Center for Young Women's Health

Herpes

 

Remember

  • Genital herpes is a STD that results from sexual contact with someone who has the virus.
  • If you have a genital sore, don't have sex - see your primary care provider.
  • There are effective ways to manage herpes
Getting Treatment:
The Division of Adolescent/Young Adult Medicine at Boston Children's Hospital offers special services in the diagnosis and treatment of herpes.

What is herpes?

Herpes is one of the most common sexually transmitted infections in the U.S. It is an infection caused by two different but closely related viruses, called Herpes Simplex Virus Type 1 (HSV-1) and Herpes Simplex Virus Type 2 (HSV-2).

How common is herpes?

Almost 90 percent of Americans will have the most common form of herpes - Herpes Simplex Virus type 1 (HSV-1) or oral herpes ("cold sores") at some time in their life. Genital herpes (HSV-2) is more common among women than men. About 1 in 5 women are infected with the herpes virus, however many don't know they are infected because they have never had or noticed the symptoms.

 

How is herpes spread?

Herpes is spread through contact with a skin lesion(s) or mucosa and the secretions from vagina, penis or anus and oral fluid with someone who is infected with the virus. This includes touching, kissing, and sexual contact (vaginal, anal, penile, and oral). Moist areas of the mouth, throat, anus, vulva, vagina, and the eyes are very easily infected. Herpes can be passed from one partner to another or from one part of your own body to another part. If one partner has oral cold sores, he/she can pass on the virus during oral sex and cause genital herpes. Herpes is most easily spread when there are open sores, but it can also be spread before the blisters actually form or even from people with no symptoms. It's very unlikely that herpes is spread by toilet seats, swimming pools, bathtubs, whirlpools, or moist towels. An infected mother can pass the virus to her baby during or after childbirth. Women who get infected for the first time close to the time of delivery are particularly likely to pass the virus to their baby. Pregnant women should always let their doctor know if they have had herpes or been exposed to herpes.

 

What are the symptoms of oral herpes?

The first infection with HSV-1 or oral herpes often causes no symptoms but it may cause sores in the mouth around the teeth and gums ("gingivostomatitis"). Typically the infection shows up as small blisters on the lips ("cold sores" or "fever blisters"), a flare-up of an earlier infection. The flare-ups are more common during colds, fevers, and sun exposure. Oral herpes can be spread through contact such as kissing, or though oral sex. Direct contact for a short amount of time is enough to spread the virus. Cold sores can cause genital herpes through oral sex. If you have oral herpes, you should avoid contact with newborn babies.

 

What are the symptoms of genital herpes?

Genital herpes may be caused by HSV-1 from oral sex or from HSV-2 from genital sexual exposure. Infection with herpes may not cause any symptoms and the person may not know they have the virus until they pass it on to another person or get symptoms when the virus is "reactivated." The first outbreak is usually the worst and most painful and occurs within 2-20 days after contact with the virus. The sores usually will go away within 2-3 weeks.

 

The first time a person becomes infected with the virus is called "primary herpes."

 

Symptoms may include:

 

Other symptoms of primary herpes infection can include:

Symptoms usually go away within 2-3 weeks; even faster if you are treated with medication. The sores usually scab over and heal without scars. But after going away, the virus stays in the body. It can cause a flare up and sores again a few days or even several years later. Symptoms are usually worse during primary herpes, and are milder with flare ups (also called "outbreaks"). However, the flare ups may come frequently enough or be painful enough, that you may choose treatment for that too.

 

How is herpes diagnosed?

Your health care provider can diagnose herpes by looking at the sores during a physical exam and by testing fluid taken from the sores to see if you have HSV-1 or HSV-2. There are also specific blood tests which can be helpful in some patients to figure out which virus type caused the symptoms or to figure out if one partner has been infected by herpes. If you think you have herpes sores, see your health care provider right away to see if you need testing and treatment.

 

Is there treatment for herpes?

Yes. Your health care provider can prescribe medications that quicken healing, make symptoms less painful, and lower the risk of getting outbreaks. These medications don't kill the virus and don't prevent you from getting outbreaks in the future. Even when you don't have any symptoms, the virus is in the body and can "flare up." However, the flare ups or outbreaks usually become fewer and less severe as time goes on. Outbreaks can be prevented or treated early with anti-viral medication to lessen symptoms.

 

Does treatment cure herpes?

No. Although herpes cannot be cured, it can be treated! For oral herpes, using a sun block on and around the borders of the lips and a hat can lessen the chance of cold sores from sun exposure. Oral medications, prescribed by your health care provider can be used to treat herpes infections and to prevent genital herpes recurrences.

 

Is there anything I can do to relieve my symptoms for genital herpes?

Your health care provider will likely prescribe an anti-herpes medication to help your sores heal faster. If you are having frequent outbreaks, your health care provider may also suggest medication to lessen the number of episodes of herpes or to start treatment as soon as tingling or other symptoms start.

 

You can do several things to help relieve your discomfort or pain during a flare up:

 

You may have some early warning signs that an outbreak is coming. These signs include; tingling, burning, and itching where you had sores before. These signs could start a few hours or days before the outbreak.

 

How often do outbreaks occur?

Half of the people who have herpes don't have any more outbreaks or flare-ups after the first occurrence of symptoms. This is especially true if the infecting herpes was HSV-1. Some people only get a few outbreaks, while others get many. People can have many outbreaks in a row and then go months or years without one. People with illnesses that weaken the immune system such as leukemia and HIV are more likely to get more outbreaks and have symptoms that are more painful and last longer.

 

What causes an outbreak?

It is not clear what causes outbreaks. Some ideas are: other infections, physical or emotional stress, fever, surgery, menstruation, sexual intercourse, skin irritation (sunburn or sun exposure), trauma, alcohol, or problems with your immune system.

 

Is there anything I can do to prevent outbreaks?

Make sure that are you are eating a healthy diet, getting enough rest, exercising, and finding ways to relieve stress. If you have frequent or severe outbreaks, talk to your health care provider about taking a medication to prevent outbreaks or to treat them early.

 

How can I prevent spreading herpes?

Does herpes cause cervical cancer?

No! Cervical cancer is caused by infection with certain human papilloma viruses, not by herpes. However, you can talk to your health care provider about when to start getting annual Pap tests.

 

Is there a connection between herpes and HIV infection?

People with herpes or other sexually transmitted infections that cause genital sores are more likely to get HIV. The sores provide a place for the HIV virus to enter and start spreading. If a person with HIV also gets genital herpes, the herpes infection is likely to be more severe.

 

While it is normal to have many different reactions after learning you have herpes, try to remember it can be managed. Many young women find it helpful to talk with others who have herpes. Support groups can provide a safe environment to connect with others and a place where you can learn about herpes and how to manage flare-ups, and sexual relationships.

 

Written and reviewed by the CYWH Staff at Boston Children's Hospital

 

Updated: 10/18/2012

 

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