What You Should Know About Herpes Simplex – HSV1 and HSV2

Herpes (HSV1 and HSV2) seems to be a misunderstood STD, same with HPV, so I’d like to cover exactly what herpes is and how to protect yourself and your partner(s).  If you want more information than what I cover in this article, please check out some of the links at the bottom of the page.

What is Herpes?

Herpes Simplex is a virus, just like HPV and HIV (meaning it’s NOT a bacteria).  There are two types of Herpes Simplex, HSV1 and HSV2.  HSVI is usually called oral herpes, or “cold sores”, and HSVII is known as genital herpes, though both types can be found in either location as well as other places in the body. It is also extremely common.  About 50% of people have HSV1 by the time they hit their 20’s (about 80% of people over 50), and about 15%-20% of people have HSV2.

How do you catch Herpes?

Herpes is a skin-to-skin transmissible virus, so even simple kissing can transmit an infection from someone who has HSV.  Other common routes are oral sex, anal sex, and vaginal sex.  Someone who has a cold sore (typically HSV1) can transmit the virus to someone else through direct contact, or even from touching the sore and then touching a vulnerable area of skin.  The virus generally needs some way to get IN the skin either through a cut, scrape, or any mucus membrane like those found in the urethra and vagina.  This means women are significantly more susceptible to infection as their genitals are mostly made of very delicate skin and mucus membranes.

Can you protect yourself from herpes?

Yes, but not entirely (unless you’re abstinent and don’t kiss anyone).  Since the virus can be transmitted from skin-to-skin contact, any area not covered by a condom or other barrier has a chance of being infected by someone who has the virus.  Use of condoms and oral barriers (dental dams) will reduce your risk, but not eliminate it.  It’s important to know whether you or your partner have HSV so you can talk about how you want to protect yourselves. 

Can I get Tested for Herpes?

Yes.  There is a blood test and a swab test.  The blood test simply tells you whether you have the virus or not, not necessarily where it is in your body.  If you have an open sore though, it can be swabbed and tested for HSV.

What are the Symptoms of herpes?

Many people who are infected with HSV never even have symptoms.  In those that do, typically HSV causes small open sores where the infection first took place.  These sores come and go throughout a person’s life, are usually not constant, and lessen in frequency over time.  The first symptom is most often a tingling, itching, or burning sensation at the site of infection and within hours to days will develop into an open sore that eventually scabs over and heals.  These sores are often “blister-like” in appearance at first, and contain the most active virus, at which time the person is most contagious.

Is there a Cure for Herpes?

No.  Once a person is infected with HSV they have it for life.  This is the scary part of the equation.  Keep in mind that herpes is super common and it’s not a sex-life death sentence.

What is the treatment for Herpes?

There are both pills and topical medications that either prevent outbreaks or significantly reduce the time they take to heal.  Common medications include Abreva (topical), and oral medications like Acyclovir, and Valacyclovir.  Typically the oral medications are reserved for severe cases.

Unfortunately I have HSV1 on my lip which results in a cold sore every 2-3 years or so, courtesy of a girlfriend I had way back when I was 19 who convinced me I couldn’t catch it.  Thankfully my lip is the only place I’ve got it!  I have a big bottle of Acyclovir and a tube of Abreva in my medicine cabinet for when I feel a cold sore coming on.  A scientific STUDY found that taking a one-time dose of 1.5 grams of acyclovir at the first onset of symptoms could actually prevent a cold sore from becoming a sore in the first place, and reducing viral shedding to less than 2 days.  Most of the time if this is done, the sore will never fully develop or open.  In addition to that, I also use Abreva topically at the first sign of a cold sore.  Doing this has drastically reduced the healing time of cold sores for me, and I haven’t had an open sore in many years. Acyclovir is a prescription medication though, so you’ll have to talk to your doctor if you want to try this.

What is the transmission rate of Herpes?

Transmission rate refers to the chance you could catch a disease.  If you avoid sex during outbreaks, but don’t wear condoms and don’t take daily medications (antivirals), there is about a 10% chance per year of an HSV infected male transmitting the virus to an uninfected female.  In the same scenario the rate drops to about 4% for an infected female transmitting the virus to an uninfected male.  This is actually fairly low.  But again, women are more than TWICE as likely to contract an STD than men, so let’s all look out for our ladies and stay protected.

Immunity and Complicated stuff…

Recent studies have shown that a prior HSV infection will significantly lower your chances of contracting another strain, or having an additional infection of the same strain in another area of your body.  So someone who has HSV1 will be less likely to contract HSV2, and vice versa.  This suggests that the immune system develops antibodies to the virus you are infected with, and those viruses are similar enough that the body has defenses already in place to fight against another strain of the same virus, preventing infection (or at least lowering the chance of infection).  Very interesting.

Is Herpes a big deal?

Medically speaking?  No, not really.  The virus is not life threatening and is mostly a mild inconvenience.  With proper treatment outbreaks are limited and in some cases never even happen again.  The biggest risk that herpes poses is a route for other infections.  Since herpes causes open sores, they leave you vulnerable to other diseases and increase your chance of contracting things like HIV.  To limit that, simply avoid contact during an outbreak.

The social stigma is the most destructive part.  People view genital herpes as such a negative thing it really affects those who have the virus.   Cold sores don’t have nearly that stigma, even though it is essentially the same thing.  Because society views kissing and touching lips as an acceptable activity, oral herpes is not nearly as frowned upon (excuse my pun).  But because society has such a negative view of sex, genital herpes is blown way out of proportion and cast as something that ruins your life.  It doesn’t.  Try to protect yourself and be as safe as you can, but beyond that, don’t worry too much!  I’d argue that not having sex because of a fear of contracting an STD is far more damaging to you than most STDs themselves.

-Freeman

Resources

https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/herpes

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5177552/

https://www.mayoclinic.org/diseases-conditions/genital-herpes/symptoms-causes/syc-20356161

https://www.thestdproject.com/herpes-so-many-people-afraid/

Freeman