Herpes is a very common and usually mild infection caused by the herpes simplex virus, or HSV. Herpes is caused by one of two viruses:
Most oral herpes cases are caused by HSV-1 and most genital herpes cases are caused by HSV-2. HSV-1 or HSV-2 can occur in either the genital or oral area, but it rare for HSV-2 to cause an oral infection. It is more common for HSV-1 to cause a genital infection.
Herpes is transmitted through direct skin-to-skin contact. This happens when a contagious area comes into contact with a tiny break in the skin or mucous membrane tissue, usually on the mouth or genitals. Most skin on the body is too thick for the virus to go through.
Oral herpes (around the mouth, sometimes called cold sores or fever blisters) can be passed on through kissing or oral sex. If a person with oral herpes performs oral sex, it is possible to pass along the infection to the partner’s genitals. If a person with genital herpes has sex, it is possible for his or her partner to get genital herpes. Any person who is sexually active can get genital herpes.
Herpes can be passed on sexually both when symptoms are present and sometimes when there are no symptoms. There are several days throughout the year (called asymptomatic reactivation, asymptomatic shedding, or subclinical shedding) when the virus may be on the surface of the skin, but there are no symptoms. Herpes can be passed through sexual contact during this time.
There are no documented cases of a person getting genital herpes from an inanimate object such as a toilet seat, bathtub, or towel. Herpes is a very fragile virus and does not live long on surfaces.
Some people with herpes don’t have any symptoms. Many others have such mild symptoms that they may not recognize the infection for many years, if ever. This means many people who have herpes are unaware of their infection.
For those that do have symptoms, the first appearance of symptoms—called a first episode—is often the most noticeable. Symptoms vary greatly and may involve small pimples or blisters that crust over like a small cut. With the first episode, some people will have flu-like symptoms, including fever and swollen glands. On the other hand, some people have a first episode so mild they don’t even notice it.
After that first infection, symptoms vary. When symptoms return—called a recurrence—some people notice so-called “classic” blisters, while others might have small bumps or sores. These can be found anywhere in the genital area, such as the thighs, buttocks or the anus. Symptoms are sometimes mistaken for jock itch, insect bites, yeast, or other conditions.
Herpes testing isn’t recommended routinely like other STIs (such as chlamydia and gonorrhea). It is only people who have symptoms or concerns (such as a partner with herpes).
The Centers for Disease Control and Prevention (CDC) says that blood tests might be useful for people who:
There are limitations to blood testing for HSV. According to CDC, testing may be inaccurate if done too soon after an infection. The recommend testing at least 12 weeks after a suspected infection. A wrong result is also possible when the person has a low risk of infection.
A blood test will tell whether or not a person has HSV-1, HSV-2, or both. If a person tests positive for HSV-2, it is virtually always a genital infection. If a person tests positive for HSV-1, it may be either an oral or genital infection. The blood test can only identify the virus type, not the site of the infection.
When a person has active herpes lesions (a.k.a. blisters, sores), a swab can be taken and tests can done that can detect the virus directly. A Nucleic Acid Amplification Testing (NAAT) can identify the specific herpes virus type someone is infected with. This is how a HSV-1 genital infection could be diagnosed.
While there is no cure for herpes, there are various treatment options available that can help manage symptoms and control outbreaks.
To help prevent contracting or passing on herpes:
