Herpes simplex, more commonly referred to as herpes, is a sexually transmitted disease caused by a virus.1 There are two main type of herpes simplex virus: herpes simplex type 1 (HSV-1) and herpes simplex type 2 (HSV-2).1,2

Herpes Simplex Type 1 (HSV-1)

Herpes simplex type 1 (HSV-1) is the type of herpes virus that usually causes cold sores. Cold sores are small blisters that develop on or around the mouth and lips.1

HSV-1 is spread via contact with infected saliva or skin, and can be transmitted by kissing or sharing food or drinks with someone infected by the virus. It's sometimes (but not always) transmitted during sexual contact. Indeed, it's common for children to contract herpes from adult family members who have it. Pregnant women can also pass the herpes virus on to their infants during birth.

HSV-1 "prefers" to infect the lips and mouth. It's not common, but it can infect a person's genitals. This type of transmission can happen during oral sex.2

Herpes Simplex Type 2 (HSV-2)

Herpes simplex type 2 (HSV-2) typically affects a person's genitals and anus. It's most commonly associated with the sexually transmitted disease known as genital herpes. But, as mentioned, HSV-1 can cause genital herpes in some cases, too. It's rare but possible for HSV-2 to infect the mouth and lips.

How Common is Herpes Simplex?

Cold sores caused by herpes simplex can be embarrassing, but they are extremely common. Over half of Americans between the ages 14 and 49 carry the herpes simplex type 1 virus—although not all of them will develop cold sores.1

Genital herpes caused by HSV-2 is also surprisingly common. Over 1 out of every 6 people between the ages of 14 and 49 carry the herpes simplex type 2 virus.2 Again, not all of these individuals will develop signs or symptoms of genital herpes, even though they have the virus.

Signs and Symptoms of Herpes Simplex

Both HSV-1 and HSV-2 often do not have any signs or symptoms at all.1 In fact, many people never even realize they have the virus, especially because it's not often included in a typical STD screening panel.

As mentioned, cold sores (which usually develop on the mouth, lips, and tongue) are the main symptoms of oral herpes. Similar sores can develop on the vagina, penis, anus, or buttocks in people with genital herpes.

Both oral and genital herpes sores can be painful and uncomfortable. They may lead to burning with urination if they occur near the genitals. These sores may break open and ooze fluid before crusting over and healing, which typically happens after about 7 to 10 days. Many people who get cold sores or genital sores report a tingly or burning sensation on the skin about a day or two before the sores develop.

Herpes sores or blisters will usually appear for the first time within a month after a person is initially exposed to the virus, along with flu-like symptoms such as:

  • Fever
  • Muscle aches
  • Fatigue
  • Swollen lymph glands in the neck (oral herpes) or groin (genital herpes)

After this initial "flare-up," the virus stays in a person's body but goes into a remission or "latency" stage.1,2 Then a person may have recurring outbreaks throughout the remainder of their lives. Usually, these outbreaks become less frequent and less severe as time goes on. These "flare-ups" happen when the herpes virus "wakes up" out of its latency stage and begins to "shed" viral components through the skin. Flare-ups can occur out of nowhere, or they can develop as a result of certain triggers, such as stress or sunburn.1

However, even without symptoms it's still possible for a person to transmit oral and genital herpes to other people. This is because viral shedding can happen with or without sores.

Complications of Herpes Simplex

Mouth and genital sores caused by the herpes virus are usually not serious, and a person with herpes can maintain a healthy and active sex life with the proper precautions. However, there are some risks associated with herpes:

  • People with herpes may be more likely to contract other sexually transmitted diseases, since sores can make it easier for other parasites, viruses, and bacteria to get into the body.
  • In rare cases, the herpes virus can infect a person's eyes (especially if a person touches their sore and then rubs their eyes without washing their hands). Symptoms of this condition (known as herpes keratitis) can include eye pain, photophobia (light sensitivity), eye discharge, and a gritty feeling in the eye.  If left untreated, herpes keratitis can lead to scarring on the eye and vision loss.

Blisters and sores can also become infected, leading to further irritation and inflammation of the skin.

Treating Herpes Simplex

Right now, there's no cure for herpes. But there are things people can do to manage their symptoms and reduce the risk of infecting other people:

  • Prescription or over-the-counter ointments are available to treat cold sores and reduce their severity and duration.
  • Many people opt to take anti-viral medications like acyclovir. These medications lower the risk of transmitting herpes to sexual partner(s) and can reduce the severity and frequency of outbreaks.
  • If you do have an active cold sore or herpes blister on your genitals, do not have sex, kiss anyone, nor share beverages or food, since you may spread the virus this way.
  • Avoid touching your blisters and practice excellent hand hygiene.
  • If blisters caused by genital herpes are uncomfortable, you can try at-home self-care strategies such as wearing loose cotton underwear or taking a warm bath.3

The main thing is to remember that sores caused by herpes simplex will go away. It's best not to touch them, pick at them, or put anything on them unless directed by your doctor.

Are you worried about unusual signs and symptoms? Are you due for an STD screening? Do you have a new sexual partner? Getting tested for STDs should be considered a normal part of any healthy sex life. It's now possible to get screened for herpes and other common STDs in the privacy of your own home.

  1. https://www.aad.org/public/diseases/contagious-skin-diseases/herpes-simplex
  2. https://www.cdc.gov/std/herpes/stdfact-herpes.htm
  3. https://medlineplus.gov/ency/patientinstructions/000653.htm