Symptoms, Causes, Treatment, and More

The herpes simplex virus, also known as HSV, is a viral infection that causes genital and oral herpes.

Many people live with asymptomatic HSV, which means they have the virus without ever having an outbreak or active episode of herpes.

Others might experience occasional episodes of small, fluid-filled blisters or sores. These blisters most commonly appear on the genitals or mouth and lips, but they can also show up on hands or fingers and other parts of your body.

HSV can be sexually transmitted, but the virus can also be transmitted in other ways. There’s a lot of stigma around herpes, but the virus is actually very common — and nothing to be ashamed of.

According to estimates from the World Health Organization:

  • about 67 percent of the world’s population under age 50 had oral or genital HSV-1 in 2016
  • about 13 percent of people between the ages of 15 and 49 had HSV-2 in 2016

Other research notes that over 90 percent of adults have HSV-1 antibodies by the time they reach their 50s.

Experts have yet to find a cure for herpes, but antivirals and home remedies can help ease the severity of symptoms. Antiviral medication may also lead to fewer herpes episodes.

Read on to learn more about the difference between HSV-1 and HSV-2, plus get the details on key signs, diagnosis, and treatment.

There are two main types of the herpes simplex virus: HSV-1 and HSV-2.

  • HSV-1. This type primarily causes oral herpes, characterized by cold sores or fever blisters that appear around your mouth or on your face.
  • HSV-2. This primarily causes genital herpes, which involves sores that appear on or around your genitals, anus, buttocks, and inner thighs. Sores can also develop inside the vagina.

It’s important to understand that, while HSV-1 is usually associated with cold sores and HSV-2 is usually associated with genital herpes, both types of the virus can be transmitted through oral or genital contact.

In short, both HSV-1 and HSV-2 can cause oral and genital herpes episodes.

Many people living with genital herpes actually have HSV-1, since the virus can easily be transmitted through oral-to-genital contact.

HSV-2 less commonly causes oral episodes, or cold sores, but it’s still possible.

HSV is a contagious virus that can be transmitted through direct contact with sores.

That said, since the virus also “sheds” on a small percentage of days, it’s possible to transmit or contract HSV even when symptoms aren’t present. In fact, many people contract HSV from people who don’t know they have the virus.

HSV-1

You can transmit or contract HSV-1, or oral herpes, through direct contact with a herpes sore, saliva, or other bodily secretions during an episode. If you’re shedding the virus, someone can contract it through direct contact with the site of the infection.

Examples of direct contact include:

  • kissing
  • oral sex
  • other skin-to-skin contact

In other words, if you touch a partner’s cold sore and then touch your own face or genitals shortly afterward, you could contract the virus. Many children contract the virus after being kissed or touched on the face by an adult with a cold sore.

The virus can, in theory, be transmitted through shared lip balm, razors, or drinkware and eating utensils, but this is pretty rare — older estimates suggest the virus can only live outside your body for a few hours to a few days.

To put it another way, if someone with a cold sore drank from a glass and immediately handed it to you, and you then put your mouth to the same place on the glass, you could potentially contract herpes. But the chances of that happening are fairly low.

Most of the time, the virus is transmitted through contact with sores or the site of the infection during viral shedding.

HSV-2

As with HSV-1, you can transmit or contract HSV-2, or genital herpes, through direct contact with a herpes sore, saliva, or other bodily secretions during an episode. HSV-2 can also be transmitted during viral shedding.

Direct contact might include:

  • kissing
  • oral sex
  • sharing sex toys during a sexual encounter
  • penetrative sex
  • other skin-to-skin contact at the infection site

Remember: Though many people think of HSV-1 as oral herpes and HSV-2 as genital herpes, both types of the virus can cause oral or genital episodes.

Anyone can contract HSV, regardless of age. If you’re exposed to HSV, you’re likely to contract the virus.

Remember, HSV is very common. But because it’s often asymptomatic, plenty of people living with the virus never have an episode or realize they’ve contracted HSV.

You may have a higher chance of contracting the virus if you:

  • have a sexual partner who lives with HSV
  • were assigned female at birth (AFAB). Evidence suggests more AFAB folks than people assigned male at birth develop HSV, but this could also mean AFAB folks are more likely to experience symptoms.
  • are immunocompromised

Some older research suggests HSV-1 antibodies may offer AFAB folks some protection against contracting HSV-2. Still, many people living with one type of the virus do contract the other type later on. You won’t contract the same type of the virus again, though, since it remains dormant in your body once you acquire it.

You may have a slightly higher chance of contracting genital HSV if you have sex without using condoms or other barrier methods. Keep in mind, though, that condoms and other barrier methods won’t always cover the infection site, since sores can appear on the buttocks or inner thighs.

HSV doesn’t always cause symptoms.

Any symptoms you do notice, and their severity, will generally depend on whether you’re experiencing a primary or recurrent infection.

Primary HSV symptoms

Symptoms of a primary infection, or first episode, will generally appear anywhere from a few days to a few weeks after exposure to the virus.

Primary episodes often include flu-like symptoms, such as:

You may notice some tingling, burning, or itching at the site of the infection before small, painful blisters appear. There could be one blister or a small cluster. These blisters will eventually burst and crust over before they begin to heal.

The blisters that develop during a primary infection may take up to 6 weeks to fully heal. These blisters can still transmit the virus until they’ve healed completely.

Sores often itch, and genital sores may cause pain during urination.

Recurrent HSV symptoms

Some people who live with HSV only ever have one episode, while others continue to have occasional episodes every several months or so.

Since your body begins to produce antibodies for the virus, recurrent episodes often become less frequent with time. They also tend to involve less severe symptoms that improve more rapidly:

  • Blisters that appear during a recurrent episode may completely heal within several days rather than several weeks.
  • Blisters may be less noticeable or painful during recurrent episodes.

If you’ve had a few episodes, you may begin to notice early signs at the site of the infection. These signs, which generally show up a few hours or days before blisters appear, can include:

  • pain
  • itching
  • burning
  • tingling

Taking antiviral medication as soon as you notice symptoms could help prevent or shorten the episode — more on that below.

Do symptoms differ depending on location?

You’ll most likely notice similar blisters and prodromal symptoms, no matter what type of the virus you have or where it shows up. The two different types of HSV share similar DNA.

The only major difference, of course, is where you experience symptoms:

  • If HSV affects your genitals, you might notice pain or burning during urination.
  • If HSV affects your mouth, you might have difficulty eating spicy or acidic foods while you have open sores.

There’s also a slight difference in where oral blisters appear, depending on whether they’re primary or recurrent. During the first episode, blisters may appear on your mouth and lips, but during later episodes, they’re more likely to appear along the border of your lip.

In some cases, a doctor or clinician can diagnose HSV by examining the blisters. They might also ask about other symptoms, including flu-like symptoms and early signs, like tingling or burning.

They’ll likely request a culture to confirm the diagnosis. A culture involves swabbing fluid from the sore and sending it to a laboratory for testing.

If you believe you’ve been exposed to HSV but have no symptoms, a blood test can determine whether you have HSV antibodies. Just know that blood tests may not accurately detect HSV until 12 weeks after you’ve acquired the infection.

General STI screenings typically don’t include testing for HSV, so you’ll want to ask your doctor or clinician about getting tested for HSV if you believe you could have the virus.

You can also test yourself for HSV antibodies with an at-home testing kit. Compare at-home herpes tests.

Experts have yet to find a cure for herpes. But various treatments can help relieve your symptoms.

Treatment for HSV includes the following.

Medication

Blisters typically improve on their own, without medical treatment. But if you experience severe or frequent outbreaks, a doctor or clinician can prescribe antiviral medications. Antivirals can help reduce the number of episodes you experience and ease the severity of your symptoms.

Options include:

Antiviral medications can also help lower your chances of transmitting the virus during an episode or shedding it when you don’t have symptoms.

Note: There’s no evidence to suggest taking antivirals will lower your chances of contracting the virus if you don’t have HSV.

These medications generally come in the form of pills and creams. Your doctor or clinician may also recommend an injection of medication to treat severe symptoms.

Home remedies

Plenty of home remedies can help ease pain and discomfort associated with herpes blisters.

To get relief, try applying the following to sores:

You’ll find 37 herpes home remedies to try here.

Trying to get rid of a cold sore? These tips can help.

Some research suggests taking a daily supplement of lysine could also help prevent herpes episodes. Dosage estimates vary, but taking between 1 and 3 grams of lysine daily appears to have benefit for managing symptoms and reducing recurrent episodes.

Once you acquire HSV, the virus lives in your nerve cells permanently. It mostly remains dormant, but it can reactivate from time to time and cause symptoms.

For some people, certain triggers can lead to an episode, such as:

While many people living with HSV only have one primary episode, or none at all, others experience symptoms every few months. You might have more episodes during your first year living with HSV, but the frequency tends to decrease over time.

Much of the time, HSV doesn’t pose a major cause for concern, and symptoms will improve without medical treatment.

That said, the virus can cause complications for certain groups of people, including:

  • newborns
  • immunocompromised people
  • people living with chronic health conditions, like cancer or HIV

It’s also possible to develop herpes in the eyes. This condition, known as herpes keratitis, can develop if you touch a herpes sore and then touch your eye.

Symptoms of herpes keratitis include:

If you’re living HSV and notice these symptoms, contact a doctor or eye doctor as soon as possible. Prompt treatment can help prevent complications, including corneal scarring and vision loss.

In general, HSV isn’t considered a serious health concern, though it is a lifelong condition.

Herpes blisters can cause some pain and discomfort, but home remedies can help ease these symptoms and may help sores heal more quickly.

Antiviral medication can also lower your chances of experiencing recurrent episodes and reduce the risk of transmitting the virus to others.

While HSV can’t be cured, many people living with the virus go years without having an episode. In other words, the virus may not affect daily life all that much.

All the same, it’s essential to have a conversation about HSV with your sexual partners before any sexual activity takes place. These tips can help you start the conversation.

A few preventive steps can also help lower your chances of transmitting HSV:

  • Avoid sharing a razor or toothbrush.
  • If you’re living with oral HSV, avoid oral sex and kissing from the time you notice early symptoms until the sores have completely healed.
  • If you’re living with genital HSV, avoid all skin-to-genital contact from the time you notice early symptoms until the sores have completely healed.
  • Wash your hands thoroughly after touching sores or applying medicine to them.
  • Apply medication with cotton swabs to reduce your contact with the sores.

Wondering what a recent diagnosis means for your sex life in the future? Get more insight on dating with herpes here.

Crystal Raypole writes for Healthline and Psych Central. Her fields of interest include Japanese translation, cooking, natural sciences, sex positivity, and mental health, along with books, books, and more books. In particular, she’s committed to helping decrease stigma around mental health issues. She lives in Washington with her son and a lovably recalcitrant cat.

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