What is it?
Herpes is a common infection caused by the Herpes Simplex Virus (HSV). There are two types of HSV that cause
very similar symptoms. HSV can infect the oral area (cold sores or fever blisters) or genital area. Most of the oral
infections are caused by HSV 1 while most of the genital infections are from HSV 2. However, either type can cause
infection in either the mouth or genital area. About 50-80% of people in the US have oral herpes. One out of five
adults have genital herpes. Many people with genital herpes do not know they have the infection because symptoms
can be mild.
What are the symptoms?
The most common symptom is a cluster of blister-like lesions. These develop at the site of contact from an infected
person. It can take 2-12 days for symptoms to develop after being exposed. Some people notice itching or burning
before the blisters break out. The blisters can be found around the mouth, in the genital area and around the
anus/buttocks area. The blisters open and cause open sores which are painful, especially in the female genital area
during urination. Swelling can also occur. Females may also have vaginal discharge. Other symptoms that occur with
first infection can include swollen lymph glands, fever, muscle aches, headache and fatigue. The sores will eventually
crust over and heal. This can take 1-3 weeks for the first infection.
Many people with genital HSV can have very mild symptoms or no symptoms at all and not know they are infected.
They can also mistake the symptoms for another problem such as jock itch, yeast infections or bug bites.
How is it transmitted?
HSV is transferred from one person to another by skin to skin contact with an infected person. The virus enters the
body through a tiny open area on the skin or through the mucus membranes of the genital or oral area. It can also be
transferred to the eye or an open cut on the body through hand contact. Children often get oral HSV from being
kissed by an infected relative. The virus is especially contagious when sores are present but can also be contagious
when there are no sores. Oral, vaginal and anal intercourse are sexual activities that can transmit the virus. Using
condoms and oral barriers can decrease the risk of getting HSV. Hand-washing is important after touching the area
that has sores to prevent spreading the virus to another part of the body. HSV does not live long on surfaces so
infection from toilet seats and towels is unlikely.
How is herpes diagnosed?
Your provider will take a history and do an examination. If there are symptoms, testing can be done by taking a viral
culture of the fluid from the sores. This test is very accurate if done early in the course of the outbreak. Testing for
other sexually transmitted infections may be recommended.
What are the complications of herpes?
Once a person is infected, recurrences of outbreaks can happen. HSV remains in the body when there are no sores
present. Recurrences can be triggered by stress, fatigue, poor nutrition, illness or, in the case of oral HSV, sun
exposure. Recurrences are usually milder than the initial outbreak and heal faster. Many people notice a burning or
tingling feeling at the site of outbreak before a recurrence happens. More outbreaks happen in the first year after
being initially infected. As time goes on, recurrences happen less frequently and become less severe.
HSV infection can increase risk for HIV infection.
HSV initial infection during pregnancy can cause damage to the fetus.
HSV infection in the vagina during vaginal delivery of a baby can cause infection and be fatal to the baby. It is
important to tell your provider if you have a history of vaginal HSV and you become pregnant. Medications may help
prevent outbreaks or cesarean delivery may be recommended.
How can herpes be treated?
There is no cure for HSV but it can be treated with anti-viral medications. These medicines can lessen the symptoms
and help the sores heal faster. The sooner medication is started, the faster the healing. The medications can be
taken daily to suppress frequent outbreaks. They can also lessen the chance of spreading the infection to a sexual
partner if taken daily. Talk to your health care provider to see if this is an option.
Other things can be done to reduce the discomfort:
Soak in a tub of cool water
Keep the infected area clean and dry
Use a hair dryer to dry the genital area after a bath or shower
Avoid tight fitting clothing
Wear cotton underwear
How can I decrease the risk of getting herpes?
Being in a monogamous relationship with an uninfected partner
Using condoms or oral barriers
Talk to your partner before engaging in sexual activities
Don’t engage in sexual activities under the influence of alcohol or drugs
If you are infected, avoid engaging in sexual activities when you are having an outbreak. Use condoms or oral
barriers between outbreaks. Talk to your health care provider about suppressive daily medication. Tell a potential
partner about your infection. Many people in long term, monogamous relationships decide together how to manage
the risk of transmitting the infection.
Where can I find more information about herpes?
Being diagnosed with HSV can cause emotional upset. HSV is a recurrent infection that is treatable. Talking to a
counselor, a medical provider or a trusted friend may help. Many people find that over time, they are able to manage
the symptoms and emotional stress. Pay attention to your body’s signals that might indicate an outbreak. Educate
yourself to help you feel in control.
Health and Wellness Education, IU Health Center
American Social Health Association
P. O. Box 13827
Research Triangle Park, NC 27709-3827
Center for Disease Control
International Herpes Alliance
National Herpes Hotline
(919) 361-8488