Herpes simplex (Greek: ἕρπης herpēs, "creeping" or "latent") is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct disorders based on the site of infection.Oral herpes, the visible symptoms of which are colloquially called cold sores or fever blisters, is an infection of the face or mouth. Oral herpes is the most common form of infection. Genital herpes, known simply as herpes, is the second most common form of herpes. Other disorders such as herpetic whitlow, herpes gladiatorum, ocular herpes, cerebral herpes infection encephalitis, Mollaret's meningitis, neonatal herpes, and possibly Bell's palsy are all caused by herpes simplex viruses.
Herpes viruses cycle between periods of active disease—presenting as blisters containing infectious virus particles—that last 2–21 days, followed by are mission period. Genital herpes, however, is often asymptomatic, though viral shedding may still occur. After initial infection, the viruses are transported along sensory nerves to the sensory nerve cell bodies, where they become latent and reside lifelong. Causes of recurrence are uncertain, though some potential triggers have been identified, including immunosuppressant drugs. The previously latent virus then multiplies new virus particles in the nerve cell and these are transported along the axon of each neuron to the nerve terminals in the skin, where they are released. Over time, episodes of active disease reduce in frequency and severity.
Herpes simplex is most easily transmitted by direct contact with a lesion or the body fluid of an infected individual. Transmission may also occur through skin-to-skin contact during periods of asymptomatic shedding. Barrier protection methods are the most reliable method of preventing transmission of herpes, but they merely reduce rather than eliminate risk. Oral herpes is easily diagnosed if the patient presents with visible sores or ulcers. Early stages of orofacial herpes and genital herpes are harder to diagnose; laboratory testing is usually required.
A cure for herpes has not yet been developed. Once infected, the virus remains in the body for life. Recurrent infections (outbreaks) may occur from time to time, especially in times of immune impairment such as HIV and cancer-related immune suppression. However, after several years, outbreaks become less severe and more sporadic, and some people will become perpetually asymptomatic and will no longer experience outbreaks, though they may still be contagious to others. Treatments with antivirals can reduce viral shedding and alleviate the severity of symptomatic episodes. It should not be confused with conditions caused by other viruses in the herpesviridae family such as herpes zoster, which is caused by varicella zoster virus. The differential diagnosis includes hand, foot and mouth disease due to similar lesions on the skin.
Herpes is a common sexually transmitted disease (STD) that any sexually active person can get. Most people with the virus don’t have symptoms. It is important to know that even without signs of the disease, it can still spread to sexual partners.
Basic fact sheets are presented in plain language for individuals with general questions about sexually transmitted diseases.
What is genital herpes?
Genital herpes is an STD caused by two types of viruses. The viruses are called herpes simplex type 1 and herpes simplex type 2.
How common is genital herpes?
Genital herpes is common in the United States. In the United States, about one out of every six people aged 14 to 49 years have genital herpes.
How is genital herpes spread?
You can get herpes by having oral, vaginal, or anal sex with someone who has the disease.
Fluids found in a herpes sore carry the virus, and contact with those fluids can cause infection. You can also get herpes from an infected sex partner who does not have a visible sore or who may not know he or she is infected because the virus can be released through your skin and spread the infection to your sex partner(s).
How can I avoid getting herpes?
You can protect yourself from getting herpes by:
- Not having sex;
- Being in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results;
- Using latex condoms and dental dams the right way every time you have sex.
Herpes symptoms can occur in both male and female genital areas that are covered by a latex condom. However, outbreaks can also occur in areas that are not covered by a condom so condoms may not fully protect you from getting herpes.
I'm pregnant. How could genital herpes affect my baby?
If you are pregnant and have genital herpes, it is even more important for you to go to prenatal care visits. You need to tell your doctor if you have ever had symptoms of, been exposed to, or been diagnosed with genital herpes. Sometimes genital herpes infection can lead to miscarriage. It can also make it more likely for you to deliver your baby too early. Herpes infection can be passed from you to your unborn child and cause a potentially deadly infection (neonatal herpes). It is important that you avoid getting herpes during pregnancy.
If you are pregnant and have genital herpes, you may be offered herpes medicine towards the end of your pregnancy to reduce the risk of having any symptoms and passing the disease to your baby. At the time of delivery your doctor should carefully examine you for symptoms. If you have herpes symptoms at delivery, a ‘C-section’ is usually performed.
How do I know if I have genital herpes?
Most people who have herpes have no, or very mild symptoms. You may not notice mild symptoms or you may mistake them for another skin condition, such as a pimple or ingrown hair. Because of this, most people who have herpes do not know it.
Genital herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. The blisters break and leave painful sores that may take weeks to heal. These symptoms are sometimes called “having an outbreak.” The first time someone has an outbreak they may also have flu-like symptoms such as fever, body aches, or swollen glands.
Repeat outbreaks of genital herpes are common, especially during the first year after infection. Repeat outbreaks are usually shorter and less severe than the first outbreak. Although the infection can stay in the body for the rest of your life, the number of outbreaks tends to decrease over a period of years.
You should be examined by your doctor if you notice any of these symptoms or if your partner has an STD or symptoms of an STD, such as an unusual sore, a smelly discharge, burning when urinating, or, for women specifically, bleeding between periods.
How will my doctor know if I have herpes?
Often times, your healthcare provider can diagnose genital herpes by simply looking at your symptoms. Providers can also take a sample from the sore(s) and test it. Have an honest and open talk with your health care provider and ask whether you should be tested for herpes or other STDs.
Can herpes be cured?
There is no cure for herpes. However, there are medicines that can prevent or shorten outbreaks. One of these herpes medicines can be taken daily, and makes it less likely that you will pass the infection on to your sex partner(s).
What happens if I don't get treated?
Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems. If you touch your sores or the fluids from the sores, you may transfer herpes to another part of your body, such as your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you touch the sores or fluids, immediately wash your hands thoroughly to help avoid spreading your infection.
Some people who get genital herpes have concerns about how it will impact their overall health, sex life, and relationships. It is best for you to talk to a health care provider about those concerns, but it also is important to recognize that while herpes is not curable, it can be managed. Since a genital herpes diagnosis may affect how you will feel about current or future sexual relationships, it is important to understand how to talk to sexual partners about STDs. You can find one resource here: GYT Campaign.
If you are pregnant, there can be problems for you and your unborn child. See “I’m pregnant. How could genital herpes affect my baby?” above for information about this.
Can I still have sex if I have herpes?
If you have herpes, you should tell your sex partner(s) and let him or her know that you do and the risk involved. Using condoms may help lower this risk but it will not get rid of the risk completely. Not having sores or other symptoms of herpes can also lower the risk, but again not completely. Even if you do not have any symptoms, you can still infect your sex partners.
What is the link between genital herpes and HIV?
Genital herpes can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. The genital sores caused by herpes can bleed easily. When the sores come into contact with the mouth, vagina, or rectum during sex, they increase the risk of giving or getting HIV if you or your partner has HIV.