Oral herpes (HSV-1) infection (or exposure without noticeable infection) is common. About 65% of the U.S. population has detectable antibodies to HSV-1 by age 40. This article will focus on HSV-1, or oral herpes, not on HSV-2, also commonly known as genital herpes. Genital herpes is considered to be a sexually transmitted disease (STD). In addition, HSV-2 virus should not be confused with human papillomavirus (HPV), the cause of genital warts, and some cervical and other cancer types.
Herpes type 2 (HSV-2) can cause genital herpes. This is one of the most common sexually transmitted infections (STIs) in the US. It causes sores or painful blisters on the penis, vagina, scrotum, anus and buttocks. Along with blisters, people with HSV-2 may experience tingling, itching or pain. Like HSV-1, HSV-2 infections are highly contagious. They can be spread easily through skin-to-skin contact. Sexual intercourse is the main route of transmission.
That being said, if on paper the HSV titres are high, indicating a high viral load in the body, this can be an indicator of an impending flare. Knowing this, we can prescribe antiviral medications with the aim of suppressing the virus activity. The idea is that we reduce the viral load of HSV, therefore helping the body’s immunity better contain the virus.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Particularly when someone is on suppressive antiviral medication and practicing safer sex, risk of transmission can be greatly reduced. Cullins suggests female condoms (condoms that go inside the vagina and cover most of the vulva, though it's important to note that not all people with vaginas are female) to provide the most protection against transmission, though condoms that go over the penis will protect what they cover.


Genital herpes is not usually accommodated by symptoms. Two-thirds of genital herpes cases are asymptomatic. Getting tested for both HSV-1 and HSV-2 is the only sure way to know if you have genital herpes. Blisters or sores in the genital area, fever, body aches, swollen lymph nodes, headaches, tiredness and painful urination call all be symptoms of genital herpes.
According to Cullins, there are no standardized guidelines from the CDC for suppressive therapy through medication, but it is an option that people with HSV should talk to their healthcare providers about. “If a person knows they have had herpes in the past that has affected their genitals, they can take suppressive therapy — for example, 500 mg of valacyclovir daily.” While it won’t prevent outbreaks, it will prevent asymptomatic virus shedding. Preventing exposure to the virus through both medication and a physical barrier can be very effective.

Diagnosing herpes is made much easier if you present to your clinician at the time that the rash is present and if possible, we can take a sample from that to be sent for Herpes PCR (Polymerase Chain Reaction) studies to confirm the diagnosis. Advanced medical investigative techniques such as this will allow us to differentiate type one from type two herpes regardless of the nature and distribution of the rash.

Herpes virus type 3 is also known as varicella-zoster virus which causes chicken pox. This virus can also lead to a recurrent infection called herpes zoster or shingles. It occurs when the virus becomes reactivated after causing chicken pox and infects the skin. So if you have had chicken pox as a child, you may get shingles afterwards. Shingles and chicken pox cause blisters anywhere on the body. They are contagious and can be spread by direct contact with fluid from the blisters.
When we say, “herpes” many of us are thinking about genital herpes, famously known as an incurable inconvenience. But there is more to it than being just a sexually transmitted infection. There are multiple ways that herpes can transmit but genital herpes is usually picked up from sexual contact. Apart from that, herpes can be transmitted when sharing an environment with someone who has the infection as well.
For mild infections, self-care may be adequate for treatment. Other treatments termed "home remedies" are not considered cures but can ease or hasten recovery. These remedies include aloe vera gel, cornstarch paste, and tea or mint leaves. A cool compress may reduce pain. There is no cure for the infection. People with severe infection symptoms, especially children, should be evaluated by a medical caregiver.
Getting tested for STDs is a basic part of staying healthy and taking care of your body — like brushing your teeth and exercising regularly. Getting tested and knowing your status shows you care about yourself and your partner. STD awareness and testing is a basic part of staying healthy and taking care of your body. It’s important to know your risk and protect your health.
I do plan on dumping him, but I don't know how. I think I am still with him because I think if my test comes back positive for genital herpes he is the only guy who will ever want me if he did in fact give it to me or I have to stay with him because I may have given it to him. Somedays I feel like I can hand the idea of having herpes for the rest of my life but other days I am not so sure. I am so afraid. Its funny I use to say I never wanted to get married and have kids, but this situation has made me realize how much I want those things and now I may never get the chance. I guess thats life. Funny, as I write this I remember the first time I had sex with him he told me he used a condom but I don't think he did. I am such an idiot. I pray my blood test comes back negative. If it comes back positive life for me will be over.

Prodrome: Early in the phase of reactivation (also called an outbreak), many people experience an itching, tingling, or painful feeling in the area where their recurrent lesions will develop. This sort of warning symptom – called a “prodrome” – often comes a day or two before lesions appear. To be on the safe side, it’s best to assume virus is active (and, therefore, can be spread through direct skin-to-skin contact) during these times.
Although the cause is unknown, outbreaks are often associated with periods of weakened immune systems, skin wounds, menstruation, fever, nerve damage, tissue damage from surgery, or exposure to extreme climate situations. A genital herpes outbreak or episode occurs when the HSV-1 or HSV-2 virus is reactivated from its dormant stage. Genital herpes is an incurable disease, and once you contract it, you may experience outbreaks throughout your lifetime. Those who are experiencing their first herpes episode of genital herpes can expect to have several (typically four or five) outbreaks within a year. Over time these recurrences usually decrease in frequency and severity. The first outbreak of herpes is often the longest outbreak experienced. After that, short and inconsistent episodes can be managed and treated with antiviral medication.
Primary orofacial herpes is readily identified by examination of persons with no previous history of lesions and contact with an individual with known HSV infection. The appearance and distribution of sores is typically presents as multiple, round, superficial oral ulcers, accompanied by acute gingivitis.[39] Adults with atypical presentation are more difficult to diagnose. Prodromal symptoms that occur before the appearance of herpetic lesions help differentiate HSV symptoms from the similar symptoms of other disorders, such as allergic stomatitis. When lesions do not appear inside the mouth, primary orofacial herpes is sometimes mistaken for impetigo, a bacterial infection. Common mouth ulcers (aphthous ulcer) also resemble intraoral herpes, but do not present a vesicular stage.[39]
During these periods, it is especially important to abstain from kissing and any form of physical contact with the blistering area, saliva, or sexual discharge. If you are infected, be sure to wash your hands after touching an infected area on either the oral or genital regions. Herpes medications can also help reduce your risk of transmitting the virus to another individual.

Condoms offer moderate protection against HSV-2 in both men and women, with consistent condom users having a 30%-lower risk of HSV-2 acquisition compared with those who never use condoms.[49] A female condom can provide greater protection than the male condom, as it covers the labia.[50] The virus cannot pass through a synthetic condom, but a male condom's effectiveness is limited[51] because herpes ulcers may appear on areas not covered by it. Neither type of condom prevents contact with the scrotum, anus, buttocks, or upper thighs, areas that may come in contact with ulcers or genital secretions during sexual activity. Protection against herpes simplex depends on the site of the ulcer; therefore, if ulcers appear on areas not covered by condoms, abstaining from sexual activity until the ulcers are fully healed is one way to limit risk of transmission.[52] The risk is not eliminated, however, as viral shedding capable of transmitting infection may still occur while the infected partner is asymptomatic.[53] The use of condoms or dental dams also limits the transmission of herpes from the genitals of one partner to the mouth of the other (or vice versa) during oral sex. When one partner has a herpes simplex infection and the other does not, the use of antiviral medication, such as valaciclovir, in conjunction with a condom, further decreases the chances of transmission to the uninfected partner.[14] Topical microbicides that contain chemicals that directly inactivate the virus and block viral entry are being investigated.[14]
Prescription antiviral medications are also commonly used to reduce the duration, severity, and incidence of outbreak. These medications include (but are not limited to) valacyclovir, acyclovir, and famciclovir. Remember that these medications will not cure HSV-1 or HSV-2. Instead, they will help reduce the amount of time the outbreak is present, and help control the severity of symptoms.
During stage 1, the virus comes in contact with the skin, enters through cracks or breaks, and reproduces. In this phase, symptoms like fever might occur. The incubation period for oral herpes is between 2 to 12 days. The symptoms last for about 3 weeks. The symptoms may be mild or serious, and occur within the first three weeks after contracting the infection. These symptoms include;
The U.S. Centers of Disease Control and Prevention explains that pain, itching or tingling in the area where the rashes will eventually appear will occur at least one to five days before the rashes are seen. Once these rashes are visible, they scab for around seven to 10 days and heal within two to four weeks.29 Aside from rashes, symptoms of shingles include fever, chills, headaches, fatigue and an upset stomach.30,31
After exposure to the virus, many people experience a so called primary infection which is typically associated with sores on or around the genitals or the anus. During a primary infection some people experience pain in the groins or a mild fever. Not all infected individuals experience a primary infection or show any symptoms at all, but they can still pass the disease on to other people.
×