Diseases and Disorders > STDs/STIs > Herpes > > Herpes - Overview

The Facts About Herpes

There may be stigma, but that doesn't stop most Americans from contracting the virus.

A pair of red lips with red herpes spots on it is against a blue and green background.
Illustration by: Brandon Cornwell

Herpes simplex virus type 1 (HSV-1), often referred to as herpes, infects an estimated 2 in 3 adults younger than age 50 worldwide.

Further education about herpes is an essential step toward ending its negative stigma and informing people how best to prevent and treat it.

Overview

Herpes is spread through skin-to-skin contact, typically involving an open sore. The virus can also be transmitted through saliva and genital secretions. For this reason, herpes is often spread during kissing, as well as vaginal, oral and anal sex.

There are two types of herpes: HSV-1 and HSV-2. HSV-1 is typically associated with oral herpes and features outbreaks of painful sores around the mouth, while HSV-2 most often presents as genital herpes.

Genital herpes is a sexually transmitted infection (STI) spread when an individual has sexual contact with someone who already has the virus. Individuals with genital herpes may suffer from outbreaks of blisters or open sores in the genital area. It's not uncommon for an infected person to present no symptoms at all, which is problematic because that individual has no idea they are potentially infecting other people.

The Centers for Disease Control and Prevention (CDC) reported an estimated 40 million to 50 million adults in the United States have genital herpes. Statistics indicate HSV-2 is more common among women and people who have had more than five sexual partners.

According to experts, most individuals with HSV-2 are unaware they are infected because of a lack of symptoms.

Herpes is spread through skin-to-skin contact, typically involving an open sore. The virus can also be transmitted through saliva and genital secretions. For this reason, herpes is often spread during kissing, as well as vaginal, oral and anal sex.

There are two types of herpes: HSV-1 and HSV-2. HSV-1 is typically associated with oral herpes and features outbreaks of painful sores around the mouth, while HSV-2 most often presents as genital herpes.

Genital herpes is a sexually transmitted infection (STI) spread when an individual has sexual contact with someone who already has the virus. Individuals with genital herpes may suffer from outbreaks of blisters or open sores in the genital area. It's not uncommon for an infected person to present no symptoms at all, which is problematic because that individual has no idea they are potentially infecting other people.

The Centers for Disease Control and Prevention (CDC) reported an estimated 40 million to 50 million adults in the United States have genital herpes. Statistics indicate HSV-2 is more common among women and people who have had more than five sexual partners.

According to experts, most individuals with HSV-2 are unaware they are infected because of a lack of symptoms.

What is herpes?

Herpes is an extremely common viral infection that can cause sores on the genitals and/or mouth.

The infection is caused by two different viruses known as HSV-1 and HSV-2. While HSV-1 is more commonly associated with oral herpes and HSV-2 with genital herpes, both can cause the development of sores on the vulva, vagina, cervix, penis, scrotum, butt, anus, inner thighs, mouth, lips and throat.

Infected individuals may experience periodic outbreaks of blisters or sores that may be itchy and painful, or minor enough to go unnoticed. People who have herpes may experience only one initial outbreak, intermittent outbreaks or no symptoms at all.

It's important to note, though, that the virus can be spread even in the absence of symptoms.

How common is herpes?

The herpes simplex viruses, which include both HSV-1 and HSV-2, are extremely common. Chances are you probably know a person—or multiple people—who has contracted herpes. You may even unknowingly have it yourself.

In fact, the World Health Organization (WHO) reported more than 3.7 billion people younger than age 50—67 percent of the world's population—have HSV-1. Genital herpes is also ubiquitous. The WHO estimated that 417 million people ages 15 to 49 have HSV-2.

Additionally, about half a billion people in that same age bracket are estimated to have had a genital infection caused by either HSV-1 or HSV-2.

How can I prevent genital herpes?

According to the CDC, since genital herpes is spread through sexual contact, the best way to prevent it is to abstain from sex altogether or have sex only with someone who is not infected and who also has sex only with you.

Condoms are known to greatly reduce the risk of spreading genital herpes, but only if they are always used correctly. It's important to note condoms protect only the area they directly cover, while sores caused by genital herpes may be in the general genital region that isn't protected by a condom.

Is there a cure for genital herpes?

There is currently no cure for herpes—genital or oral. However, a doctor can prescribe medications to help reduce symptoms and expedite healing when you experience an outbreak.

Act fast, because these treatments work best when started shortly after the outbreak emerges. These medications can help to lessen the frequency and intensity of symptoms and outbreaks, too.

What are the symptoms of herpes?

The symptoms of herpes vary based on whether they are affecting the oral area or the genital area.

The initial infection of oral herpes tends to be the worst and can cause severe flu-like symptoms. The initial infection can cause sores to emerge on or around the lips and inside the mouth. Sores usually begin to heal within four to six days. Subsequent outbreaks of oral herpes tend to be milder.

Of course, there may be no symptoms at all.

Similar to oral herpes, the initial, or primary, infection of genital herpes is typically the worst, with subsequent outbreaks lessening in severity. Symptoms can include the emergence of blisters or ulcers on or around the genitals or even on the mouth or lips. Again, some people never experience any symptoms at all.

Other common symptoms of genital herpes include:

  • Fever
  • Headache
  • Joint pain
  • Trouble urinating

Diagnosis and testing

Oral herpes can be definitively diagnosed with a blood test or biopsy. However, a doctor may diagnose an individual simply due to the location and appearance of the blisters or sores.

Similarly, genital herpes is diagnosed with blood tests or through testing cells extracted from the fluid inside the blister. CDC guidelines dictate testing for genital herpes is only necessary if symptoms are present.

Treatment of herpes

For people who are asymptomatic or have few outbreaks, treatment is not always necessary. However, many people who experience outbreaks opt to use medication that shortens flare-ups and reduces symptoms. Some antiviral ointments and creams can achieve this, but only when started quickly after the first symptoms appear.

According to Cleveland Clinic, HSV-2 outbreaks can be treated with topical or oral medications, including:

  • Acyclovir (brand names: Sitavig, Zovirax)
  • Famciclovir (Famvir)
  • Valacyclovir (Valtrex)

And oral herpes can be treated with:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Over-the-counter creams such as L-lysine, benzocaine (brand name: Orajel) or docosanol (Abreva)

Prevention

Avoid physical contact with anyone who has a cold sore to reduce your risk of contracting HSV-1. While you can still spread the virus even without a cold sore, it's not as likely.

Physical contact that should be avoided with someone who has an active cold sore includes:

  • Kissing or touching the skin around the mouth
  • Oral sex
  • Sharing eating utensils and dishes
  • Sharing makeup

The best way to avoid or reduce your chances of contracting genital herpes is to abstain from sex altogether, only have monogamous sex with an uninfected person who only has sex with you or always practice safer sex.

The social stigma surrounding herpes

Both oral herpes and genital herpes are extremely common infections among adults worldwide. Though there is no cure, there are treatments available that shorten outbreaks and reduce symptoms. Suppression treatments also can significantly reduce an infected person's chances of spreading the virus to their sexual partner(s).

Despite the fact that more than half of the world's population has either oral or genital herpes, social stigma around people who are infected remains. Further education is necessary to reduce these negative and unfair beliefs and to instead focus on reducing the spread of the virus.

FAQs

How do you know if you have herpes?

Herpes can be diagnosed based on a physical evaluation by a doctor, though a diagnosis can be confirmed only with blood tests or a biopsy.

Can herpes simply go away?

There is currently no cure for herpes. However, while the virus never leaves your body, the virus often lies dormant, causing infrequent outbreaks or, for some people, no symptoms at all. Outbreaks can be shortened by certain medications.

How do you get herpes?

Herpes is spread through skin-to-skin contact with an infected person, typically involving an open sore. The virus can also be transmitted through saliva and genital secretions.

How can I get more information on herpes?

Here are some links to useful resources from the CDC, Planned Parenthood and Cleveland Clinic for patients and caregivers: