What Is Herpes? Here's Everything You Need To Know About This STD
While you may be well aware of herpes' existence, odds are, you don't actually know enough about it. At one point or another, you've likely seen a fictional character in a TV show find out they have it, heard a friend complain about a cold sore, or perhaps even questioned whether you yourself had it. But what is herpes? What can you to reduce your risk of getting it? How do you get it? And if you do get it, what can you do about it?
These are all good questions to ask yourself — especially considering how common this STD is. In fact, more than one out of every six Americans between the ages of 14 and 49 years old has genital herpes, according to the Centers for Disease Control and Prevention (CDC). And according to Dr. Hunter Handsfield, professor emeritus of medicine at the University of Washington Center for AIDS and STD, more than 50 percent of American adults have oral herpes (cold sores or fever blisters). Dr. Handsfield defines herpes as a recurrent skin condition that’s caused by the herpes simplex virus (HSV). There are two types of HSV: herpes simplex virus type 1 (HSV-1), which is typically responsible for oral herpes causes, and herpes simplex virus type 2 (HSV-2), which is typically responsible for genital herpes cases. Confusingly enough, though, it's possible to get either strain in either place.
One of the reasons it’s so common is that it can be spread not only during vaginal sex, anal sex, and oral sex, but also from skin-to-skin contact — such as a hand job. That said, rest assured that you can’t get herpes from holding hands, hugging, sneezing, or coughing, according to Planned Parenthood.
Both oral and genital herpes types can cause itchy or painful blisters and sores on your genitals, butt, anus, and inner thighs, among other parts of your body. The CDC notes that some cases of genital herpes are cause by the HSV-1 virus. This is because oral herpes caused by HSV-1 can spread to the genitals via oral sex.
When these blisters pop up, it’s called an “outbreak” — the first of these typically happens between two and 20 days after you’re infected, and lasts about two to four weeks, according to Planned Parenthood. The American Sexual Health Association (ASHA) reports that for people with genital HSV-2, the average number of outbreaks is about four to five per year. People with genital HSV-1 experience less than one outbreak per year, on average. Herpes is especially contagious when sores are open, but it can still get passed to a partner when there are no sores whatsoever. When you’re first infected with the HSV-2, you may experience flu-like symptoms, like muscle aches, headache, swollen glands, and fever, and chills. Another relatively common symptom of genital herpes is the sensation of burning when you pee. Dr. Peter Leone, adjunct professor of medicine and epidemiology at the University of North Carolina, tells Elite Daily that HSV-2 has a higher rate of those aforementioned recurrent outbreaks than HSV-1.
Still, it’s worth noting that it’s not always obvious that you have herpes. Dr. Handsfield notes that many people are completely unaware they have been infected because their symptoms are super mild. Or, they may assume their sores are something else, like a blemish or an ingrown hair. Even if you don’t have symptoms, you can still transmit herpes to someone else.
Unfortunately, Dr. Mary Jane Minkin, an OB/GYN at Yale-New Haven Hospital and clinical professor at Yale University School of Medicine, tells Elite Daily that there is no cure for herpes, and that it’s common to experience repeat outbreaks — particularly in that first year after you got it.
“Those painful blisters will clear up,” she explains. “Unfortunately, the virus travels up nerve roots, where it can just ‘hang out’ — and then travel down the nerve root. In other words, you can join a convent and never have sex again, but you can still have an outbreak from the virus living in these nerve roots.”
If you feel a tingling feeling, itching, or burning on or around your genitals, those are all potential warning signs that an outbreak is coming, according to Planned Parenthood. Once you feel those warning signs, Planned Parenthood advises abstaining from any form of sexual contact — even with a condom — and then waiting to resume any intimate activities until about a week after the sores heal. The ASHA reports that recurrent outbreaks may cause similar symptoms as the first episode, including blister-like lesions and painful sores. These lesions will often look like an ingrown hair, a pimple, razor burn, hemorrhoids, or an insect bite. Over time, these lesions crust over and ultimately scab.
But here's the good news: Recurrent outbreaks tend to be less severe, less frequent, and last for about half the time of the first episode (about two to 12 days). The ASHA notes that herpes triggers can vary from person to person, but many people are able to identify specific factors that seem to reactivate the virus, such as lack of sleep, poor diet, stress, or friction on the skin around the genitals.
Whether or not you notice any new sores or blisters, the only way to know for sure if you have herpes is to get checked out by your doctor, or at a community health clinic or local Planned Parenthood. If you do have sores or blisters, your healthcare provider can take a sample of fluid from the sores and conduct a test for traces of the virus. If you don’t have these symptoms, the only way to find out if you have herpes is via a blood test. Remember: STD testing is something you may have to ask for since it’s not generally included in a regular checkup. Also, note that many doctors do not test for herpes unless you specifically ask them to. This is why it’s super important to be open and honest with your doctor about your sexual health — fill them in if you’ve had any new partners since your last STD testing, or are experiencing any new symptoms you’re concerned about. Remember: They’re there to help you, not to contribute to any shame you may have or make you feel judged about your sex life and your choices.
While there is no cure for herpes, there are ways to ease your symptoms, according to Dr. Minkin.
“The bad news is that it can come back,” she explains. “The good news is that we do have very effective medicine to treat it. If someone has herpes, we can have them take a low dose of the anti-herpes medicine every day, and prevent another outbreak.”
Herpes medicine can not only reduce the duration and frequency of outbreaks but can also reduce the risk of transmitting the virus to sexual partners. According to Dr. Leone, the most commonly prescribed herpes medications include valacyclovir (Valtrex), famciclovir (Famvir), and acyclovir (Zovirax). Not everyone decides to pursue treatment for herpes. If your outbreaks aren't bothering you or you have other reasoning for not getting treatment, you may continue getting outbreaks, or they may stop on their own after a while. Rest assured, however, that it likely won't get any worse if you don't take medication.
Whether or not you decide to get treatment, Planned Parenthood reports that other strategies can help you alleviate any pain or discomfort during an outbreak, such as taking a pain reliever and putting an ice pack on the sores. If you have genital herpes, Planned Parenthood recommends keeping that area as dry as possible since moisture can prevent sores from drying up and healing. And if you have oral herpes, you should wear SPF on your lips or stay out of the sun as much as possible, since sunburns can trigger flare-ups.
Your doctor can work with you to figure out the best herpes treatment plan for you, based on your symptoms, medical history, and current lifestyle. But regardless of whether you receive treatment or not, it's important to take certain measures for the sake of your health and your partner's. Dr. Leone advises filling your sexual partners in on the fact that you’ve been diagnosed with herpes. While it may feel awkward or uncomfortable, it’s crucial that you’re transparent about this fact so that you and your partner can both practice safe sex. The important thing to remember, according to Dr. Handsfield, is that herpes is both treatable and preventable.
“Probably the main misconception that contributes to the stigma around herpes is the mistaken belief that nothing can be done, when in fact, effective treatment can reduce both outbreak frequency and transmission risk,” he says.
Dr. Handsfield notes that there are several days throughout the year when herpes can still be contagious in the absence of symptoms. That's why both he and Dr. Leone advise avoiding sexual contact while you're experiencing an outbreak, and always using condoms when you're not having an outbreak. Remember, however, that while condoms can significantly reduce the risk of spreading herpes, it doesn't eliminate the risk entirely, because it can be transmitted through skin-to-skin contact.
Herpes may be annoying and incurable, but here’s the thing: it won’t get worse over time, and it won’t cause other serious health problems such as cancer or infertility like other STDs can (looking at you, chlamydia and HPV). The only thing to be aware of, really, is that having genital herpes can make it easier to transmit as well as get HIV, according to Dr. Handsfield. If you’re worried about contracting herpes, remember to use condoms, have open and honest conversations with your partners about their sexual health, keep an eye out for any symptoms, and get tested regularly. And if you’re feeling embarrassed or distressed about having herpes, keep in mind these things: it’s super common, it’s not dangerous, and it’s definitely treatable. Some people stop experiencing outbreaks altogether, and guess what? Those who don’t are still totally capable of having healthy, fulfilling sex lives. All it takes is a little bit of awareness around the symptoms, an understanding of your triggers, some extra precautions in between outbreaks, and of course, open communication with your partner.