What's in this article?
What is Herpes?
Herpes simplex virus, or HSV, is an extremely common and usually mild viral infection. One in five adults in the US is believed to be infected with genital herpes. HSV causes cold sores or fever blisters (oral herpes), and it also causes genital sores (genital herpes). Even if the HSV infection is not currently causing signs and symptoms, it may cause symptoms later. Herpes can be a recurring and upsetting disease but is rarely dangerous. However, it can cause recurrent painful sores and can be severe for people with suppressed immune systems. HSV frequently causes psychological distress and may play a major role in the spread of HIV (HSV causes people to be more susceptible to HIV). Although there is not yet a cure for herpes, appropriate treatment is effective in helping to control the disease.
Genital herpes is a sexually transmitted infection caused by HSV (herpes simplex virus). This virus affects the genitals, the cervix, as well as the skin in other parts of the body. There are two types of herpes simplex viruses: a) HSVp1, or Herpes Type 1, and b) HSV-2, or Herpes Type 2.
Herpes is a chronic condition. Chronic, in medicine, means long-term. However, many people never have symptoms even though they are carrying the virus. Many people with HSV have recurring genital herpes. When a person is initially infected the recurrences, if they do occur, tend to happen more frequently. Over time the remission periods get longer and longer. Each occurrence tends to become less severe with time.
What does Herpes look like and how would I know if I had it?
Symptoms of primary herpes (the first episode) usually develop within 2-14 days after the virus is transmitted. The infection usually develops quickly during the first episode and causes obvious symptoms because the immune response is not well developed. However, some people have a very mild first episode and may not notice symptoms until a later episode.
During the first episode, the virus starts to multiply within the skin cells and the skin becomes red and sensitive. Soon afterward, small red bumps appear and may develop into blisters or painful sores. Individuals may also experience flu-like symptoms including swollen glands, headache, muscle aches, or fever. Sometime the glands in the groin may enlarge and cause discomfort. In the following week or so, the blister-like sores break open, scab over, and heal without scarring. However, signs of herpes may be obvious like previously stated or may cause no discomfort and be undetectable.
Causes of Genital Herpes?
When HSV is present on the surface of the skin of an infected person it can easily pass on to another person through the moist skin which lines the mouth, anus and genitals. The virus may also pass onto another person through other areas of human skin, as well as the eyes.
A human cannot become infected by touching an object, such as a working surface, washbasin, or a towel which has been touched by an infected person.
The following can be ways of becoming infected:
- Having unprotected vaginal or anal sex
- Having oral sex with a person who gets cold sores
- Sharing sex toys
- Having genital contact with an infected person.
HSV leaves the skin just before a blister appears. The virus is most likely to be passed on just before the blister appears, when it is visible, and until the blister is completely healed. HSV can still pass onto another person when there are no signs of an outbreak (but it is less likely).
If a mother with genital herpes has sores while giving birth it is possible that the infection is passed on to the baby (see section on pregnancy below).
How is Herpes diagnosed?
Your health care provider can often diagnose herpes on the basis of your history and the examination of the sores. The health care provider may take a sample of fluid from the sore(s) to determine if the herpes virus is present and to determine if you have HSV-1 or HSV-2.
Is there a cure or treatment for herpes?
Yes. Once you’ve been tested and diagnosed with oral or genital herpes, it can be treated … but not cured.
Remember, herpes is not life-threatening in adults … and depending on the severity of herpes outbreaks, no treatment may be necessary. Oral antiviral medications most commonly, acyclovir (Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex) are safe and effective, and can prevent or shorten the duration of outbreaks, reduce the frequency and severity of recurrent outbreaks, and decrease the risk of spreading the infection to others.
Herpes can recur
Even if you’re being treated for herpes, outbreaks may continue … the frequency of recurring outbreaks depends on the duration and severity of the first herpes episode. An initial infection that lasts five weeks or more correlates with almost twice the number of recurrences, compared to an initial infection that doesn’t last as long.
Additionally, there’s a 60% likelihood of recurring outbreaks with HSV-2, compared to a 14% likelihood of recurrences with HSV-1. The good news is that people with recurrent outbreaks usually have milder symptoms, or no symptoms at all. Be sure to continue to use latex condoms or a dental dam to minimize the risk of spreading herpes to your sexual partner, even if you don’t notice any outbreak symptoms … this is especially important if you are pregnant.
Episodic vs. suppressive therapy
With episodic therapy, you only take the prescribed medication when you’re experiencing herpes symptoms; however, to minimize the aggravation of symptomatic herpes (more than five outbreaks per year), daily suppressive therapy may be your best option … this also reduces the risk of transmitting herpes to an uninfected partner. We’re happy to help you determine the best treatment for you, including FDA-approved use of Valtrex to treat recurrent genital herpes.
Note: The Clinic does not provide medical consultation for HSV-1 positive test results because this type of herpes is usually a benign infection that is most often asymptomatic, or only results in cold sores on the lip. Please see your regular doctor for HSV-1 oral or topical treatment options.
Pregnancy and treatment
Ideally, to protect the health of your baby, avoid genital exposure to HSV-1 or HSV-2 during pregnancy.
In general, herpes can also be treated during pregnancy with prescription medication. Consult your regular doctor about the risks involved, and to identify a treatment that’s best for you and your baby.