Herpes simplex commonly known as herpes is a common viral infection. It causes sores on your genitals and/or mouth. Herpes can be annoying and painful, but it usually doesn’t lead to serious health problems. If you’ve ever had a cold sore or fever blister, you picked up the herpes simplex virus.
Herpes are categorized into two types: herpes type 1 (HSV-1) and herpes type 2 (HSV-2). However, most cold sores are caused by herpes simplex virus type 1 (HSV-1). Other names for cold sores caused by HSV-1 are:
- Oral herpes.
- Mouth herpes.
HSV-1 can cause genital herpes, but most cases are caused by herpes type 2. In HSV-2, the infected person may have sores around the genitals or rectum. Although HSV-2 sores may occur in other locations, these sores are usually below the waist. But either HSV-1 or HSV-2 can cause a herpes sore on the face or genitals.
How do you get herpes simplex?
Herpes simplex is easily spread from skin-to-skin contact with someone who has the virus. You can get it when your genitals and/or mouth touch their genitals and/or mouth. This is usually during oral, anal, and vaginal sex.
You can still get herpes even if the penis or tongue doesn’t go all the way in the vagina, anus, or mouth. You don’t have to cum to spread herpes simplex. All it takes is some quick skin-to-skin touching. You can also get herpes from kissing someone who has oral herpes.
The skin on your genitals, mouth, and eyes can be infected easily. Infection can however occur in other areas if there’s a way for the herpes virus to get in, like through a cut, burn, rash, or other sores. Sometimes herpes can be passed in non-sexual ways, like if a parent with a cold sore gives you a peck on the lips. Most people with oral herpes got it when they were kids. A mother can pass genital herpes to a baby during vaginal childbirth, but that’s pretty rare.
You can spread herpes to other parts of your body if you touch a herpes sore and then touch your mouth, genitals, or eyes without washing your hands first. You can also pass herpes to someone else this way.
Who gets herpes simplex?
Most people get HSV-1 (herpes simplex type 1) as an infant or child. This virus can be spread by skin-to-skin contact with an adult who carries the virus. An adult does not have to have sores to spread the virus.
A person usually gets HSV-2 (herpes simplex type 2) through sexual contact. About 20% of sexually active adults carry HSV-2. Some people are more likely to get HSV-2. These people:
- Are female.
- Have had many sex partners.
- Had sex for the first time at a young age.
- Have (or had) another sexually transmitted infection.
- Have a weakened immune system due to a disease or medicine.
What happens once you have HSV-1 or HSV-2?
Once a person becomes infected with a herpes virus, the virus never leaves the body. After the first outbreak, the virus moves from the skin cells to nerve cells. The virus stays in the nerve cells forever. But it usually just stays there. In this stage, the virus is said to be dormant, or asleep. But it can become active again.
Some things that can trigger (wake up) the virus are:
- Sun exposure
- Menstrual periods
What are the signs and symptoms of herpes?
A person can have HSV and not know it. Symptoms may not appear for months or years. Many people who do get symptoms do not realize that they are due to HSV. If you develop signs and symptoms of herpes simplex, you can expect to have these for as long as listed below:
- Oral (mouth) herpes: 2 to 3 weeks
- Genital herpes: 2 to 6 weeks (the first outbreak)
The first outbreak can last longer and be more severe than future outbreaks. Early symptoms include itching, burning, or tingling at the site where blisters or sores may appear. This is followed by painful red sores or tiny blisters and sometimes swollen glands, fever and body aches. Sometimes people have severe flu-like symptoms, such as fever, headache and muscle aches. Over time, outbreaks usually happen less often and the symptoms are milder.
People (most often women) with genital herpes may have trouble urinating or have a burning feeling while urinating. Sometimes the herpes simplex virus can spread to one or both eyes. If this happens, you can have pain, light sensitivity, discharge, and a gritty feeling in the eye. Without prompt treatment, scarring of the eye may result. Scarring can lead to cloudy vision and even loss of vision.
How do doctors diagnose herpes simplex?
During an outbreak, a dermatologist often can diagnose herpes simplex by looking at the sores. The best test for herpes involves taking a swab from the sore as soon as possible after it develops.
Blood tests are not routinely done, but in some cases such as pregnancy, blood tests may be helpful. Most blood tests are accurate 12 to 16 weeks after possible exposure to HSV. A positive herpes test does not tell you how long you have had the virus.
What are the treatment for herpes simplex?
There is no cure for herpes simplex. The good news is that sores often clear without treatment. Many people choose to treat herpes simplex because treatment can relieve symptoms and shorten an outbreak.
Treatment is mostly with an antiviral medicine. An antiviral cream or ointment can relieve the burning, itching, or tingling. An antiviral medicine that is oral (pills) or intravenous (shot) can shorten an outbreak of herpes.
These medicines can lessen the severity of an outbreak and also lower the chances of passing the virus to a partner. It can also shorten the time it takes for a sore to heal. Medication works best if it is started as soon as possible after an outbreak begins.
However, it is not necessary to treat herpes, but you can talk to your doctor or health care provider if you want more information about this medication.
There are things you can do at home to help manage herpes sores.
You can also help ease the pain by:
- taking a warm bath
- keeping your genital area dry (moisture makes the sores last longer)
- wearing soft, loose clothes
- putting an ice pack on the sores
- taking a pain reliever like aspirin, ibuprofen or acetaminophen.
- applying medicine that you can buy without a prescription, such as benzocaine to the blisters.
- avoiding things that could trigger another outbreak, such as stress and getting a sunburn.
Avoid spreading the virus
The following may reduce the risk of spreading the herpes simplex virus:
Oral herpes (herpes simplex type 1)
If you have sores on your face do not:
- kiss anyone.
- have oral sex.
- share items such as silverware, cups, towels, and lip balms.
If you have tingling, burning, itching, or tenderness where you had a herpes sore, keep that area of your body away from others. You can prevent spreading the sores to other parts of your body by:
- Washing your hands after touching a cold sore.
- Using a cotton-tip swab to apply herpes medicine to a cold sore also helps.
Genital herpes (herpes simplex type 2)
When you have sores or symptoms do not have sex with uninfected partners.
- If you do not have sores or symptoms, use a latex condom to lower the risk of spreading the virus. You should know that even with a condom, it is possible to spread the virus if it lies on nearby skin that the condom does not cover.
- If you are pregnant tell your doctor if you or your partner has genital herpes. You may need to take medicine at the end of your pregnancy to prevent passing the virus to your baby.
If you find out that you have herpes, try not to freak out. There are a few ways that you can stop it from spreading to your partners and other parts of your body.
- Always use condoms and dental dams during oral, anal, and vaginal sex.
- Talk with your doctor about taking herpes medication every day, which can lower your chances of spreading herpes.
- Don’t have sex during a herpes outbreak, even with a condom. There may be sores on places the condom doesn’t cover.
- Learn how to tell when an outbreak is coming, and stop having sex right when you notice these signs. You may feel a burning, itching, or tingling feeling that lets you know you’re about to get sores.
- Don’t have sex until your sores are totally gone, and the scabs heal and fall off.
- Don’t touch your herpes sores, because you can spread the infection to other parts of your body or other people. If you touch a sore, wash your hands with soap and water right after.
- Don’t wet contact lenses with spit — this might spread your oral herpes to your eye.
- If you have a cold sore on your mouth, don’t kiss anyone — especially babies, children, or pregnant women.
- Always tell your sexual partners that you have herpes before you have sex, so you can work together to prevent it from spreading. Telling someone you have an STI can be hard, but herpes is super common and doesn’t lead to serious health problems. So try not to be too embarrassed or stressed out about it.