Herpes Causes And Risk Factors
Causes of herpes include acquiring the virus through sexual contact, coupled with immune system suppression and sometimes nutritional deficiencies.
HSV-1 is primarily transmitted by oral-oral contact. On the other hand, HSV-2 is considered a sexually transmitted disease and usually passed during oral or vaginal sex.
A scary finding is that more cases of genital herpes than ever before are now being caused by HSV-1 , and about 85 percent of people with genital herpes dont even know it. Studies show that about 50 percent of the new genital herpes infections in young adults are due to HSV-1 and about 40 percent in older adults. The fact that most people dont ever find out theyre infected is one of the reasons that transmission rates are steadily climbing.
Risk factors for acquiring herpes include:
- Kissing someone who has symptoms of an active herpes virus
- Engaging in any form of unprotected sex
- Having sex with multiple partners
- Spreading the virus through contact with cold sores on the eyes, secretions on the fingers, or ulcers/sores on buttocks and upper thighs
- Having certain other illnesses that lower immune function, such as HIV/AIDS, an autoimmune disorder or hepatitis
- Eating a poor diet that causes nutrient deficiencies and lowered immunity
- Smoking cigarettes, drinking high amounts of alcohol or abusing drugs
Antiviral Tablets To Stop The Herpes Virus Multiplying
Antiviral medicines taken by mouth, such as valaciclovir or acyclovir, are the most effective in controlling symptoms, although they cant cure genital herpes. They stop the virus from multiplying in body cells where the virus is present. The medicine only works while you are taking it. The infection can come back when you stop taking it.
Antiviral tablets are used in the following two ways:
- To treat outbreaks as they happen : The aim is to shorten the time each outbreak lasts and to relieve symptoms. This works best when taken as soon as you get symptoms and before the blisters appear.
- To prevent or reduce recurrences : If you get frequent or severe recurrent outbreaks, your doctor may recommend you take antiviral tablets every day to help prevent recurrences. Suppressive therapy is taken continuously, every day, for months or years. Suppressive antiviral therapy may help reduce the risk of transmitting the virus to sexual partners.
Antiviral creams bought over the counter from the pharmacy are not recommended as a treatment for a first episode or recurrent genital herpes as they are of little benefit. Antiviral tablets are the preferred treatment.
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What Is The Prognosis For A Person With Genital Herpes
As discussed previously, there is no cure for genital herpes infection, and the infection persists for life. People vary in the number and severity of outbreaks they experience. For those with frequent outbreaks, taking antiviral medications as suppressive therapy can decrease the frequency of outbreaks.
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Types Of Antiviral Drugs
There are three oral antivirals recommended for the treatment of oral or genital herpes:
| Famvir, 250 mg | Twice daily |
Preventing genital herpes recurrence is important as it reduces the risk of HIV. According to the CDC, having an active genital herpes infection increases the risk of HIV by 200% to 300%.
Home Remedies And Lifestyle
At-home treatments for herpes are used to relieve pain. They do nothing to alter the course of the infection but can make you more comfortable as the herpes sores begin to heal.
There are several things you can do if have an outbreak of oral or genital herpes:
- Use a cold compress. Place a cloth-covered ice pack on the sores for 15 minutes several times daily to reduce pain. Keep the ice pack moving to prevent frostbite.
- Do not touch or scratch. Avoid touching and rubbing the sores. Doing so can spread the infection to other areas of the skin.
- Keep the sores clean. Herpes sores can become infected with bacteria if touched with soiled hands. Wash your hands thoroughly with soap and water after going to the bathroom or before applying medications.
- Reduce stress. Stress can increase your sensitivity to pain during a herpes outbreak. You can reduce stress by performing gentle exercises or practicing mind-body therapies like meditation, yoga, and guided imagery.
To reduce the risk of spreading herpes, avoid kissing and sharing objects that come into contact with saliva, like drinking straws and eating utensils.
It’s important to note that oral herpes can be spread to the genitals, and that genital herpes can be spread to the mouth. To reduce the risk of infection, use condoms and dental dams during oral sex. Better yet, avoid sex altogether if you are having an active herpes outbreak .
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Prevention Of Genital Herpes
The best protection against STIs is to always use barrier protection such as condoms, female condoms and dams . Because herpes is spread by skin-to-skin contact, condoms will reduce the risk of transmission, but it will not protect sexual partners completely as condoms do not cover the entire genitals.
Using lubricant with a condom during sex will also reduce the risk of trauma to the genital skin. This has been shown to reduce HSV transmission, especially in the first six months of a sexual relationship. Silicone-based lubricants are recommended.
Remember that herpes transmission can occur when symptoms are present , but may also occur even if there are no genital symptoms through asymptomatic viral shedding.
For people who have frequent episodes of genital herpes, antiviral medication, taken daily, helps to reduce transmission of herpes to a sexual partner.
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Are There Side Effects From Treating Genital Herpes With Antiviral Drugs
Antiviral drugs are very well-tolerated by most people because they target the virus, not healthy cells. Side effects are rare. Specialist guidelines state that regular kidney function tests for people taking aciclovir long-term are no longer required. The drug has now been used for without problem for over thirty years treating genital herpes. It can be used in pregnancy, indeed it is even recommended that women take it from week 36. See our pregnancy page.
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What Happens During An Outbreak
Genital herpes is an infection caused by the herpes simplex virus. You catch it by having intimate contact with someone who has the virus.
In between episodes, most people don’t know they have been infected by it. The virus remains in your nervous system and can be reactivated from time to time to give you symptoms. Outbreaks can occur in the genital area if the first infection was in the genitals. They cause crops of small painful blisters in the genital area and back passage . Herpes can also cause recurrent cold sores if the primary infection was around the mouth.
No one knows why outbreaks occur, although sunlight, physical illness, excess alcohol, and stress are all thought to be trigger factors. They often do become less frequent over time.
Recurrent episodes of genital herpes generally don’t last as long as the first outbreak. They are sometimes preceded by itching or tingling in the genital area. Recurrent outbreaks usually last about 7-10 days, shorter than the primary infection which can last up to two weeks. They are also often milder than a primary infection but as R35506 found, the shallow ulcers left when the blisters break can still be quite painful.
How Does Genital Herpes Affect Pregnancy
Herpes simplex virus doesnt affect fertility or your ability to conceive. Pregnant women diagnosed with HSV-2 should start a daily antiviral at 36 weeks of pregnancy as prescribed, to prevent outbreaks during delivery. If you have an active infection at the time of childbirth, you can pass the herpes virus to your baby. Neonatal herpes puts a baby at risk for blindness, brain damage, skin infections and death. Your healthcare provider will perform a cesarean section to lower this risk.
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How Long After Herpes Outbreak Is It Still Contagious
For oral herpes, cold sores are usually contagious for up to 15 days and are generally no longer contagious once all symptoms have cleared, which includes the blister itself and any scabbing.
Someone carrying genital herpes should wait until 7 days after the sore heals to begin engaging in sexual activity, as the herpes virus can spread from sores not covered by a condom.
What Happens If You Dont Get Herpes Treatment
The good news about herpes is that its not deadly or even very dangerous. It might be annoying, but herpes doesnt get worse over time or cause serious health problems like other STDs can.
If you dont get treated for herpes, you might keep having regular outbreaks, or they could only happen rarely. Some people naturally stop getting outbreaks after a while.
There are a few reasons people may decide not to get treatment. They might not have that many outbreaks, or their outbreaks dont really bother them. Or maybe theyre not having sex, so theyre not that worried about having herpes right now. Whatever your situation is, getting treatment for herpes is your choice.
Having herpes can make it easier to get HIV, because the sores give HIV an open pathway into your body. So always use condoms to help prevent the spread of both herpes and HIV.
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Frequently Asked Questionsexpand All
People with HSV-2 infection have an increased risk of getting human immunodeficiency virus if they have sex with an HIV-infected partner. Taking suppressive therapy does not decrease this risk.
If a woman is pregnant and infected with HSV, it can be passed to the fetus during birth while passing through the womans infected birth canal. This is most likely to occur if a woman first becomes infected with HSV during pregnancy and in a woman who has her first outbreak late in pregnancy. But it also can occur during a recurrent outbreak in a woman who was infected before pregnancy, although the risk is much lower.
If you have sores or warning signs of an outbreak at the time of delivery, you may need to have a cesarean delivery to reduce chance of infection. The decision depends on many factors, including where the sores are on your body and whether the fetus would come into contact with them during delivery.
Yes, in most cases. The herpes virus cannot be passed to a baby through breast milk. However, the baby could get infected by touching a sore on your body. Make sure any sores that the baby could come into contact with are covered when you hold your baby or while breastfeeding. Wash your hands with soap and water before and after feeding your baby. If you have sores on your breast, you should not breastfeed your baby from that breast.
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Could I Have Genital Herpes And Not Know
Unless no one has ever kissed you, and unless youve never had sex, it is possible that youve picked up a herpes virus.
Oral herpes, usually caused by the herpes simplex virus type 1 , shows up as cold sores or fever blisters on the mouth. Even a casual peck on the lips from someone with a cold sore can give you the virus. Thats why its so common: As many as 50% to 80% of adults in the U.S. have oral herpes.
Genital herpes, most often caused by the second type of herpes virus , is less common, but plenty of people still have it. Roughly one in five U.S. adults has genital herpes. But up to 90% of those who have it dont know they are infected. You could be one of them.
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Treatment For Genital Herpes
There is no medication to cure your body of the herpes virus. Treatment is aimed at easing symptoms, reducing the frequency of recurrences and reducing transmission.
Symptoms can be improved by:
- ice packs to the affected area
- pain-relieving medication such as paracetamol
- antiviral medication such as acyclovir, famciclovir and valaciclovir. These can reduce the severity of an episode if taken early enough . Topical antivirals usually used for cold sores on the lips or face are not suitable for use on the genitals.
Do Natural Remedies Help
There are several options that can be tried to ease the pain. A73612 and Donnor52059 suggest dabbing cornstarch directly on the sores. I can’t find any scientific studies that have researched this, but I can’t see that it would do any harm.
A73612 also recommends squirting water from a bottle over the sores when you pee. This is a time-honoured method that will help to ease the pain.
Yolandayw mentioned taking a simple painkiller such as paracetamol during an outbreak. Feelbroken advised putting Vaseline on the sores. Lidocaine 5%, a local anaesthetic gel that numbs the area, is another option. Some people find it helpful to put on five minutes before passing urine. You need to get it on prescription and it doesn’t suit everyone. Some people develop sensitivity to it which makes the symptoms worse.
Yolandayw also advised using ice as a home remedy. Simply wrap the ice in a tea towel and apply for 5-10 minutes. Never put ice directly on the skin as this can cause ‘ice burn’. Drinking plenty of water can also be helpful as it reduces the concentration of urine, making it less painful when you have to pee.
D91907 mentioned putting aloe vera gel on the sores. There is some scientific evidence that aloe vera is useful for both genital and oral herpes.
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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.
What Are The Signs Of Herpes In Children
The herpes virus can be spread to babies and children if they are kissed by someone that is infected and has active cold sores. Although rare, it is also possible to spread herpes to a child or infant by touch if a person touches their cold sore and then touches the baby or child.
Precautions can be taken to protect infants and other children from getting the virus. Avoid kissing children if you have a cold sore and ask other people not to as well. Wash your hands frequently if you have a cold sore and you are around children.
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Treatment If The Blisters Come Back
Go to a GP or sexual health clinic if you have been diagnosed with genital herpes and need treatment for an outbreak.
Antiviral medicine may help shorten an outbreak by 1 or 2 days if you start taking it as soon as symptoms appear.
But outbreaks usually settle by themselves, so you may not need treatment.
Recurrent outbreaks are usually milder than the first episode of genital herpes.
Over time, outbreaks tend to happen less often and be less severe. Some people never have outbreaks.
Some people who have more than 6 outbreaks in a year may benefit from taking antiviral medicine for 6 to 12 months.
If you still have outbreaks of genital herpes during this time, you may be referred to a specialist.
Can Genital Herpes Come Back
Yes. Genital herpes symptoms can come and go, but the virus stays inside your body even after all signs of the infection have gone away. The virus becomes active from time to time, leading to an outbreak. Some people have outbreaks only once or twice. Other people may have four or five outbreaks within a year. Over time, the outbreaks usually happen less often and are less severe.
Experts do not know what causes the virus to become active. Some women say the virus comes back when they are sick, under stress, out in the sun, or during their period.
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What You Need To Know
- Herpes simplex virus , also known as genital herpes, is most likely to be spread when an infected person is having an outbreak, but it can also be transmitted without any symptoms being present.
- Medications can help reduce your symptoms, speed up the healing of an outbreak and make you less contagious.
- If you know you have genital herpes before becoming pregnant, your physician will monitor your condition throughout your pregnancy. If you have an active outbreak at the time of delivery, cesarean section may be recommended.
Is Herpes Simplex Related To Herpes Zoster
Herpes simplex and the varicella-zoster virus are related, but they arent the same. VZV causes chickenpox and shingles.
Like HSV-1 and HSV-2, shingles can cause a painful, blistering rash. The shingles rash usually shows up on the back, side, abdomen , neck and face. It is often only on half of your body, following the pattern of your nerves. See your healthcare provider if you have a new rash and suspect you may have shingles.
A note from Cleveland Clinic
Herpes simplex is a virus. Once you have herpes, its a lifelong condition. A herpes infection can lead to outbreaks , but youll also have times when you have no symptoms. The main sign of herpes is sores that appear on the infected skin. Some people choose not to treat herpes, especially if symptoms are mild. Others take antiviral medications to reduce the severity and frequency of outbreaks.
Last reviewed by a Cleveland Clinic medical professional on 05/17/2022.
References
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