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Herpes Simplex

What is herpes simplex?

The herpes simplex virus, also known as HSV, is an infection that causes herpes. Herpes can appear in various parts of the body, most commonly on the genitals or mouth. There are two types of the herpes simplex virus.

  • HSV-1: Also known as oral herpes, this type can cause cold sores and fever blisters around the mouth and on the face.
  • HSV-2: This type is generally responsible for genital herpes outbreaks.

Read more: Genital herpes »

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Causes

What causes herpes simplex?

The herpes simplex virus is a contagious virus that can be passed from person to person through direct contact. Children will often contract HSV-1 from early contact with an infected adult. They then carry the virus with them for the rest of their lives.

HSV-1

Infection with HSV-1 can happen from general interactions such as:

  • eating from the same utensils
  • sharing lip balm
  • kissing

The virus spreads more quickly when an infected person is experiencing an outbreak. Anywhere from 30 to 95 percent of adults are seropositive for HSV-1, though they may never experience an outbreak. It’s also possible to get genital herpes from HSV-1 if someone who performed oral sex had cold sores during that time.

HSV-2

HSV-2 is contracted through forms of sexual contact with a person who has HSV-2. It is estimated that around 20 percent of sexually active adults in the United States are infected with HSV-2, according to the American Academy of Dermatology (AAD). While HSV-2 infections are spread through contact with a herpes sore, the AAD reports that most people get HSV-1 from an infected person who is asymptomatic, or does not have sores.

Risk factors

Who is at risk of developing herpes simplex infections?

Anyone can be infected with HSV, regardless of age. Your risk is based almost entirely on exposure to the infection.

In cases of sexually transmitted HSV, people are more at risk when they participate in risky sexual behavior without the use of protection, such as condoms. Other risk factors for HSV-2 include:

  • having multiple sex partners
  • having sex at a younger age
  • being female
  • having another sexually transmitted infection (STI)
  • having a weakened immune system

If a pregnant woman is having an outbreak of genital herpes at the time of childbirth, it can expose the baby to both types of HSV, and may put them at risk for serious complications.

Learn more: Birth-acquired herpes »

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Symptoms

Recognizing the signs of herpes simplex

It is important to understand that someone may not have visible sores or symptoms and still be infected by the virus. And they may transmit the virus to others.

Some of the symptoms associated with this virus include:

You may also experience symptoms that are similar to the flu. These symptoms can include:

HSV can also spread to the eyes, causing a condition called herpes keratitis. This can cause symptoms such as eye pain, discharge, and a gritty feeling in the eye.

Diagnosis

How is herpes simplex diagnosed?

This type of virus is generally diagnosed with a physical exam. Your doctor may check your body for sores and ask you about some of your symptoms. Your doctor may also request HSV testing. This is known as a herpes culture. It will confirm the diagnosis if you have sores on your genitals. During this test, your doctor will take a swab sample of fluid from the sore and then send it to a laboratory for testing.

Blood tests looking for antibodies to HSV-1 and HSV-2 can also help diagnose these infections. This is especially helpful when there are no sores present.

Learn more: Serum herpes simplex antibodies test »

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Treatment

How is herpes simplex treated?

There is currently no cure for this virus. Treatment focuses on getting rid of sores and limiting outbreaks.

It is possible that your sores will disappear without treatment. However, your doctor may determine you need one or more of the following medications:

These medications can help infected individuals reduce the risk of spreading the virus to others. The medications also help to lower the intensity and frequency of outbreaks. These medications may come in oral (pill) form, or may be applied as a cream. For severe outbreaks, these medications may also be administered by injection.

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Outlook

What is the long-term outlook for herpes simplex?

People who become infected with HSV will have the virus for the rest of their lives. Even if it does not manifest symptoms, the virus will continue to live in an infected person’s nerve cells. Some people may experience regular outbreaks. Others will only experience one outbreak after they have been infected and then the virus may become dormant. Even if a virus is dormant, certain stimuli can trigger an outbreak. These include:

  • stress
  • menstrual periods
  • fever or illness
  • sun exposure or sunburn

It is believed that outbreaks may become less intense over time because the body starts creating antibodies. If a generally healthy individual is infected with the virus, there are usually no complications.

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Prevention

Preventing the spread of herpes simplex infections

Although there is no cure for herpes, you can take measures to avoid becoming infected, or to prevent spreading HSV to another person.

If you are experiencing an outbreak of HSV-1, some preventative steps to take include:

  • Try to avoid direct physical contact with other people.
  • Don’t share any items that can pass the virus around, such as cups, towels, silverware, clothing, makeup, or lip balm.
  • Don’t participate in oral sex, kissing, or any other type of sexual activity during an outbreak.
  • Wash your hands thoroughly and apply medication with cotton swabs to reduce contact with sores.

Individuals with HSV-2 should avoid any type of sexual activity with other people during an outbreak. If the individual is not experiencing symptoms but has been diagnosed with the virus, a condom should be used during intercourse. But even when using a condom, the virus can still be passed to a partner from uncovered skin. Women who are pregnant and infected may have to take medicine to prevent the virus from infecting their unborn babies.

  • What do I need to know about dating with herpes simplex? Do you have any tips for people dating with herpes?
  • The herpes virus can be shed from an infected person even when there are no lesions visible. So caution is important. Some may wish to take daily prophylactic oral Valtrex (an antiviral oral medicine) to help cut down on shedding. Herpes can also be spread on any skin: fingers, lips, etc. Depending on sexual practices, herpes simplex can be transferred to genitals and or buttocks from the lips of someone who has fever blisters. Honesty between partners is very important so these issues can be discussed openly.

    - Sarah Taylor, MD
  • Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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