What Are The Differential Diagnoses
Other medical conditions could be confused with genital herpes or cold sores. The conditions are severe, and it is wise to consult with a medical expert. Herpes could be distinguished from these conditions with a lab test or medical exam.
- Medical reactions: Medication might lead to sensitive reactions and allergies that could appear as rashes. Although medication-induced rashes do not appear in the genital area, they are common around the patient’s mouth and lips.
- Concurrent HSV-2 or HSV-1: If the patient has either type of herpes, they could also be infected with the other. The viruses are different, and having one does not prevent or cause the other.
- Pre-cancer or Cancer: Lesions around and in your genital area could be symptoms of cancer. The appearance of precancerous or cancerous shouldn’t have blisters that come with HSV lesions. However, your doctor should be able to tell the difference.
- Syphilis: Syphilis is an STD that manifests in genital sores that could be confused with herpes. Your OBGYN should be capable of telling the difference through visual lesions inspection.
- Canker sores: Usually, canker sores are red, raw, painful, and whitish in the middle. They are due to oral trauma and can appear in the mouth. While the painful sensation of cold sores and canker sores is alike, a lesion looks different.
How Do You Get Herpes
The skin on your genitals, mouth, and eyes can be infected easily. Other areas of skin may get infected if theres a way for the herpes virus to get in, like through a cut, burn, rash, or other sores. You dont have to have sex to get herpes. Sometimes herpes can be passed in non-sexual ways, like if a parent with a cold sore gives you a peck on the lips. Most people with oral herpes got it when they were kids. A mother can pass genital herpes to a baby during vaginal childbirth, but thats pretty rare.
You can spread herpes to other parts of your body if you touch a herpes sore and then touch your mouth, genitals, or eyes without washing your hands first. You can also pass herpes to someone else this way.
Herpes is most contagious when sores are open and wet, because fluid from herpes blisters easily spreads the virus. But herpes can also shed and get passed to others when there are no sores and your skin looks totally normal.
Most people get herpes from someone who doesnt have any sores. It may live in your body for years without causing any symptoms, so its really hard to know for sure when and how you got it. Thats why so many people have herpes its a pretty sneaky infection.
Because the virus dies quickly outside the body, you cant get herpes from hugging, holding hands, coughing, sneezing, or sitting on toilet seats.
Transmission Of Genital Herpes
Genital herpes is a sexually transmitted disease spread by skin-to-skin contact. The risk of infection is highest during outbreak periods when there are visible sores and lesions. However, genital herpes can also be transmitted when there are no visible symptoms. Most new cases of genital herpes infection do not cause symptoms, and many people infected with HSV-2 are unaware that they have genital herpes.
To help prevent genital herpes transmission:
- Use a condom for sexual intercourse.
- Use a dental dam for oral sex.
- Limit your number of sexual partners.
- Be aware that nonoxynol-9, the chemical spermicide used in gel and foam contraceptive products and some lubricated condoms, does not protect against STDs.
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Can Women Who Have Sex With Women Get Genital Herpes
Yes. It is possible to get genital herpes, or any other STI, if you are a woman who has sex only with women.
Talk to your partner about her sexual history before having sex, and ask your doctor or nurse about getting tested if you have signs or symptoms of genital herpes. Use a dental dam during oral sex and avoid sexual activity during an outbreak.
Is It Safe To Breastfeed If I Have Genital Herpes
Yes as long as there isnt an open lesion on your chest or breast. If you have an active outbreak while breastfeeding, its possible to spread the infection to your nipples through touch. Careful hand-washing can prevent this spread. You shouldnt nurse from a breast that has herpes sores. You can pump breast milk until the sores heal. Dont give your baby expressed breast milk if the pump comes into contact with an open sore.
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I Had Lesions When I Was Evaluated But My Culture Was Negative Does This Mean That I Dont Have Herpes
Not necessarily. Although lesions can be caused by something other than herpes, false negative herpes tests can occur if the samples are not taken appropriately, if there is a long transport time between the clinic and the laboratory, or if cultures were taken late in the course of the lesions. Lesions that occur early in the course of a herpes outbreak are much more likely to have positive cultures than cultures taken after the lesions crust over.
Herpes Myths To Stop Freaking Out About
A surprising number of people you know probably have herpes.
Shocked? You shouldnt be, since the virus is very common. According to the World Health Organization, 3.7 billion people under age 50 have herpes simplex virus type 1 thats 67 percent of the global population in that age bracket. Another 417 million people between ages 15 and 49 worldwide have herpes simplex virus type 2 .
Many people consider HSV-1 more benign, but it turns out theres not much difference between the two types of virus. While its true that HSV-2 is a sexually transmitted disease and can cause genital sores or blisters, type 1 can do the same thing.
One big misconception is that cold sores are caused by HSV-1 and genital herpes are always type 2, but thats not always the case, says Sarah Vensel, a physician assistant in San Francisco. Cold sores are so common theyve been normalized at this point. But genital herpes is sometimes the exact same virus just in a different location.
Not only is herpes incredibly common its also totally manageable. Allow us to set your mind at ease and debunk three widespread herpes myths:
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Can I Catch Herpes Again On Another Part Of My Body Can My Partner Catch Herpes Back Off Me On Another Place
It is rare for people to re-catch a virus that they already have for a second time even on a different part of the body. Their immune system defends them against this. The virus does not travel through the body. So a person with a genital infection can kiss or perform oral sex there is no risk of infecting a partner by doing this the virus will not travel inside the body from the genitals to the mouth.
How can I protect my new partner? What about my new partner? How likely am I to infect my new partner?
Already, you are a safer partner than many others because you have been diagnosed so you will avoid sex from the moment you notice the start of an outbreak, until the time when it has totally cleared up. A man with genital herpes can protect a partner easily if his outbreaks appear in the area covered by a condom.
A woman with genital herpes can tell a man that he is half as likely to catch genital herpes from a woman, compared to the chance of a woman catching it from a man. This information can be useful for diagnosed women when talking to a new partner.
Herpes simplex infections are common. Many new partners will have one or both types already but not know. See the governments statistics for new genital herpes infections diagnosed in clinics in 2019 and add a further 53,000 cases which how many are probably diagnosed by GPs.
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Understanding Herpes With H Hunter Handsfield Md
Herpes expert H. Hunter Handsfield, MD, explains the basics about genital herpes, including the difference between genital HSV-1 and HSV-2 infection, testing options and the importance of knowing virus type, and the three-prong strategy for prevention. See more herpes videos at sexualhealthTV.com.
Have a question about herpes youd like Dr. Handsfield or our other experts to answer? Visit our Ask the Experts page to learn how.
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How To Prevent Transmission
The blisters and cold sores that appear during a herpes outbreak are very contagious. People can help prevent the spread of herpes by avoiding certain types of contact during an outbreak.
For example, when a person has a herpes outbreak during which they will have noticeable symptoms they should avoid:
- kissing, and any other form of oral contact
- engaging in oral sex
- sharing objects that have come into contact with saliva, such as lip balm
The virus can also spread even when a person has no symptoms.
Using condoms and other barrier methods correctly during sexual activity can help reduce the chance of herpes transmission. However, it does not completely rule out the possibility of transmission, as barrier methods do not protect the whole area around the genitals.
People can also take an anti-herpes medication to help prevent transmission to any sexual partners.
Anyone who has herpes during pregnancy should talk with their doctor about the possibility of passing it to the baby.
People with the herpes virus may not have any symptoms. If symptoms do appear, however, they are usually most severe during the first outbreak.
The following sections will list some symptoms by herpes type.
Whats The Difference Between Genital Herpes And Oral Herpes
Because there are 2 different kinds of herpes simplex viruses that can live on many body parts, lots of people are confused about what to call these infections. But its actually pretty simple:
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When you get either HSV-1 or HSV-2 on or around your genitals , its called genital herpes.
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When you get either HSV-1 or HSV-2 in or around your lips, mouth, and throat, its called oral herpes. Oral herpes sores are sometimes called cold sores or fever blisters.
HSV-1 usually causes oral herpes, and HSV-2 usually causes genital herpes each strain prefers to live on its favorite area. But its totally possible for both types of herpes simplex to infect either area. For example, you can get HSV-1 on your genitals if someone with a cold sore on their lips gives you oral sex. And you can get HSV-2 in your mouth if you give oral sex to someone with HSV-2 on their genitals.
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How Do You Get Genital Herpes
Genital herpes is a sexually transmitted infection that causes blisters or sores on the skin on or around the genitals. Genital herpes is caused by the herpes simplex virus type 1 and type 2. Once you have been infected with herpes simplex virus, it stays in your body forever.
You cant catch genital herpes by sharing cups, towels or from toilet seats. You can still share a bed, kiss or cuddle your partner and not risk infecting them with herpes.
What Are The Symptoms Of Herpes Simplex
Many people with the infection never experience any herpes symptoms. If you do notice symptoms, youll experience them differently depending on whether youre having your first herpes outbreak or a repeat outbreak. Recurring symptoms are usually milder than the first outbreak. Symptoms dont last as long with later outbreaks. Some people may only have one or two outbreaks during their lifetime. Others may have as many as four or five outbreaks a year.
People who do have herpes symptoms may experience:
- Cold sores around their lips, mouth or tongue. They may look crusty or like fluid-filled blisters.
- Tingling, itching or burning.
- Pain while urinating.
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It’s Possible For Oral Herpes To Cause Genital Herpes And Vice Versa
Cold sores and genital herpes are both caused by herpes viruses. You can catch genital herpes from a cold sore and vice versa, even though they are traditionally different strains of herpes.
Cold sores are typically caused by the herpes simplex virus 1 and are known as oral herpes. Genital herpes is usually caused by HSV2, though roughly one-third of genital herpes cases are caused by HSV1. Both are spread by skin-to-skin contact.
If you kiss someone with a cold sore, you’re at risk of contracting oral herpes. If you have sexual intercourse with a partner with genital herpes, you can also develop it. And yes, herpes can be spread through oral sex. You can get genital herpes from a partner with a cold sore.
This article explains how you can get genital herpes from a cold sore and vice versa. It also details how herpes can spread through oral sex and offers tips to prevent herpes transmission.
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Where Does The Herpes Virus Live In The Body
The herpes simplex viruses are latent, meaning they can live in the body without causing symptoms. After the initial infection, the virus gets into the nerve roots and spreads to the sensory nerve ganglia, the junctions where nerves from different parts of the body come together. For the genital area, the ganglia are adjacent to the spinal cord in the lower back. For orofacial herpes , the ganglia are located behind the cheek bone.
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Herpes Encephalitis And Meningitis
Herpes Encephalitis
Herpes simplex encephalitis is inflammation of the brain caused by either HSV-1 or HSV-2. It is a rare but extremely serious brain disease. Untreated, herpes encephalitis is fatal most of the time. Respiratory arrest can occur within the first 24 to 72 hours. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates. Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis.
Herpes Meningitis
Herpes simplex meningitis is inflammation of the membranes that line the brain and spinal cord. It is mainly caused by HSV-2. Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light. Fortunately, herpes meningitis usually resolves after about a week without complications, although symptoms can recur.
How Common Is Genital Herpes
Genital herpes infection is common in the United States. CDC estimated that there were 572,000 new genital herpes infections in the United States in a single year.1 Nationwide, 11.9 % of persons aged 14 to 49 years have HSV-2 infection .2 However, the prevalence of genital herpes infection is higher than that because an increasing number of genital herpes infections are caused by HSV-1. 3 Oral HSV-1 infection is typically acquired in childhood because the prevalence of oral HSV-1 infection has declined in recent decades, people may have become more susceptible to contracting a genital herpes infection from HSV-1. 4
HSV-2 infection is more common among women than among men the percentages of those infected during 2015-2016 were 15.9% versus 8.2% respectively, among 14 to 49 year olds. 2 This is possibly because genital infection is more easily transmitted from men to women than from women to men during penile-vaginal sex. 5 HSV-2 infection is more common among non-Hispanic blacks than among non-Hispanic whites . 2 A previous analysis found that these disparities, exist even among persons with similar numbers of lifetime sexual partners. Most infected persons may be unaware of their infection in the United States, an estimated 87.4% of 14 to 49 year olds infected with HSV-2 have never received a clinical diagnosis. 6
The age-adjusted percentage of persons in the United States infected with HSV-2 decreased from 18.0% in 19992000 to 12.1% in 2015-2016. 2
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Who Might Get Herpes Simplex
People of any age can contract herpes simplex. You are more likely to get the virus if you:
- Were assigned female at birth.
- Have had multiple sex partners.
- Started having sex at a young age.
- Have a history of any sexually transmitted infection .
- Have a weakened immune system.
- Dont use condoms for intercourse and dental dams for oral sex.
Who gets HSV-1, commonly known as oral herpes?
Anyone can get HSV-1. Most people contract HSV-1 during childhood. It spreads when an adult who has the virus has close contact with a child, such as when a family member kisses a child.
Who gets HSV-2, commonly known as genital herpes?
Genital herpes affects sexually active teens and adults of all genders and races. It can spread if you have multiple sexual partners and dont use condoms or dental dams.
People assigned female at birth are more at risk. Delicate vaginal tissue can tear, making it easier for the infection to get in. Black people who were AFAB are especially vulnerable, with an estimated 1 in 2 people AFAB between the ages of 14 and 49 infected with HSV-2.
Testing For Genital Herpes
If you think you may have genital herpes you should make an appointment with your GP or local sexual health services.
If there are symptoms present such as blisters, sores and ulcers, your doctor or nurse may be able to make a diagnosis straight away.
If you have visible blisters, your doctor or nurse may take a swab for testing, to check if this is herpes and what type. This swab can also test for another STI which causes blisters called syphilis.
The genital herpes swab tests are very reliable, though if the ulcer is too dry then it may be less likely to find a positive result.
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