpes caused by HSV-2, are spread through sexual contact.

Herpes gladiatorum is thought to be transmitted by direct contact of skin abrasions with an infected person's oral secretions, which occurs by direct contact with an infected person or by touching an object that an infected person has touched.

Risk Factors

Playing a close-contact sport, like wrestling, is a significant risk factor for contracting herpes gladiatorum. Any skin-to-skin contact with an infected area can spread the infection.

The virus can be passed from person to person through fluids left behind on wrestling mats. Wrestlers often have a lot of skin exposed and are in frequent contact with mats and with other wrestlers.

The Risk of Wrestling

Nearly 72% of all herpes gladiatorum outbreaks are contracted from wrestling partners.

Rugby is another sport in which herpes outbreaks happen frequently. Other close-contact sports like martial arts and combat training can be risky. Military experts warn that service members have a 33% chance of passing herpes gladiatorum on to a sparring partner.

Herpes Gladiatorum Treatment

There is no cure for herpes gladiatorum. Once infected, you will carry the virus for life. However, you will not always be in a state of active infection.

Much like treatment for other forms of herpes, there are effective antiviral medications you can take to treat outbreaks when they occur. If you get frequent outbreaks, talk to your healthcare provider about taking a daily antiviral medication to suppress them.

When to See a Healthcare Provider

If you think you may have contracted herpes gladiatorum, it is best to see a healthcare provider right away. The antiviral medications most often used to treat this infection must be prescribed, and it's important to rule out other types of viral or bacterial infections.

Herpes infection with blisters in or around the eye, systemic symptoms (experienced throughout the body) like a fever, or other symptoms such as confusion could be signs of more severe complications. Be sure to discuss these symptoms with your healthcare provider immediately or seek urgent care.

Diagnosis

The diagnosis is usually based on confirmation by a PCR (polymerase chain reaction, DNA detection) or culture of the virus from an active lesion. The PCR is the most sensitive option.

An antibody testing requiring a blood sample may be offered, but it is not typically used since it is not as accurate for an acute infection.

Talk to your healthcare provider about the best option to confirm your diagnosis.

Treatments

HSV-1 infections can't be cured, but there are options for treating flare-ups. Systemic antiviral medications are usually prescribed, and options for initial treatment and recurrent infections include:

  • Valtrex (valacyclovir)
  • Zovirax (acyclovir)

Both of these medications may also be used as suppressive therapy to help prevent flare-ups. Dosing varies depending on whether the medication is used to treat an initial infection, recurrent infection, or as a preventive option.

Living With Herpes Gladiatorum

Herpes gladiatorum is very contagious, so avoiding contact with infected individuals and taking specific preventive measures are vital to avoid this virus.

Prevention strategies for avoiding HSV-1, especially for people at high risk of contracting the virus as wrestlers, include:

  • Change and clean uniforms after every use.
  • Clean headgear or other personal equipment daily.
  • Clean the soles of shoes on a disinfectant-soaked towel before stepping onto a wrestling mat.
  • Do not share soap, towels, or other personal hygiene items.
  • Report sores or blisters to the coaching staff.
  • Shower immediately after sports or activities.
  • Wash hands before and after practices or competitions.
  • Wash your towel with hot water, detergent, and bleach, if possible.

Preventing Herpes Flare-Ups

Once infected with a herpes virus, your symptoms may go away for a time but can flare up again, especially when you have:

  • Another illness of infection
  • Hormonal changes
  • Increased stress
  • Poor diet

The key to preventing a herpes flare-up is taking care of your overall health and wellbeing.

Outlook

A herpes gladiatorum infection doesn't usually cause severe health problems, but it is a lifelong infection for which there is no cure. There are medications that can help control outbreaks and flare-ups, but you may continue to have symptoms from time to time.

Summary

Herpes infections are viral infections that cannot be cured and cause a wide range of symptoms. Herpes gladiatorum is a type of HSV-1 infection that develops mostly on the head, neck, and trunk and appears with blisters and a rash. This type of herpes infection is very contagious but not usually life-threatening.

A Word From Verywell

Having herpes can be embarrassing and uncomfortable. Herpes gladiatorum is a type of herpes virus that develops from skin-to-skin contact, often during sports like wrestling. Practicing good hygiene and caring for your overall health can help you avoid infection or prevent flare-ups.

 

Frequently Asked Questions

  • Is herpes gladiatorum a sexually transmintted infection (STI)?

    Herpes gladiatorum spreads through skin-to-skin contact in close contact sports, like wrestling or rugby. It is possible to contract this virus during sexual contact, but this form of herpes isn't primarily known as an STI.

  • How do you know if you have herpes gladiatorum?

    It can be challenging to tell if you have herpes gladiatorum because many skin conditions can cause blisters and a rash. Your healthcare provider will diagnose you by testing an active lesion when you have one. They may be able to get information by testing your blood for antibodies, but this is unlikely to confirm the diagnosis.

  • How long does herpes gladiatorum last?

    Herpes lasts forever once you are infected and cannot be cured. However, you will go through periods in which you have symptoms and others when you don't. Blisters usually last a week or two during a flare-up.

  • Is herpes gladiatorum the same as shingles?

    Both herpes gladiatorum and shingles are caused by viruses in the herpes family, but herpes gladiatorum is caused by HSV-1 and shingles is caused by the varicella-zoster virus (VZV).

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  5. Duarte LF, Farías MA, Álvarez DM, Bueno SM, Riedel CA, González PA. Herpes simplex virus type 1 infection of the central nervous system: insights into proposed interrelationships with neurodegenerative disorders. Front Cell Neurosci. 2019;0 doi.org/10.3389/fncel.2019.00046

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By Rachael Zimlich, BSN, RN
 Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio.