Herpes

The Basics

Herpes is a super-common STD caused by the herpes simplex virus, of which there are two kinds: type 1 (HSV-1) and type 2 (HSV-2). Though genital herpes is frequently caused by HSV-2 and oral herpes (think cold sores) is caused by HSV-1, researchers have noticed that HSV-1 can also lead to genital herpes. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. Xu F, Sternberg MR, Kottiri BJ. JAMA, 2006, Aug.;296(8):1538-3598.

Regardless, most people don’t know if they have either type, because symptoms are often mild or nonexistent. As a result, almost 90 percent of people who have herpes don’t know it. The CDC estimates that 776,000 people get new herpes infections every year.

How You Get It

“Herpes is very, very common,” says Raquel Dardik, M.D., an OB/GYN at NYU Langone Medical Center.

You usually get HSV-1 from nonsexual contact when you're a kid, whereas HSV-2 typically gets transmitted during sexual contact with someone who has genital herpes. With HSV-2, it's also way easier for men to transfer the virus to women, as opposed to the other way around.

Though getting diagnosed can cause anger or shame—or even make you question whether your partner has been cheating—remember most people who have herpes don’t know they do.

“If someone has a herpes genital outbreak, you treat the disease, but the virus stays in the nerves in that area," Dardik says. "And you can shed the herpes without having an outbreak.” This is called asymptomatic shedding. In other words, your partner may have passed it to you, not knowing he or she had it in the first place.

One more thing: "If you have type 2 and get exposed to cold sores [type 1], your reaction will be quite moderate," says Gil Weiss, M.D., an assistant professor of clinical medicine at Northwestern Memorial Hospital.

What’s It Like?

Nothing! Unless you’re having a herpes outbreak, you won’t see anything different in the mirror.

If you do have an outbreak, it usually means a painful sore will appear on the genitals, rectum, or mouth. After about four days, the sore may break open and can take up to four weeks to heal. "If you go online [and Google herpes], you'll see very dramatic pictures," Weiss says. "But most people have very mild symptoms or don't know they have it."

How Serious Is It?

If by serious, you mean incurable, then yes, herpes is serious. But if serious means significantly impacting your day to day, then nope, herpes isn’t that serious.

“My patients are often most upset about herpes,” Dardik says. “There seems to be some real emotional stigma there. Even if your partner tests positive for the virus, it might be awkward up front but might not have any permanent impact on the relationship,” Dardik says.

Even if your partner tests positive for the virus, it might not have any permanent impact on the relationship.

Genital herpes does make it easier to contract and spread the HIV virus. And it can have more serious complications for pregnant women. So if you’re pregnant and have a history of genital herpes, you should talk to your doc.

What Can I Do?

Though herpes is pretty common, it’s not part of a routine STI panel. Doctors don’t like to test without symptoms because of the potential for false positives. If you do have symptoms, talk to your doctor about getting a herpes blood test (a type-specific HSV serologic test).

Most doctors will prescribe acyclovir or valacyclovir (a.k.a Valtrex), daily antiviral medications that can reduce outbreaks and even help suppress genital herpes so it’s not passed as easily.

Using condoms can also help reduce your chances of spreading or getting the herpes virus. But they're not 100 percent effective, since you can still transmit the virus even if you're not experiencing symptoms. And if you're having an outbreak, it's best to abstain from sex entirely.

Researchers have been looking for a potential cure or vaccine for years. Most recently a company called Rational Vaccines completed a promising first phase of human clinical trials testing a vaccine called Theravax^HSV-2. But they’re not the only ones looking for a cure. In June 2016, another vaccine, simply dubbed GEN 003, completed its phase II trials with similar so-far-so-good results.

A cure or vaccine would be huge for the one in six people who have genital herpes. Until then, we suggest sticking to open, honest convos with your partners.

The number of people infected with three major STDs is at an all-time high (yikes!). We're tackling common misconceptions about STIs and STDs to help #ShattertheSTIgma. Because getting tested should be NBD.

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