Hearing the word herpes can bring up a lot of emotions: fear, embarrassment and even shame. But the truth is, herpes is one of the most common sexually transmitted infections (STIs) in the world. Many people have it and don’t realize it.
Herpes shouldn’t feel like a life sentence or a modern-day scarlet letter. Herpes is manageable, treatable and much more common than most people realize.
Keep reading to learn more about the virus and ways you can protect your health.
What is herpes?
Herpes is caused by the herpes simplex virus (HSV). There are two main types:
- HSV-1, most often linked to cold sores (fever blisters) around the mouth
- HSV-2, most often linked to genital herpes
Both viruses are highly contagious. It’s estimated that about half of Americans ages 14 to 49 are infected with HSV-1 and about one in eight of the same age range are infected with HSV-2.
“HSV-1 is usually transmitted during childhood,” said Angela Feng, DO, a family medicine physician with Banner Health. “While HSV-2 is usually spread through sexual contact and can increase the risk of HIV infection, as it provides direct contact with blood.”
How do you get herpes?
Herpes is very common because it spreads easily through skin-to-skin contact.
“It is usually spread while asymptomatic, so most people who carry the virus have no idea because they never have noticeable symptoms,” Dr. Feng said. But the virus is more likely to spread during an active infection.
HSV-1 is most often spread to others through oral-to-oral contact, such as kissing or sharing objects (like lip balm, drinks, utensils or toothbrushes). Oral herpes can also cause genital herpes and be spread through oral sex.
You can get HSV-2 by having vaginal, anal or oral sex with someone who has it. It is also possible to get genital herpes if you receive oral sex from a partner who has oral herpes.
The risk of contracting herpes from toilet seats, swimming pools or towels is very low.
Common symptoms of herpes
Many people never experience symptoms. When they do appear, however, the first outbreak is often the most noticeable.
Herpes symptoms include:
- Painful blisters or sores near the mouth, lips, genitals (vagina or penis) or rectum
- Itching, burning or tingling before the blister forms
- Swollen lymph nodes
- Fever, exhaustion and flu-like symptoms during the first outbreak
- Crusting or scabbing as sores heal
These blisters eventually break open, form ulcers and then heal on their own within a couple of weeks. Later outbreaks tend to be milder and shorter.
What triggers herpes?
Outbreaks can be unpredictable, but some triggers may increase your risk:
- Stress
- Lack of sleep
- Sun exposure
- Illness or weakened immune system
- Changes in hormones
- Skin irritation or trauma to your mouth area
Treatment options for herpes
While there is no cure for herpes, treatments can help shorten the length of an outbreak and manage any pain related to sores.
Over-the-counter treatments
OTC options can help with symptoms but won’t stop the virus from spreading. Treatments include:
- Abreva (docosanol) can help shorten healing time for cold sores caused by oral herpes
- Topical anesthetics (like lidocaine or benzocaine creams) can ease pain and itching
Some people try lysine, an amino acid found in foods such as dairy products, fish and chicken to prevent outbreaks.
“Lysine may help reduce the severity or frequency of herpes outbreaks but there isn’t strong enough evidence to recommend it as a proven treatment,” Dr. Feng said.
Prescription treatments
“Antiviral medications are very effective in decreasing the severity and duration of herpes symptoms,” Dr. Feng said. “They work better the sooner you start them.”
FDA-approved antivirals include:
- Valtrex (valacyclovir)
- Zovirax (acyclovir)
- Famciclovir
There are two main ways these medications can be used:
- Episodic therapy: Taken only during an outbreak, usually for several days. It helps shorten healing time and lessen pain.
- Suppressive therapy: Taken daily to prevent outbreaks and lower the chance of spreading herpes to partners.
Your health care provider can help you decide which approach is best, based on how often you experience symptoms and your lifestyle.
How to prevent herpes from spreading
Herpes spreads easily, especially when sores are present. But it can also spread when there are no symptoms. To help prevent it from spreading to others:
- Keep drinking cups, utensils, towels, and washcloths separate from those used by other family members and wash them thoroughly after use.
- Don't kiss others, avoid skin-to-skin contact and abstain from sex (oral, anal, vaginal) during the most infectious time, which is when any tingling or burning is felt in the infected area up until the open sores have completely resolved.
- Wash your hands well and often and avoid touching your face and eyes.
- Use condoms or dental dams correctly and consistently (though herpes can still spread from uncovered skin)
- Take daily suppressive therapy if you or your partner has frequent outbreaks.
Should I tell my sexual partner I have herpes?
Yes, it honestly matters.
“To help decrease the spread, it’s important to disclose any sexually transmitted infection (STI) to any sexual partner,” Dr. Feng said. “Open communication builds trust and helps partners make informed decisions.”
Discussing herpes doesn’t have to be scary. Many people appreciate the honesty and will want to support you in managing it safely.
Have you met with your doctor yet?
If you think you may have herpes or have questions about symptoms or prevention, schedule an appointment with your health care provider.
“You should talk to your provider anytime you have questions,” Dr. Feng said. “Together, you can make a plan that fits your needs, whether that’s treatment during outbreaks or daily medication for prevention.”
See your provider right away if you:
- Notice blisters or sores around your mouth, genitals or anus
- Have pain, itching or tingling that doesn’t go away
- Are pregnant or planning to become pregnant and have herpes (to prevent spreading it to your baby)
Your provider can confirm a diagnosis with a swab test (if you have symptoms) or with a blood test.
Takeaway
Herpes is common but manageable. Having it doesn’t make you dirty or unworthy of love. It’s a virus that spreads easily, often without symptoms.
If you are sexually active, it’s important to have regular sexual health check-ups, as there is a chance you can pick up an STI. If you’re worried you might have herpes or want to discuss treatment options, talk to your provider or a Banner Health specialist.
Although your sex life isn’t anyone else’s business, it’s important to be honest with your provider. With proper care and understanding, you can stay healthy and confident.
