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HSV-1 vs HSV-2: Breaking the Stigma of Herpes

Does a diagnosis of herpes have you living with shame? Is it impacting your romantic relationships?

Herpes is a common sexually transmitted infection (STI), but it still carries a big social stigma and is generally misunderstood. This can have a big impact on mental health. What’s even worse, some may be too embarrassed to tell a sexual partner and may avoid telling them altogether.

Herpes shouldn’t feel like a life sentence or a modern-day scarlet letter. Don’t be afraid to get help and get on the right path with your life and relationships.

“Any STI sounds scary, but what is scary is when it is not talked about,” said Randy S. Gelow, MD, a family medicine physician at Banner Health Center in Phoenix, AZ. “Knowing what is out there and ways to protect yourself will just allow you to live a healthier life—and a life without fear.”

Dr. Gelow helped break down the two common types of herpes viruses and answered some common questions associated with them.

What is herpes simplex?

“Herpes” is caused by an infection known as herpes simplex virus (HSV). The two most common are herpes simplex virus type 1 and 2. About 1 in 2 Americans ages 14-49 are infected with HSV-1, and approximately 1 in 8 of the same age range are infected with HSV-2.

Although they are the same family of the virus, they are different subtypes. In the case of HSV-1 (oral herpes), it is more readily spread to others by touch such as kissing, shared objects (such as shared eating utensils, lip balm, cups and toothbrushes) or oral sex which means that this virus can infect other parts of the body like hands/fingers, neck, nostrils, etc. HSV-2 is generally contracted through vaginal, anal, or oral sex with someone who has the virus.

“HSV-1 historically is transmitted during childhood,” Dr. Gelow said. “HSV-2 historically is transmitted through sexual contact and can increase the risk of HIV infection by two-to four-fold as it provides direct contact with blood.”

What are the signs and symptoms of HSV?

Most commonly, HSV-1 causes sores around the mouth and lips—often called cold sores or fever blisters.  HSV-1 can cause “genital herpes,” but most genital herpes infections are caused by HSV-2. Typically, someone with HSV-2 will have herpes sores around the genital area or rectum.

Symptoms are usually the most intense during the first herpes outbreak and become less intense over time. Symptoms can last 2-4 weeks before resolving on their own without medicine, and even longer during the initial infection.

Some of the symptoms of herpes include itching, tingling or burning sensation, tiredness, swollen lymph nodes and flu-like symptoms, but many with HSV may have no symptoms at all.

“While there are some tell-tale signs of HSV, not everyone may show visible signs or symptoms, resulting in an infected person unknowingly transmitting it to a partner via contact,” Dr. Gelow said. “Unfortunately, there are no studies that show how often this happens, but we do know that the virus sheds 10-20% of the time in those who are asymptomatic.”

How is herpes simplex treated?

There is no cure for herpes at this time, but there are affordable treatments that can help people with herpes.

“Antiviral medications (not an antibiotic) is the treatment of choice for HSV,” Dr. Gelow said. “The antiviral medicine can be used per outbreak as treatment or as a daily medicine to help prevent outbreaks and reduce the risk of transmitting the virus it to others.”

How can I prevent HSV from spreading?

HSV is highly contagious. To help prevent it from spreading to others:

  • Keep drinking cups and utensils as well as towels and washcloths separate from those used by other family members and wash them well 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 sores have completely resolved.
  • Wash your hands well and often and avoid touching your face and eyes.
  • The consistent and correct use of condoms can help prevent the spread, but HSV can still spread from areas not covered by a condom.

Why should I tell my sexual partners?

“In order to help decrease the spread, it is important to disclose any STI (including herpes) to any sexual partner, so they can make the informed decision to proceed or not,” Dr. Gelow said. “Being able to freely talk about these conditions makes it easier to disclose to potential sex partners.”

Have you met with your doctor yet?

Do you believe you have herpes? Don’t live in fear and take action to protect yourself and others.

If you are sexually active, it is important to have a regular sexual health check-up as there is a chance you can pick up an STI. These don’t always cause symptoms, but they can put you at greater risk of long-term health problems.

Although your sex life isn’t anyone else’s business, it’s important to be honest with your doctor, otherwise, you’re doing yourself, and possibly your sexual partners, a disservice.

Need help finding a doctor who is right for you? Check out our doctor profile videos and patient reviews.

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