Herpes Gladiatorum: Symptoms, Causes and Treatment

Medically reviewed by Dr. Ola Tarabzuni

Key Takeaways

  • Herpes gladiatorum, or mat herpes, is a viral skin herpes infection primarily caused by herpes simplex type 1 (HSV-1).
  • Mat herpes is commonly transmitted through direct skin-to-skin contact or contact with contaminated objects in contact sports like wrestling, rugby, and martial arts.
  • Symptoms include skin herpes rash including, clusters of fluid-filled blisters, painful sores, swollen lymph nodes, and fever. Prompt recognition and medical attention are essential.
  • Diagnosis involves clinical evaluation, physical examination, and laboratory testing such as viral culture or PCR tests.
  • Treatment focuses on managing symptoms and promoting healing. Antiviral medications, topical treatments, and pain management are commonly used.
  • Preventive measures to stop the spread of herpes gladiatorum include avoiding skin-to-skin contact during outbreaks, practicing good hygiene, covering lesions, avoiding sharing personal items, and regular viral testing.
  • Education, awareness, and communication among athletes, coaches, and sports organizations are vital for prevention and transmission reduction.


In the world of contact sports, athletes are constantly pushing their limits to achieve greatness. However, amidst the fierce competition, there’s a lurking adversary known as herpes gladiatorum, commonly called mat herpes. This highly contagious viral infection poses significant challenges for athletes, their coaches, and healthcare professionals. You may wonder why Herpes gladiatorum is common in athletes. Skin-to-skin contact and breaks in the skin facilitate transmission. Shared equipment and close personal contact contribute to its spread. Intense physical activity and sweating can weaken the immune system, increasing susceptibility.

In this article, we will delve into the intriguing world of herpes gladiatorum, exploring its symptoms, causes, and additionally the latest advancements in treatment.

What is Herpes Gladiatorum?

Herpes gladiatorum is a herpes simplex virus type 1 skin infection. Herpes gladiatorum is often known as mat herpes due to its prevalence among wrestlers. This virus is also responsible for cold sores or fever blisters on the lips.

Infections with Herpes gladiatorum are common in people who participate in contact sports. Once infected with the virus, a person is affected for life. A person may experience “flare-ups” of symptoms induced by stress or disease. The illness can appear anywhere on the skin. However, it is usually observed on athletes’ heads, necks, and trunks.

Are only athletes prone to develop the Infection? No, The HSV-1 strain of the herpes gladiatorum virus can also be spread by kissing, sharing food or drink containers, dining utensils, cell phones, or lip balm with other persons.

Herpes Gladiatorum Vs Mucocutaneous Herpes or Cold sore

Herpes GladiatorumMucocutaneous Herpes (Cold Sores)
Caused byHerpes simplex virus type 1 (HSV-1)Herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2)
Mode of TransmissionDirect skin-to-skin contact with an infected personDirect contact with a cold sore or infected saliva
Commonly affectsWrestlers, athletes, and individuals involved in close-contact sportsGeneral population, often around the lips or mouth
Primary symptomsPainful, fluid-filled blisters or lesions on the skin, typically on the face, neck, or trunkSmall, fluid-filled blisters or sores on or around the lips, mouth, or nose
Incubation period2 to 12 days2 to 12 days
RecurrenceMay recur due to skin trauma or viral reactivationRecurrent outbreaks are common, usually in response to triggers like stress, sunlight, or illness
Extra-oral involvementLesions may also appear on the neck, arms, and other exposed skinTypically limited to the area around the mouth and lips
ComplicationsRarely, may cause severe systemic illness in immunocompromised individualsGenerally mild, but can be bothersome or painful
DiagnosisClinical examination, viral culture, or polymerase chain reaction (PCR) testing of a swab from the lesionClinical examination and history, may not require laboratory testing
TreatmentAntiviral medications (e.g., acyclovir, valacyclovir) to reduce severity and duration of symptomsAntiviral creams or ointments (e.g., acyclovir, docosanol) and oral antiviral medications for severe or recurrent cases
PreventionAvoiding skin-to-skin contact during outbreaks, good hygiene practices, and maintaining a clean sports environmentAvoiding close contact with infected individuals, not sharing personal items, and practicing good hand hygiene
Why do I have herpes in my arm? Consult an Online Doctor

What are the Symptoms of Herpes Gladiatorum Infection?

The mat herpes symptoms typically manifest within a few days of exposure. Athletes who contract herpes gladiatorum may experience the following:

Clusters of Fluid-Filled Blisters

Herpes skin lesions appear as small, fluid-filled facial, neck, shoulders, and trunk blisters. These blisters may be painful and itchy and can additionally rupture, leading to the formation of sores. Patients often describe these as herpes bumps on the body. 

Herpes Glagiatorum Painful Sores

The blisters eventually break open, leaving shallow ulcers or sores on the affected areas. These sores can be tender and painful and may take time to heal.

Swollen Lymph Nodes in Herpes Gladiatorum

The body’s immune response to the infection can result in swollen and tender lymph nodes in the nearby areas.

Fever and Mat Herpes

Some individuals may develop a mild to moderate fever along with other symptoms.

Itching and Discomfort in Herpes Simplex 1

Blisters and sores can cause intense itching and discomfort, interfering with an athlete’s performance and overall well-being.

Causes of Herpes Gladiatorum

Herpes gladiatorum is primarily caused by the herpes simplex virus type 1 (HSV-1), which is responsible for oral herpes (cold sores). The infection is often spread through direct skin-to-skin contact or contact with contaminated objects in environments where close physical contact is common, such as contact sports. The following are the leading causes of herpes gladiatorum:

Skin-to-Skin Contact

Direct touch with an infected person’s skin can spread the virus. This can occur during close physical contact, such as grappling, wrestling, or other contact sports, where contestants make direct skin-to-skin contact leading to mat herpes.

Contaminated Objects

Herpes gladiatorum can also be spread by contact with contaminated objects or surfaces. Examples are shared equipment, towels, mats, and other covers that have come into contact with the virus. Because the virus may survive on surfaces and remain infectious for long periods, transmission is possible if proper hygiene practices are not followed.

Warm and Moist Environments

The herpes simplex virus thrives in warm and moist environments. Sports arenas, training facilities, and locker rooms provide ideal conditions for the virus to survive and spread. Sweating during intense physical activity can also create a conducive environment for transmission.

Compromised Immune System

People who have compromised immune systems are more vulnerable to herpes gladiatorum. e.g. athletes who are weary, stressed, or have other underlying health issues that impact their immune function are included.

Viral Shedding

Even without visible symptoms like sores or blisters, an infected individual can still shed the virus and transmit it to others. This is called asymptomatic viral shedding, and it can occur periodically, increasing the risk of transmission.

Poor Hygiene Practices

Insufficient personal hygiene, such as improperly washing hands or sharing unwashed equipment, can contribute to the spread of HSV. It is vital to maintain good hygiene practices to minimize the risk of infection.

Outbreaks Within a Sports Community 

Suppose a single athlete within a sports team or community has an active herpes gladiatorum outbreak. In that case, there is a higher likelihood of transmission to other athletes due to the close physical contact and shared environment.

Lack of Awareness and Education

Insufficient knowledge about herpes gladiatorum and its transmission can contribute to its spread. Hence athletes and sports organizations that lack an understanding of the infection may not implement appropriate preventive measures or take necessary precautions to reduce transmission risks.

Pre-existing HSV infection 

Athletes with a history of herpes simplex virus infection, either oral (HSV-1) or genital (HSV-2), may be more prone to developing herpes gladiatorum if it spreads to other body parts through contact sports. Existing infections can increase the risk of recurrent outbreaks and transmission.

Proximity and Crowded Environments

Contact sports often involve training and competing in close quarters, such as locker rooms, gyms, or sports facilities. These crowded environments can facilitate the transmission of the herpes simplex virus, especially if proper hygiene practices and preventive measures are not followed.

Athletes, coaches, and sports organizations must be aware of these causes and take preventive actions to reduce the chance of transmission. Regular viral testing, tight cleanliness practices, and infection prevention education may be used to establish safer sporting settings and hence protect athletes from developing herpes gladiatorum.

How do you stop herpes gladiatorum from spreading? See an Online Doctor

How is Herpes Gladiatorum Diagnosed?

Herpes gladiatorum is usually diagnosed using clinical evaluation, physical examination, and laboratory testing. The following are the most popular approaches for diagnosing this condition:

Clinical Evaluation

A healthcare professional will review the individual’s medical history and inquire about symptoms, recent exposure to contact sports or individuals with herpes infections, additionally any previous history of herpes infections. This initial evaluation helps in assessing the likelihood of herpes gladiatorum.

Physical Examination

A thorough physical examination assesses characteristic symptoms such as clusters of fluid-filled blisters, painful sores, and swollen lymph nodes. The healthcare provider may examine the affected areas and take samples for further testing.

Viral Culture For Herpes Gladiatorum

A viral culture is taking a sample from a blister or sore and submitting it to a lab for testing. The item is tested for the presence of the herpes simplex virus. This test can assist in confirming a herpes gladiatorum diagnosis and additionally identify the specific strain of the virus.

Polymerase Chain Reaction (PCR) Test

PCR testing is a compassionate method that detects and amplifies the genetic material of the herpes simplex virus in a sample. This test can provide rapid and accurate results, even in cases where the viral load is low.

Read More: Pimples vs Herpes: Appearance, Symptoms and Treatments

Herpes Gladiatorum Treatment

The Mat herpes treatment focuses on managing symptoms, promoting healing, and reducing the risk of transmission. Here are the standard treatment options:

Antiviral Medications

Acyclovir, valacyclovir, and famciclovir are popular antiviral drugs administered to athletes with herpes gladiatorum. These drugs aid in the suppression of herpes simplex virus replication, the reduction of the severity and duration of outbreaks, and additionally, aid the acceleration of the healing process. Hence they work best if taken early in the course of the infection.

Topical Treatments

Topical antiviral creams or ointments may be prescribed to relieve discomfort and aid the healing of blisters and sores. These creams, e.g. acyclovir or penciclovir, are applied to affected areas daily.

Pain Management

Over-the-counter pain medications like acetaminophen or ibuprofen may help to ease the pain caused by herpes gladiatorum. Temporary relief can also be obtained via topical anesthetics or numbing lotions.

Prevention of Secondary Infections

Athletes with herpes gladiatorum should be cautious to prevent secondary bacterial infections in the affected areas. Keeping the blisters and sores clean, using sterile dressings if needed, and following proper wound care practices are essential to prevent complications.

While these treatments can help manage symptoms and encourage recovery, there is currently no cure for herpes gladiatorum. The virus can survive in the body and produce future outbreaks. Athletes who have had herpes gladiatorum in the past should be aware of the risk of recurrence and adopt preventive measures.

Consult now if you are an athlete experiencing painful blisters.

How do you Stop Hererpes Gladiatorum from Spreading?

To prevent contracting HSV-1, which causes herpes gladiatorum, avoid skin-to-skin contact with infected individuals, especially when sores are visible. Here are some preventive measures and cautions that with help in the spread of Mat herpes.

Good Hygiene Practices

Maintaining good hygiene is crucial to prevent the spread of herpes gladiatorum. Athletes should avoid touching or scratching the affected areas, wash their hands thoroughly, and keep the blisters and sores clean and dry. It is also important not to use personal items, such as towels, clothing, or equipment, to minimize the risk of transmission.

Education and Awareness

Provide thorough education on herpes gladiatorum to athletes, coaches, and the sporting community. This provides details on the infection, transmission methods, and protective measures. Additionally, educational resources and awareness campaigns can assist in spreading knowledge and modelling appropriate behaviour.

Prompt Identification and Isolation

Athletes should keep a close eye on their health and report any symptoms, including tingling, itching, or sores or blisters, as soon as they occur. Athletes should avoid playing contact sports if they exhibit herpes gladiatorum signs until they have been examined and cleared by a medical practitioner to stop the illness from spreading.

Avoid Direct Contact with Active Lesions

The patient should avoid direct skin-to-skin contact with people if they have current herpes gladiatorum lesions or open sores. Transmission to other athletes can be minimized during practice or contests by appropriately bandaging or treating the infected regions.

Disinfection of Equipment and Facilities

Regularly clean and sanitize shared equipment, such as mats, safety gear, and playing fields. Utilize suitable herpes simplex virus-resistant disinfectants. Ensure that the showers, locker rooms, and sports facilities are thoroughly cleaned and sanitized.

Social Distancing and Limiting Close Contact

Encourage athletes to keep a reasonable space between themselves and others whenever possible, both during practice and outside the sporting environment. Avoid activities that require extended and close personal contact and limit unnecessary physical contact, primarily if an outbreak is known to be present.

Regular Testing and Monitoring

In particular, if there is a known history or risk of herpes gladiatorum, implement routine testing measures for players participating in contact sports. In sports groups, regular testing can help identify asymptomatic people and stop the illness from spreading.

How do wrestlers prevent herpes? Ask an Online Doctor

Consult a Doctor

Consult a doctor if you experience fluid-filled blisters, painful sores, swollen lymph nodes, or fever related to herpes gladiatorum or suspect exposure to an active herpes infection through close skin-to-skin contact, especially in contact sports. Recurring outbreaks require a doctor’s visit for effective management. Discussing concerns about transmission and seeking accurate information from a healthcare professional is crucial.


How serious is herpes gladiatorum?

Herpes gladiatorum can be a severe health risk for athletes because it can be uncomfortable, interfere with sports participation, and perhaps result in consequences. If HSV-1 infection affects the eye, prompt medical care is necessary as this illness can be catastrophic.

How long is herpes gladiatorum contagious?

Herpes gladiatorum is contagious if active lesions or open sores are present.

How often does herpes gladiatorum flare up?

Herpes gladiatorum flare-ups might occur more frequently or less frequently, depending on the individual. Years may pass between occurrences for some people’s outbreaks, but others may experience more frequent recurrences. It can vary from once or twice a year to once a month. The immune system of the person, general health, and specific triggers can all impact how frequently flare-ups occur. 

What antibiotics are used for herpes gladiatorum?

Antibiotics are not typically used to treat herpes gladiatorum. Antiviral medications, e.g. acyclovir, valacyclovir, or famciclovir, are the primary treatments for herpes gladiatorum.

Is herpes gladiatorum painful?

These are fluid-filled blisters which may or may not cause pain. These lesions can interfere with an athlete’s performance and overall well-being. Itching and discomfort are also common symptoms associated with herpes gladiatorum.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

Get started today

Talk to online doctors now and get medical advice, online prescriptions, and referrals within minutes. On-demand healthcare services at your fingertips.

talk to online doctor 24/7 free

See a doctor now

Continue in Browser