Risk For Genital Herpes
According to the US Centers for Disease Control and Prevention , about 1 in 6 Americans ages 14 to 49 years have genital herpes. While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. Except for people in monogamous relationships with uninfected partners, everyone who is sexually active is at risk for genital herpes.
Risk factors for genital herpes include:
- History of an STD
- First sexual intercourse at an early age
- High number of sexual partners
- Low socioeconomic status
Women are more susceptible to HSV-2 infection because herpes is more easily transmitted from men to women than from women to men. About 1 in 5 women, compared to 1 in 9 men, have genital herpes. African-American women are at particularly high risk.
People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. These people are also at risk for more severe complications from herpes. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes.
What Are The Symptoms Of Herpes
Genital herpes infections are very common, but many people donât even know they have them. This is because many people donât have any physical symptoms from the herpes infectionâthat is, their infections are asymptomatic .
Symptoms of genital herpes differ for everyone, and many people may not have classic symptoms or any symptoms at all. Some people may suspect that their symptoms are caused by another type of infection .
Herpes symptoms, for those who experience them, are often unpleasant. The initial herpes outbreak can be shocking and the most severe outbreak.
Triggers And Factors That Bring On Outbreaks
Triggers and Environmental Factors are many, and vary with each person. Some of the more common triggers for outbreaks are rubbing, chafing, friction, overexposure to wind, cold, wet, heat, sun , restrictive clothing, and sweating.
Extreme environments of any sort, be they physical, emotional, auditory, etc., may create more stress chemicals in the body, and subsequently trigger nerve response that may possibly increase reactivation of HSV.
Foods reported by some to affect outbreaks include coffee, chocolate, nuts, popcorn, and alcohol.
Women report a tendency to be more susceptible to outbreaks around menstruation. Tampons are reported by some women to aggravate Herpes, probably due to the friction or chafing with insertion and removal. Wearing tight underwear or pads that rub or chafe can irritate the area and possibly precipitate an outbreak. Some women also report irritation from standard feminine hygiene products, and find non-chlorinated, natural cotton brands to be less irritating. Seventh Generation makes a great line of chlorine free personal products, including feminine hygiene, wipes, and soaps. A favorite personal soap thats mild and non-irritating is California Baby Super Sensitive Shampoo & Body Wash.
Personal and lifestyle factors which may directly influence recurrence include stress, lack of sleep, poor diet, fatigue, and illness. You will discover your own personal triggers and learn to avoid or mitigate them.
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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.
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.
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How Do People Get Genital Herpes
Infections are transmitted through contact with HSV in herpes lesions, mucosal surfaces, genital secretions, or oral secretions. 5 HSV-1 and HSV-2 can be shed from normal-appearing oral or genital mucosa or skin. 7,8 Generally, a person can only get HSV-2 infection during genital contact with someone who has a genital HSV-2 infection. However, receiving oral sex from a person with an oral HSV-1 infection can result in getting a genital HSV-1 infection. 4 Transmission commonly occurs from contact with an infected partner who does not have visible lesions and who may not know that he or she is infected. 7 In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on 10.2% of days, compared to 20.1% of days among those with symptomatic infections. 8
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Suppressive Therapy For Recurrences
To suppress outbreaks, treatment requires taking pills daily on a long-term basis. Acyclovir and famciclovir are taken twice a day for suppression. Valacyclovir is taken once a day. The doses for these antiviral drugs are reduced in people with impaired renal function.
Suppressive treatment can reduce the frequency of outbreak recurrences by 70% to 80%. It is generally recommended for people who have frequent recurrences . Because herpes recurrences often diminish over time, you should discuss annually with your provider whether you should stay with drug therapy or discontinue it.
There is some evidence that valacyclovir may help prevent herpes transmission, particularly in situations where one heterosexual partner has HSV-2 and the other partner does not. However, this drug does not completely prevent transmission. While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences.
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How To Cope After Diagnosis
Many posters were occupied with the issue of passing on the infection. Yolandayw points out that you can minimise the risk of transmission by postponing sex until all the sores have healed. She also mentioned that condoms should be used. They won’t completely prevent transmission but they will help.
Ending on a positive note, many posters emphasised that there was light at the end of the tunnel. Learning of the diagnosis may feel stressful at first, but it’s a manageable condition and certainly nothing to be ashamed of. Lucy03934 has had genital herpes for 25 years. She’s been married for 18 years and has two sons – living proof that there is life after herpes.
What Causes Recurrent Herpes Simplex Labialis
Herpes simplex labialis is the result of a virus called herpes simplex virus type 1 . The initial acquisition usually occurs before age 20. It typically affects the lips and areas around the mouth.
You can get the virus from close personal contact, such as through kissing, with someone who has the virus. You can also get oral herpes from touching objects where the virus may be present. These include towels, utensils, razors for shaving, and other shared items.
Since the virus lays dormant inside the nerve cells of the face for the rest of a persons life, symptoms arent always present. However, certain events can make the virus reawaken and lead to a recurrent herpes outbreak.
Events that trigger a recurrence of oral herpes might include:
The original acquisition may not cause symptoms at all. If it does, blisters may appear near or on the mouth within 1 to 3 weeks after your first contact with the virus. The blisters might last up to 3 weeks.
In general, a recurrent episode is milder than the initial outbreak.
Symptoms of a recurrent episode may include:
- blisters or sores on the mouth, lips, tongue, nose, or gums
- burning pain around the blisters
- tingling or itching near the lips
- outbreaks of several small blisters that grow together and may be red and inflamed
Tingling or warmth on or near the lips is usually a warning sign that the cold sores of recurrent oral herpes are about to appear in 1 to 2 days.
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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.
Why Do I Keep Having Herpes Outbreaks
Once you get infected with the herpes virus, it doesnt go away from your body.
The outbreak can be controlled and muted with medications, but it remains in the body and stays dormant. Various triggers can cause the outbreaks to recur.
These include illness, stress, fatigue, sunlight, low immune system, and various others.
Shaving is one such trigger that isnt that common but can cause the infection to go from one person to another if you use another infected persons razor.
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Sex And Physical Irritation
Friction from intercourse can irritate tissue and trigger a herpes outbreak.
Obviously, that doesnt mean to avoid having sex forever or that youll break out if you do.
But it does mean if youre having early warning signs that an outbreak is coming on, like sensitivity or tingling, then wait for them to pass.
They may be prodrome symptoms that signal contagiousness and an impending outbreak. And making them worse might encourage the outbreak to happen.
So since sex can sometimes trigger outbreaks, just be careful to minimize irritation. Try using a water-based lubricant. However, lubricants that contain the spermicide nonoxynol-9 can irritate soft tissue of the vaginal walls.
Other physical irritations can cause herpes outbreaks:
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.
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What Causes Herpes On The Tongue
Either of the two herpes viruses can bring on tongue herpes and its lesions:
Herpes Simplex Virus, Type 1 : Better known as oral herpes, its also sometimes called cold sores or fever blisters.
Herpes Simplex Virus, Type 2 : Known as genital herpes, HSV-2 can also infect the tongue, particularly during oral sex.
Because herpes is highly contagious, you can easily spread it via open sores and saliva to other parts of your body including your lips, cheeks, gums, the roof of your mouth, inside your nose, throat, chin, eyes, fingers, and elsewhere on your skin.
You also can infect others by kissing, sharing toothbrushes or eating utensils, being sexually intimate, or licking someone .
Why Do Some Get More Outbreaks Than Others
Research has founda gene which helps some people control the virus so they get no further episodes. So if you get a lot of outbreaks, you can blame a parent! However, good or bad genes, you can still help your body to prevent outbreaks see antiviral treatment, or you can try self-help treatments. There are two pages of suggestions on our Tips to prevent recurrences leaflet. It is available to members. Outbreaks normally decline in frequency and severity over time.
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The Emotional Side Of Herpes
Many people feel embarrassed and ashamed upon learning that they have genital herpes, or theyre worried about getting it from a sexual partner or prospective sexual partner.
If either case describes you, take the time to educate yourself about the causes and symptoms of herpes, treatments, and steps you can take to stop the spread of herpes, such as using condoms.
What Happens During Your Initial Herpes Outbreak
Your first herpes outbreak, known as the initial or primary infection, is usually the most severe. Some lucky people remain asymptomatic, but its common to experience intense flu-like symptoms within seven to 14 days of becoming infected with the herpes virus.
Symptoms of an initial outbreak often include:
- -Fever and chills
- -Difficult or painful urination
- -A tingling sensation in the affected areas
You can expect your initial herpes outbreak to last two to four weeks before it finally clears up. The good news, at least, is that future outbreaks are usually shorter and less painful than the first.
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Herpes Encephalitis And Meningitis
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 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.
Whats The Typical Frequency Of Genital Herpes
The herpes simplex virus type 2, better known as genital herpes or HSV-2, is a sexually transmitted infection. Despite having no cure, a number of techniques are proven to reduce the frequency and duration of each genital herpes outbreak.
You may recognize a genital herpes outbreak by the appearance of blisters and lesions. Most people experience their first outbreak two to 12 days after initial exposure to the virus. After the blisters break, it may take up to four weeks for herpes ulcers to heal.
After the first outbreak, recurring outbreaks are common but dont last nearly as long. Sores tend to heal within three to seven days in recurring outbreaks, and the number of outbreak periods may even decrease over time.
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How Often Do Outbreaks Occur
The number of outbreaks someone has varies from person to person. The average number of outbreaks for a person with genital HSV-2 is four to five per year. The average for genital HSV-1 is less than one outbreak per year.
Usually, there are more outbreaks during the first year, and many people find that outbreaks become less severe and less frequent with time.
Herpes triggers are highly individual, but with time, many people learn to recognize, and sometimes avoid, factors that seem to reactivate HSV in their own bodies. Illness, poor diet, emotional or physical stress, friction in the genital area, prolonged exposure to ultraviolet light , surgical trauma, and steroidal medication may trigger a herpes outbreak.
The frequency of outbreaks can often be managed through effective stress management, and getting adequate rest, nutrition, and exercise. For people with frequent outbreaks, suppressive therapy with any one of the antiviral treatments can reduce outbreaks by as much as 80%.
How Can Herpes Be Prevented
Correct and consistent use of latex condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.25,26
The surest way to avoid transmission of STDs, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested for STDs and is known to be uninfected.
Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV.
Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. 27 Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences.
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How Can I Protect My Sex Partners
You can take steps to protect others from herpes. Keep in mind that you can spread it even when you dont have symptoms.
Avoid sex during outbreaks: Youre more likely to give your partner herpes while you have an outbreak. Avoid sexual contact from the time you notice the first signs, such as tingling or pain, until the scabs fall off and your skin is back to normal.
Try not to touch your sores: If you do, wash your hands right away. A good cleaning may stop the spread to another part of your body or to your partner.
Use condoms: They wont totally protect your partner, but they can lower the chances of spreading the virus.
Talk to your doctor: They might prescribe a drug to make it less likely youll give herpes to someone else. As with condoms, the medicine wont 100% protect your partner.
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