What Are The Different Types Of Herpes
There are two types of herpes simplex virus: HSV I and HSV II. HSV I commonly causes oral herpes, or cold sores. This virus can show up as an upper respiratory tract infection during early childhood. HSV II is the cause of most cases of genital herpes. However, it is possible for HSV I to cause genital herpes and HSV II to cause oral herpes.
Clinicians cannot tell the difference between the two types by physical examination alone, but there are differences between the two viruses. For example, genital herpes caused by HSV II is much more likely to recur. This diagnosis can be helpful in establishing a health care plan.
How Does Genital Herpes Affect Pregnant Women
While genital herpes rarely causes serious health problems in healthy men and women, HSV-2 can be dangerous for pregnant women and the neonate, particularly during the last trimester of pregnancy. The virus may cause premature labor and babies can contract the virus in the womb or when passing through the birth canal.
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.
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How Will My Healthcare Provider Know If I Have Genital Herpes
Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore and test it. If sores are not present, a blood test may be used to look for HSV antibodies.
Have an honest and open talk with your healthcare provider about herpes testing and other STDs.
Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.
How Is Genital Herpes Diagnosed
HSV nucleic acid amplification tests are the most sensitive and highly specific tests available for diagnosing herpes. However, in some settings viral culture is the only test available. The sensitivity of viral culture can be low, especially among people who have recurrent or healing lesions. Because viral shedding is intermittent, it is possible for someone to have a genital herpes infection even though it was not detected by NAAT or culture. 11
Type-specific virologic tests can be used for diagnosing genital herpes when a person has recurrent symptoms or lesion without a confirmatory NAAT, culture result, or has a partner with genital herpes. Both virologic tests and type-specific serologic tests should be available in clinical settings serving patients with, or at risk for, sexually transmitted infections. 11
Given performance limitations with commercially available type-specific serologic tests , a confirmatory test with a second method should be performed before test interpretation. If confirmatory tests are unavailable, patients should be counseled about the limitations of available testing before serologic testing. Healthcare providers should also be aware that false-positive results occur. In instances of suspected recent acquisition, serologic testing within 12 weeks after acquisition may be associated with false negative test results. 11
Providers are strongly encouraged to look at CDCs STI Treatment Guidelines for further diagnostic considerations.
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What If I Am Pregnant
It is important to tell your obstetrician that you or a partner have had genital herpes, so that they can monitor you for symptoms and manage your pregnancy safely. There is a risk you can pass the virus on to your baby if you have a vaginal delivery during a first attack of genital herpes. If this happens you may be recommended to have a caesarean delivery.
Whats The Outlook For Someone With Either Condition
You can easily treat genital pimples at home. But if they dont go away in a week or more, see your doctor in case another condition is causing your pimples to appear.
Herpes cant be cured, but it can be successfully managed with prescription antibiotics and OTC pain relievers. Researchers are working to find a cure or vaccine.
Pimples can appear suddenly for a number of reasons, so its hard to fully prevent them. Keeping the area clean with a gentle cleanser is usually sufficient.
You can take quick, easy action each time you have sex to prevent yourself from getting herpes.
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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.
What Should I Do If I Have Genital Herpes
If you have genital herpes:
- See a doctor or nurse as soon as possible for testing and treatment.
- Take all of the medicine. Even if symptoms go away, you need to finish all of the antiviral medicine.
- Tell your sex partner so they can be tested and treated if necessary.
- Avoid any sexual contact while you are being treated for genital herpes or while you have an outbreak.
- Remember that genital herpes is a lifelong disease. Even though you may not have a genital herpes outbreak for long periods of time, you can still pass the virus to another person at any time. Talk with your doctor or nurse about how to prevent passing the virus to another person.
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Is There Any Resistance To Genital Herpes Medication
Resistance to drugs that treat genital herpes even after 20 years of use is very rare. Herpes medications may not work as well in patients who are very immunosuppressed and have been treated with these drugs for a long time. Each individuals response to treatment may vary. In some cases, patients may need more drugs to suppress their viral outbreaks than others.
Does A Cold Sore On My Mouth Mean I Have Genital Herpes
No, a cold sore on your mouth usually means you have herpes simplex virus type 1 . You can get HSV-1 by kissing someone or sharing utensils, towels, razors, or lipstick with someone who has HSV-1.
HSV-1 cannot turn into HSV-2 , but you can get a cold sore on your mouth from HSV-2 if you give oral sex to someone with HSV-2. Cold sores caused by HSV-1 or HSV-2 are contagious. You can spread it to other people or other parts of your body if you touch an open sore and then touch another part of your body. That means if you have a cold sore and give oral sex to someone, that person will get the herpes virus on his or her genitals.
Avoid touching your cold sore as much as possible. If you touch your cold sore, wash your hands right away to avoid spreading the infection to other parts of your body or other people.
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Getting Tested For Genital Herpes
The herpes virus doesnt always trigger outbreaks and symptoms, so testing is an important way to monitor your health. The Centers for Disease Control and Prevention recommends testing if you are experiencing symptoms that could be related to herpes or if you recently had sex with a new partner who has genital herpes.
There are a few different ways to test for and diagnose herpes:
- Tissue or herpes sore sample
- Polymerase chain reaction to test for the presence of herpes DNA
- Blood test to detect the presence of HSV antibodies
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How Do I Know If I Have Genital Herpes
Most people with genital herpes have no symptoms or have very mild symptoms. Mild symptoms may go unnoticed or be mistaken for other skin conditions like a pimple or ingrown hair. Because of this, most people do not know they have a herpes infection.
Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. This is known as having an outbreak. The blisters break and leave painful sores that may take a week or more to heal. Flu-like symptoms also may occur during the first outbreak.
People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they have HSV-2. However, repeat outbreaks are usually shorter and less severe than the first outbreak. Although genital herpes is a lifelong infection, the number of outbreaks may decrease over time.
Ask a healthcare provider to examine you if:
- You notice any symptoms or
- Your partner has an STD or symptoms of an STD.
STD symptoms can include an unusual sore, a smelly genital discharge, burning when peeing, or bleeding between periods .
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Is There A Cure For Herpes Simplex
There is no cure for herpes simplex. Once you have the virus, its a lifelong infection.
What is the outlook for people with herpes simplex?
For many people, the first herpes outbreak is the most severe. Many outbreaks are less frequent and milder after the first year of infection. Some people may have only one outbreak and never have another again.
Herpes infection doesnt usually pose a serious health risk. The risk of a health complication due to herpes is higher in infants and if you have HIV/AIDS, cancer or an organ transplant.
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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How Can I Reduce My Risk Of Herpes Simplex
Preventing HSV-1
You can reduce your risk of contracting HSV-1 by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores arent present, but its less likely.
If someone has an active HSV-1 infection, avoid:
- Sharing utensils, cups, lip balms or other personal care products.
- Touching the skin near their mouth.
Preventing HSV-2
If youre sexually active, you can take these steps to protect yourself and others from the herpes virus and other STIs:
- Be monogamous with one sexual partner or limit your number of partners.
- Get tested for STIs and complete any prescribed treatment.
- Tell your sexual partners if you have genital herpes so they can get tested.
- Use condoms during intercourse and dental dams during oral sex.
Wash your hands often if you have an outbreak or are around someone with symptoms.
If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:
- Dont have sex when your partner has active symptoms. Condoms may not cover all sores, so you may still get the virus.
- Make sure your partner takes antiviral medication as prescribed.
- Wait to have sex until scabs fall off active lesions.
How To Know If You Have Herpes
This article was medically reviewed by Lacy Windham, MD. Dr. Windham is a board certified Obstetrician & Gynecologist in Tennessee. She attended medical school at the University of Tennessee Health Science Center in Memphis and completed her residency at the Eastern Virginia Medical School in 2010, where she was awarded the Most Outstanding Resident in Maternal Fetal Medicine, Most Outstanding Resident in Oncology, and Most Outstanding Resident Overall.There are 11 references cited in this article, which can be found at the bottom of the page. This article has been viewed 842,512 times.
Research shows that around 1 out of every 6 people has some form of herpes.XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source The herpes simplex viruses are the viruses responsible for oral and genital herpes infections, and they can cause sores, itching, painful urination, and vaginal discharge. Although doctors can treat symptoms, ease pain, and reduce the possibility of spreading the virus, herpes cannot be cured. Studies show that you can find out if you have herpes by examining high risk behaviors, recognizing the symptoms, and getting tested by a medical professional.XTrustworthy SourceFamilyDoctor.orgFamily-focused medical advice site run by the American Academy of Family DoctorsGo to source
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What Are The Complications Of Genital Herpes
Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. 5 Both HSV-1 and HSV-2 can also cause rare but serious complications such as aseptic meningitis . 5 Development of extragenital lesions may occur during the course of infection. 5
There are also potential complications for a pregnant woman and her newborn child. See How does herpes infection affect a pregnant woman and her baby? below for information about this.
Genital Herpes And Pregnancy
It is important to avoid contracting herpes during pregnancy. A first episode during pregnancy can create a greater risk of transmission to a newborn.
Fortunately, it is rare for women with genital herpes to infect their babies. If you know that 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, a C-section may be recommended. Depending on individual diagnosis, though, the American Congress of Obstetricians and Gynecologists endorses suppressive therapy to reduce the frequency of C-section.
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Genital Herpes By Race/ethnicity
As with most infectious diseases, genital herpes is more prevalent among some racial/ethnic groups than others. This is especially true of Black people in the United States who are nearly 4 times as likely to have HSV-2 as White people.
The causes for this disparity are many, including poverty and limited access to health care and diagnosis. Institutional racism and healthcare discrimination can often discourage people from seeking the care they need, as well. Moreover, living in a community where STI rates are already high increases the likelihood of infection.
Even more concerning is the fact that genital herpes increases the risk of HIV, in part because open sores provide HIV easier access into the body and the inflammatory response attracts the very immune cells that HIV targets for infection.
As a result of these intersecting risk factors, a 2013 study in the journal PLoS suggested that genital herpes in Black people increases their vulnerability to HIV three times more than in White people.
The herpes virus is spread by skin-to-skin contact with a person who has the herpes virus:
- Most often, from herpes sores or blisters
- Less often, from normal looking skin where the virusfirst entered the body
- The herpes virus enters the body through the:
- Lining of the mouth
- Regular skin that has small cracks or cuts
People who dont know they have herpes can still spread the virus to others.
Do Symptoms Differ Depending On Location
Youll 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 .
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.
Theres also a slight difference in where oral blisters appear, depending on whether theyre primary or recurrent. During the first episode, blisters may appear on your mouth and lips, but during later episodes, theyre more likely to
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