Herpes is a viral family that includes herpes simplex and varicella-zoster, the virus that causes chickenpox and shingles. Herpes viruses are known for staying in one’s system and recurring, causing outbreaks that come and go over time. Does herpes go away completely?
Understanding how to deal with herpes infections can help keep you from passing these common viruses to others. However, herpes does not typically go away; once you are infected, the virus will stay in your system for life.
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Herpes is typically used to refer to two viruses—herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). These two viruses are very similar but have some key differences.
HSV-1 primarily affects the mouth and is typically transmitted through skin-to-skin contact (or, rarely, contact with infected items). In contrast, HSV-2 primarily affects the genitalia and is considered a sexually transmitted infection (STI).
However, oral sex can result in genital infections with HSV-1 and oral infections with HSV-2, so the line can blur a little. Both cause similar symptoms, namely sores on the mouth or genitals when they cause symptoms at all.
HSV-1 is often contracted by contact with skin or saliva and is extremely common. HSV-2, on the other hand, is typically contracted during sex, especially if condoms are not used, although it can sometimes transmit even with condom use.
As many people have HSV-2 asymptomatically, any unprotected sex with an unknown partner carries the risk of contracting herpes. Your partner may not know they have it or may find out only after you have sexual contact. HSV-1 can also be asymptomatic.
You can also get oral HSV-2 by giving oral sex and genital HSV-1 by receiving oral sex. You should use a condom or dental dam when giving or receiving oral sex outside a strictly monogamous relationship. If you have an active outbreak, you should avoid sex until the outbreak has cleared up.
Herpes simplex is typically divided between oral and genital herpes, depending on where symptoms are experienced. Symptoms are localized to the oral or genital area, although people may have both types of herpes at once.
The majority of infected people do not experience symptoms, especially with HSV-2. Symptoms for the first infection include:
Painful sores on the mouth or genitals that break and form blisters (oral herpes sores are often called "cold sores”)
Swollen lymph nodes
People with suppressed immune systems can experience more severe and persistent ulcers. In a few cases, herpes can cause aseptic meningitis, an inflammation of the brain’s lining, but this is very rare. Rarely, herpes blisters may spread to other areas, such as the buttocks, fingers, or eyes.
Herpes simplex is a very common virus that most of us are exposed to at some point, especially HSV-1.
Initial infections with HSV-1 are more common in childhood and early adolescence. It is transmitted by contact with saliva, so it can be picked up when parents or elder relatives kiss children or through shared utensils, towels, or other items.
More than half of us carry some strain of HSV-1, but not everyone shows symptoms.
Typically, you only get HSV-2 from genital contact with an infected partner. This means that people who have multiple sexual partners and routinely have unprotected sex are at the highest risk.
Most transmission occurs when a person is asymptomatic. You are more likely to pass on genital herpes if you have symptoms, but many people contract the virus from an asymptomatic person.
Newborns can also become infected by herpes if their mother has genital herpes (of either type) due to exposure during vaginal delivery.
Also, transmission is more likely from a penis to a vagina than from the reverse.
After the initial infection, herpes simplex typically becomes dormant. However, it is still in your system and can result in an outbreak, although outbreaks tend to decrease over time.
Some things that trigger an outbreak include:
A viral infection
Hormonal changes such as puberty and changes through the menstrual cycle
Injuries to the face or genitals, respectively, that result in the skin breaking
Genital herpes, as an STI, carries with it a certain level of stigma. Many people with genital herpes are afraid to date (out of fear of stigma or infecting their partner). Counseling can help you deal with the stigma and get on a more even keel.
If you are pregnant and have an active genital herpes outbreak, your doctor may recommend a C-section. Neonatal herpes infection can cause serious health issues for your baby, including blindness, low birth weight, poor feeding, seizures, and, rarely, encephalitis, which can lead to death. Antiviral therapy can reduce the risk to your baby.
Some people may eventually stop having herpes outbreaks altogether, although this does not mean the virus has been eliminated, only well controlled.
Oral herpes is not associated with stigma, but genital herpes is often because people assume that anyone with an STI is promiscuous and/or careless when this is not necessarily the case.
The virus that causes genital herpes is typically transmitted through direct genital contact, meaning penis in vagina (PIV) or penis in anus (PIA) sex. You can also get genital herpes if receiving oral sex from somebody who has oral herpes or from sharing sex toys without thoroughly cleaning them.
Using condoms, including during oral sex, and dental dams can reduce the risk of transmitting herpes.
There is no cure for herpes and no way to remove the virus from your body. Potential vaccines are, however, in clinical trials.
If you have an active outbreak, your doctor may prescribe antiviral medications, which can shorten the duration and severity of the outbreak. The most common medicine used is acyclovir.
If you are in a relationship and want to have unprotected sex, daily suppressive therapy can reduce the likelihood of transmission to your partner. It can also reduce the risk of transmitting herpes to a baby during delivery.
When experiencing an outbreak, you should take an over-the-counter pain reliever to reduce symptoms. Cool compresses applied directly to the sores can also reduce pain and itching. If you have sores on your labia, urinating in a tub of water can reduce pain.
You should wash your sores gently with soap and water and pat dry. Wearing loose-fitting underwear can also help.
Avoid doing the following, as these can make your sores worse and more painful:
Picking at sores, can result in an infection and also potentially transmit the virus to your hands
Using any kind of ointment or lotion unless recommended or prescribed by your doctor
Wearing synthetic underwear
Wearing tight-fitting pants
While the virus that causes herpes stays in your system, some people’s bodies can suppress it entirely. These people have no outbreaks, but it does not mean herpes has gone away, and it can potentially come back if your body is under strain.
Both kinds of herpes are contagious and are spread through saliva and sexual secretions. This means that the best way to prevent herpes is to take steps to reduce the spread.
Preventive measures include the following:
Not sharing utensils, towels, and other similar things, especially with young children
Avoiding unprotected sex with people you do not know well
Using a condom or dental dam during oral sex
Not having sex if you have an active genital outbreak
Not kissing if you have sores in or around your mouth
Not sharing toothbrushes or lipstick
Washing your hands after touching a sore
Not sharing sex toys
If you have genital herpes, have your partner tested. If you both have the same strain, you do not need to worry about it as long as you are monogamous and free of other STIs.
There is no cure for herpes, and most people will continue to have outbreaks. In some cases, however, outbreaks may stop, but this does not mean the virus is gone.
Both forms of herpes are contagious. The best way to avoid genital herpes is to avoid unprotected sex with multiple partners. However, people who practice safe sex can get it, and it’s important to avoid stigma.
If you have herpes, talk to your doctor about antiviral medications that can help shorten the duration of outbreaks and potentially prevent them.