What Is Herpes?
Genital herpes is a viral infection that can cause blisters and open sores on the genitals caused by herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Genital herpes is common in the U.S. It is estimated that more than one of every six people aged 14 to 49 years have genital herpes.
Oral herpes (also called cold sores or fever blisters) are painful blisters that form on or near the lips and inside the mouth that are usually caused by HSV-1.
Cold sores are not canker sores. Canker sores are also painful red or white sores that can form in the mouth and on the tongue, but they do not typically blister or scab over.
What Are Symptoms of Herpes?
Some people with herpes may not be aware they have it because they never have any symptoms, or symptoms are very mild. Others may develop symptoms within a few weeks of being infected with the herpes virus.
Symptoms of genital herpes include:
- Blisters in the genital area
- In women, this area includes the vagina, anus, buttocks, or thighs
- In men, this area includes the penis, scrotum, anus, buttocks, or thighs
- Blisters may become painful open sores, which crust over as they heal
- Blisters on the mouth or lips
- Pain in the joints
- Difficulty urinating
The first time symptoms occur is usually the worst, and symptoms may last up to 2 to 3 weeks. After that, people may have outbreaks where symptoms recur. Outbreaks usually include blisters and open sores in the genital area that are usually not as severe as the first occurrence and do not last as long.
Outbreaks may occur every month or more often, or just once or twice a year. In some cases, people can tell when an outbreak is about to happen, because they feel itching or pain beforehand, but other people have no symptoms. In general, herpes outbreaks tend to become less frequent over time as people age.
Symptoms of oral herpes (cold sores) may include:
- Painful blisters on the lips, mouth, nose, or throat,
- Blisters eventually open and form scabs
- Mouth and throat pain
- Neck swelling
- Body aches
- General ill feeling (malaise)
The first attack of cold sores usually happens during childhood and the first outbreak lasts about 12 days. After the first time, pain and blisters can return but the other symptoms do not usually recur, symptoms are milder, and they can last 8 days or less.
Sometimes people can tell when cold sores are recurring and they feel pain, tingling, burning, or itching on the lips about a day before blisters form.
What Causes Herpes?
Genital herpes is caused by herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) that is passed from person to person during vaginal, oral, or anal sex.
Oral herpes is usually caused by HSV-1 that is passed from person to person from kissing, sharing a fork or knife, or some other type of close contact.
People who give oral sex to people with genital herpes can get cold sores on their mouth.
Herpes spreads more easily when a patient has blisters and open sores, though it is also possible to spread the virus when no symptoms are present.
Certain triggers can make outbreaks more likely to occur, such as:
- Menstrual periods
- Recent fever
- Physical injury
How Is Herpes Diagnosed?
Both genital and oral herpes are diagnosed with a physical exam. Often, herpes can be diagnosed just by looking at the sores.
If you have blisters or sores a doctor can order tests to look for herpes:
- A sample of cells or fluid from a sore is sent to a lab
- If you don't have symptoms a blood sample may be taken to check for herpes antibodies
- A herpes blood test cannot determine who gave you the infection or how long you have been infected
What Is the Treatment for Herpes?
There is no cure for herpes, but the virus usually causes the most symptoms during the first few years. After that, it causes mild to no symptoms. When the virus is active, people can take medicines to help reduce and prevent symptoms.
Certain antiviral medicines may be prescribed to help reduce symptoms of genital herpes and speed up the healing of an outbreak, such as:
Home remedies that can help reduce the pain of genital herpes during an outbreak include:
- Use a portable bath ("Sitz bath") or your bathtub and sit in warm water for about 20 minutes. Avoid bubble baths.
- Keep the genital area clean and dry.
- Avoid tight clothing.
- Over-the-counter (OTC) pain medicines such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may help with pain.
For oral herpes (cold sores), most people will need treatment the first time they occur. People who have had cold sores before or people who have mild symptoms may not need treatment.
When needed, treatment for cold sores may include:
- Antiviral medications
- Acyclovir (Zovirax)
- Valacyclovir (Valtrex)
- Famciclovir (Famvir)
- Antiviral topical ointments
- Acyclovir (Zovirax ointment or cream)
- Penciclovir (Denavir topical)
- Pain-relieving pills and gels that go on the mouth, many of which are available over-the-counter (OTC)
- A home remedy for cold sores includes sucking on ice or popsicles
How Do You Prevent Herpes?
Herpes, both genital and oral, is spread from skin-to-skin contact with an infected person. This includes vaginal, anal, and oral sexual contact. The best way to avoid getting herpes is to avoid contact with another person’s mouth or genitals. If you do have close sexual contact, practicing safe sex is the best way to prevent the spread of the virus.
Herpes is most easily spread when you have blisters and open sores on your body, though it is also possible to spread the virus when you have no symptoms.
Practicing safe sex includes:
- Telling your sex partner you have herpes
- Using a condom every time you have sex
- Condoms may not fully protect against getting herpes
- Not all herpes sores occur in areas covered by a latex condom
- Herpes virus can be shed from areas of the skin without a visible herpes sore
- Avoiding kissing anyone when you have cold sores
- Avoiding sex when you have symptoms
- Avoiding oral sex if you have blisters or open sores (in the genital area or around your mouth)
- Being in a long-term mutually monogamous relationship with a partner who is not infected with herpes reduces your risk of contracting the virus
- If you have oral herpes, do not share utensils, glasses, water bottles, towels, lip balm, or razors, especially when you have an outbreak.
- Taking an antiviral medicine every day may also reduce the risk of spreading the virus.
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