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.
A Cure For Herpes There Is Progress To Report
It takes a persistent scientist to stop a persistent virus.
A decade ago, Fred Hutchinson Cancer Research Center virologist Dr. Keith Jerome began exploring the idea that lifelong infections with herpes viruses might be cured by using the DNA-cutting tools of gene therapy.
Initial research showed these techniques could knock out small quantities of latent virus, and the work of improving the results fell to Jeromeâs senior staff scientist, Dr. Martine Aubert. Five years ago, the team reported they had damaged the genes of 2%-4% of herpes virus in infected mice. Aubertâs work was an important proof of principle, but far short of a cure.
Nevertheless, she persisted.
On Aug. 18, the team led by Jerome and Aubert published a paper in Nature Communications showing that, through a series of incremental improvements on their original method, they had destroyed up to 95% of herpes virus lurking in certain nerve clusters of mice.
âThis is the first time that anybody has been able to go in and actually eliminate most of herpes in a body,â said Jerome, who is also spearheading research at Fred Hutch and the University of Washington on COVID-19. âIt is a completely different approach to herpes therapy than anybodyâs ever had before.â
How Is Herpes Simplex Treated
Some people have few to no herpes outbreaks and choose not to have treatment. But many people prefer to use medications that shorten outbreaks and reduce symptoms.
During an outbreak, you may use an antiviral ointment or cream to help lessen your symptoms and help them go away faster, but it only works if you start it soon after you start an outbreak. Many people with HSV-2 take daily oral medications to keep outbreaks at bay.
Your provider may prescribe a topical medication or oral medication such as:
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What Happens At A Sexual Health Clinic
The doctor or nurse at the sexual health clinic will:
- ask about your symptoms and your sexual partners
- use a small cotton bud to take some fluid from 1 of your blisters or sores for testing
The test cannot:
- be done if you do not have visible blisters or sores
- tell you how long you have had herpes or who you got it from
Symptoms might not appear for weeks or even years after you’re infected with the herpes virus.
What Is Oral Herpes
Oral herpes is primarily caused by HSV-1, although it is also possible to have an HSV-2 infection around the mouth.
A person with an oral herpes outbreak may first feel itching, burning, or tingling around the mouth, lips, or tongue. Later, cold sores or small blisters may develop in these areas or anywhere on the skin.
Roughly four to six days after these cold sores start leaking, they start healing by forming a crust. Outbreaks of oral herpes can last for two to three weeks, which can be shorter than the two to six weeks of a genital herpes outbreak.
People who develop symptoms of herpes may first experience tingling, itching, or burning, then notice sores or blisters forming around the mouth or genitals.
Symptoms tend to develop 220 days after exposure to the virus.
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Treatment For Genital Herpes
There are three antiviral medications that are FDA-approved for the treatment of genital herpes:
- Acyclovir: The oldest antiviral medication for herpes is acyclovir. It has been available since 1982 in a topical form and sold since 1985 in pill form. Acyclovir has been shown to be safe in persons who have used it continuously for as long as 10 years.
- Valacyclovir: A newer drug, valacyclovir, actually uses acyclovir as its active ingredient. This medication delivers acyclovir more efficiently so that the body absorbs much of the drug, which has the advantage of taking the medication fewer times during the day.
- Famciclovir: Famciclovir uses penciclovir as its active ingredient to stop HSV from replicating. Like valacyclovir, it is well absorbed, persists for a longer time in the body, and can be taken less frequently than acyclovir.
Antiviral medication is commonly prescribed for patients having a first episode of genital herpes, but they can be used for recurrent episodes as well. There are two kinds of treatment regimens: episodic therapy and suppressive therapy.
Diet High In Lysine And Low In Arginine
In previous sessions I told you about the relationship between herpes and lysine and also between herpes and arginine.
You already know that lysine intake helps to prevent herpes outbreaks and arginine intake contributes to their appearance and increases their intensity and duration.
For this reason, your diet should be rich in lysine and poor in arginine.
You will achieve this purpose if you consume foods high in lysine and low in arginine such as milk and its derivatives.
A classic combination is to eat brown rice with cooked dried beans. While brown rice is rich in arginine, dried beans contain an excess of lysine that overcomes the lack of this amino acid in brown rice.
Popcorn contains more arginine than lysine, but people infected with the herpes virus can enjoy popcorn if they sprinkle it with nutritional yeast that adds a cheesy flavor.
Arginine is neutralized because one tablespoon of nutritional yeast contains 190 mg more lysine than arginine.
Fish, meats and dairy products are rich in lysine. However, eating too much of these protein-rich foods can raise your bodys acidity and cause a herpes outbreak. Moderation is the key.
If you cant get the foods you like to make up a diet high in lysine and low in arginine, you can use a lysine supplement.
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Who Is At Risk For Developing Herpes Simplex Infections
Anyone can contract HSV, regardless of age. If youre exposed to HSV, youre likely to contract the virus.
Remember, HSV is very common. But because its often asymptomatic, plenty of people living with the virus never have an episode or realize theyve 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 . 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 wont 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 wont always cover the infection site, since sores can appear on the buttocks or inner thighs.
How To Get Rid Of Herpes The Conventional Way
For most people with herpes, the virus typically represents nothing more than an inconvenience however, the real risk is for immuno-compromised patients who cant easily manage infections. In these patients, such as those with HIV/AIDS, herpes simplex infection is associated with increased morbidity and mortality.
As of 2017, there is not currently a herpes vaccine available to prevent HSV-1 or HSV-2.
Doctors sometimes prescribe medications to help keep the herpes virus suppressed or to speed up healing of cold sores by reducing bacteria that can cause infections. Some medications that are now used to control herpes include:
- Nucleoside analogues and antiviral medications
- Creams/ointment to help lower pain and inflammation near the site of sores
- Over-the-counter painkillers to reduce aches, tenderness or fever
However, its important to understand that even with early detection and prescription medications, either form of the herpes virus cannot be totally cured so transmission is always still possible. Medications for viruses dont always work long term and are not a cure-all.
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Why You Should Go To A Sexual Health Clinic
You can see a GP, but they’ll probably refer you to a sexual health clinic if they think you might have genital herpes.
Sexual health clinics treat problems with the genitals and urine system.
Many sexual health clinics offer a walk-in service, where you do not need an appointment.
They’ll often get test results quicker than GP practices and you do not have to pay a prescription fee for treatment.
Is Genital Herpes Related To Shingles
Shingles, also called herpes zoster, is caused by the varicella zoster virus , which causes chickenpox earlier in life. The natural history of varicella zoster infection is similar to genital herpes infection in that VZV also becomes latent in the sensory nerve roots. Later in life the virus may exit, causing shingles.
Recurrences in shingles cause blister lesions in a single area of skin called a dermatome. Shingles is not a sexually transmitted infection and is independent from genital herpes.
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How Is Herpes Simplex Diagnosed
Healthcare providers may diagnose herpes simplex based on how the sores look. Your provider may take a sample from the sore. Laboratory analysis of the sample can confirm or rule out the herpes virus.
If you dont have sores, your healthcare provider can use a blood test to check for HSV-1 and HSV-2 antibody, a marker showing youve been exposed to the virus. The blood test doesnt show an active infection . But it informs your provider whether youve been exposed to the herpes virus in the past. If this is your first infection, you may not test positive for herpes if there hasnt been enough time for your body to develop antibodies. The HSV-1and HSV-2 antibody test may be repeated in eight to 12 weeks.
Improve Your Sleep Habits
Sleep is one of your most valuable defenses against disease. Rest doesnt just refresh your mind, it recharges your immune system as well.
Stop fatigue from zapping your immune system and making you vulnerable to cold sore outbreaks with these tips:
- – Create a soothing sleep environment
- – Reduce technology and blue light before bedtime
- – Develop a consistent evening routine to wind down
- – Get regular exercise during the day
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Billions Worldwide Living With Herpes
About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show, highlighting the need to improve awareness and scale up services to prevent and treat herpes.
About 13% of the worlds population aged 15 to 49 years were living with herpes simplex virus type 2 infection in 2016, the latest year for which data is available. HSV-2 is almost exclusively sexually transmitted, causing genital herpes. Infection can lead to recurring, often painful, genital sores in up to a third of people infected.
Herpes simplex virus type 1 is mainly transmitted by oral to oral contact to cause oral herpes infection sometimes leading to painful sores in or around the mouth . However, HSV-1 can also be transmitted to the genital area through oral sex, causing genital herpes.
Around 67% of the worlds population aged 0 to 49 had HSV-1 infection in 2016 an estimated 3.7 billion people. Most of these infections were oral however, between 122 million to 192 million people were estimated to have genital HSV-1infection.
Genital herpes is a substantial health concern worldwide beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductivehealth says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at the World Health Organization .
First And Subsequent Episodes
The first genital herpes outbreak will generally be worse than the ones that follow. During a first outbreak, the appearance of lesions will often be accompanied by:
- Pain or burning with urination
- Unusual vaginal discharge
Subsequent attacks tend to be shorter and less severe. They are often preceded by genital pain or shooting pain in the legs, hip, or buttocks several hours or days before the attack.
Over time, the number of outbreaks tends to decrease and become less severe.
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‘i Hope That This Study Changes The Dialogue Around Herpes Research And Opens Up The Idea That We Can Start Thinking About Cure Rather Than Just Control Of The Virus’
â Dr. Keith Jerome, Fred Hutchinson Cancer Research Center
Whereas most research on herpes has focused on suppressing the recurrence of painful symptoms, the Fred Hutch gene therapy work addresses the root cause of reactivation: the presence of latent virus in infected nerve cells.
âI hope that this study changes the dialogue around herpes research and opens up the idea that we can start thinking about cure, rather than just control of the virus,â Jerome said.
It will still take a long time before these experiments lead to the first human trials of gene therapy to cure herpes. Jerome estimates that will be at least three years away.
Herpes simplex viruses afflict billions of human beings around the globe. According to the World Health Organization, two-thirds of the world population under the age of 50 carry herpes simplex virus type 1, or HSV-1, which primarily causes cold sores, while 491 million people aged 15-49 are infected with closely related HSV-2, which is the cause of sexually transmitted genital herpes.
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.
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Can Genital Herpes Be Treated
Your physician can prescribe different medications to help reduce your symptoms and speed up the healing of an outbreak. These medicines work best when you start them soon after an outbreak occurs.
To reduce pain during an outbreak:
- Sit in warm water in a portable bath or bathtub for about 20 minutes. Avoid bubble baths.
- Keep your genital area clean and dry, and avoid tight clothes.
- Take over-the-counter medications, such as acetaminophen or ibuprofen. Avoid aspirin.
Let your physician know if you are worried about your genital herpes. He or she can recommend a support group to help you cope with the virus.
Side Effects And Follow
Side effects with these herpes drugs are considered mild, and health experts believe these drugs are safe in the long term. Acyclovir is the oldest of the three, and its safety has been documented in people taking suppressive therapy for several years.
People taking suppressive therapy should see their doctor at least once a year to decide if they should continue. You may find taking the pills every day to be inconvenient, the drugs may not work for you, or you may naturally have fewer outbreaks as time goes on. Your doctor can help you make treatment choices to suit your needs.
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Is Herpes Simplex Related To Herpes Zoster
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.
How Herpes Is Treated
There is no cure for herpes.
- The health care provider may prescribe antiviral medicine to help speed up the healing process. It also shortens the time when the virus can spread from the herpes sores.
- Pain may be treated with medicine such as Tylenol or Motrin or by applying an ice pack wrapped in a towel to the affected area.
- If sores are in the mouth, avoid foods high in acid, like citrus fruits and juices.
- The infected area should be kept clean and dry.
- Wash hands often and avoid touching the sores to prevent spreading the virus.
- It is important to stay healthy by getting enough rest, having proper nutrition and exercise and managing stress well.
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