What Is It?

Herpes simplex virus (HSV) is a common viral infection of the skin and mucous membranes. It is characterized by an inflammation of small blisters and sores closely grouped together that can be found anywhere on a person's skin. The blisters are usually painful and may cause itching, burning and tenderness around the infected area.

HSV infections can be unattractive, thus emotionally distressing and debilitating with recurring episodes. HSV is also related to the viruses that cause chicken pox, shingles, mononucleosis and the Epstein-Barr Virus.

What Causes It?

Herpes infections are caused by a virus, which can be transmitted by direct skin-to-skin contact. There are two types of herpes simplex viruses; herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). HSV-1 or oral herpes is usually associated with "fever blisters" or "cold sores" with infections on the lips, mouth, gums, and face. It is transmitted directly through oral secretions during kissing, or contact with contaminated dishes, towels, or lip balms. HSV-2 or genital herpes usually results in blisters on the buttocks, penis, vagina or cervix and is sexually transmitted. Both types, HSV-1 and HSV2, can be found in either area of the body and are contagious.

There are two distinct stages of the virus: primary and recurrent. The primary infection with either HSV-1 or HSV-2 is usually more severe than recurrent outbreaks and may last from seven to fourteen days. The primary episode forms small skin blisters that eventually rupture as painful open sores. The blisters dry out, crust over and slowly heal over a period of time. During this time, the infection is generally accompanied by flu-like symptoms, including fever, headache, and swollen glands, particularly in the lymph nodes near the groin for HSV-2.

Once the body is infected with the herpes virus, it lives in the body for a lifetime, generally without symptoms. This period is called "latency." After each outbreak, the virus penetrates the cells of skin tissue and travels down through the nerve cell pathways where it lies dormant (inactive) or latent in the nerve roots of the body until the infection is reactivated. The virus is not apparent during this resting phase.

Recurrent episodes after the primary outbreaks are usually milder and feature most of the same symptoms that tend to erupt in the same region on the body. Recurrences are more frequent with HSV-2 genital herpes than with HSV-1 oral herpes. It is not completely known what triggers flare-ups, but there are a number of aggravating factors that may encourage recurring episodes. Prolonged exposure to strong sunlight, upper respiratory tract infections, dermabrasion, laser resurfacing or dental surgery can trigger oral herpes. Known triggers for genital herpes include surgical trauma, menstrual cycle, or emotional stress.

Before an outbreak, many people experience an itching, tingling sensation, or soreness in the area where the recurrent blisters will develop. This early warning symptom indicates the virus may be present on the skin is called a "prodrome"-which often precedes flare-ups by a day or two and is considered contagious when prodromal symptoms are present.

Herpes simplex virus can become active without causing any apparent signs or symptoms. It enters into body fluids, such as saliva, semen or vaginal fluids. This type of transmission is called "asymptomatic shedding." There are no symptoms during the shedding, but the virus can spread and infect others during this time.

What Can Be Done?

There is no known cure for herpes simplex virus. However, there are oral antiviral medications that can help reduce the frequency of breakouts, speed healing time and lesson severity of infections. Three prescription medicines are currently approved for oral and genital herpes: Zovirax®, Valtrex®, and Famvir®. These drugs are safe and have few side effects. Antiviral medicine can bring great relief to people who have frequent or bothersome outbreaks. However, most people with herpes don't feel the need to take medicine because their outbreaks are mild. During a mild outbreak, infections can be managed at home.

Why Know Your Herpes Status?

Why should you take the time and trouble to find out your herpes status? What are the benefits to you and to those you care about of knowing if you do, or don't have HSV-2. It's all about how increased knowledge helps you manage the risks better. Use this section to find out how knowing can put you in control.

Benefits to you of knowing if you're positive for HSV-2

Genital herpes outbreaks can be treated using drugs. The common ones used are: Acyclovir, Valtrex or Famvir, but these should only be given if the doctor knows you have the condition. A positive result in an HSV-2 test can aid in the diagnosis of genital herpes. This means that, if you have genital symptoms, it will be more likely that they will be appropriately treated. People with genital herpes may receive the wrong treatment because they don't have typical symptoms. A definitive diagnosis, aided by the result of an appropriate test lessens the chances of this happening.

If you get a true primary infection (i.e. the first time you have been infected, not necessarily the first time you get symptoms), then there is evidence that rapid onset of treatment may reduce viral load which may reduce the frequency and severity of outbreaks later on.

Benefits to you of knowing if you're negative for HSV-2

If you know you don't have herpes, then you know you might have to take steps to stay that way. This is especially important as it is projected that herpes will reach a plateau with nearly half of all adults infected. Knowing your herpes status, and that of your sex partners, helps you to manage your risk better. Studies of couples where one partner has HSV-2 and the other doesn't have shown that acquisition of the virus is not inevitable. However, you need to know where you stand before you can manage your risk.

Benefits to others of knowing if you're positive for HSV-2

80-90% of the people who have genital herpes don't know they have it, yet can transmit the virus to their sex partner. This can happen regardless of whether symptoms are present or not and studies have shown that the majority of transmission may take place when symptoms are absent. Knowing you're positive means you can take steps to reduce the chances of passing the virus to those you care about.

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