Herpes: Understanding What It Is, How It Spreads, and How to Manage It

Herpes is one of the most misunderstood STIs out there. From exaggerated warnings in high school sex ed to jokes in TV shows, we often get the message that having herpes is the worst thing that could happen. But the truth is, herpes is far less of a big deal than it’s made out to be, and the stigma surrounding it is worse than the reality of living with it.

Here’s the reality: herpes is very common, manageable, and often symptom-free or only causing mild symptoms. So, let’s clear up some common questions about herpes and get rid of the fear-based myths.

What is herpes and what are the different types?
Herpes is a virus belonging to the same family as shingles and chickenpox. It’s a lifelong infection, but it’s manageable with the right treatment. There are two main strains of the herpes virus: HSV-1 and HSV-2. Most cold sores around the mouth are caused by HSV-1, but HSV-1 can also cause genital herpes. On the other hand, HSV-2 typically causes genital herpes but can sometimes show up around the mouth. You can actually have both types of herpes at the same time.

The important thing to remember is that both strains are treated the same way by healthcare providers, and there’s no “good” or “bad” type of herpes—it’s just herpes.

What are the symptoms of herpes?
Herpes can cause blisters, open sores, and discomfort like itching or burning. Some people may experience frequent flare-ups, while others might never have any symptoms or just experience one mild outbreak. Once you have herpes, the virus stays in your body for life, but it doesn’t always show up.

The first outbreak is often the worst, and may even feel like you have the flu, with body aches and fever. HSV-2, the strain that often affects the genitals, is more likely to be symptomless and harder to diagnose. It can also be spread even when you don’t have visible symptoms.

A common misconception is that herpes always looks like the severe cases shown in educational videos or online. Many people with herpes have very mild symptoms or none at all, and their first outbreak might just look like a small pimple or a minor cut, which is why so many people don’t even know they have it.

How is herpes spread?
Herpes is spread through direct contact with an infected person’s sores, saliva, or genital fluids. It requires skin-to-skin contact to spread, meaning it’s most likely to be passed through the mouth, genitals, or other mucous membranes like the inside of your mouth or genital area.

Using condoms or dental dams can reduce the chance of passing herpes, but it doesn’t eliminate the risk completely, since herpes can spread from skin that doesn’t have visible sores. Even without an outbreak, it’s still possible to spread herpes, but medication can help reduce this risk.

When should you get tested for herpes?
Healthcare providers don’t routinely test for herpes, so it’s important to speak up if you think you’ve been exposed or have symptoms. If you have sores, a healthcare provider may be able to diagnose herpes just by looking at them. They might also take a sample to confirm the virus.

There’s also a blood test for herpes that shows if you’ve been exposed to the virus at any point in your life. However, it can’t tell you when or where you were exposed, and a positive result doesn’t guarantee that you’ll have flare-ups or be contagious. It’s a good idea to get tested for STIs regularly, especially if you have new or multiple partners, even if you don’t have symptoms.

How is herpes managed?
While herpes isn’t curable, there are medications available to help manage it. The FDA-approved medications for herpes include acyclovir, valacyclovir, and famciclovir. These medications can be taken episodically (at the first sign of an outbreak) or as suppressive therapy (daily) to reduce the frequency of flare-ups and the risk of spreading it to others.

Using condoms and dental dams along with medication can help lower the chances of transmitting the virus, but, again, there’s still some risk.

How to cope with a herpes diagnosis
It’s common for people to feel shame when they’re first diagnosed with herpes because of the stigma around it. But it’s important to remember that having herpes doesn’t define you. You are still the same person you were before the diagnosis. Understanding that herpes is common, manageable, and not something to be ashamed of can help you move past the stigma and embrace your health.