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Herpes is caused by a virus: the herpes simplex virus (HSV).
HSV is in a family of viruses called herpes viruses. This family includes Epstein-Barr virus, the cause of mono; and varicella zoster, the cause of chicken pox and shingles.
Although there are several viruses in the herpes virus family, each are separate viruses and different from one another.
There are two types of herpes simplex; herpes simplex type 1 (HSV-1) and herpes simplex type 2 (HSV-2).
HSV is a common and usually mild recurrent skin condition.
HSV can cause oral herpes (cold sores or fever blisters on the mouth or facial area) as well as genital herpes (similar symptoms in the genital region).
The majority of oral herpes cases are caused by HSV-1 and the majority of genital herpes cases are caused by HSV-2; however, both type-1 and type-2 can occur in the genitals, oral area or both.

About 50 percent to 80 percent of the adult population in the United States has oral herpes.
Most people contract oral herpes when they are children by receiving a kiss from a friend or relative.
About one in five adults in the United States has genital herpes, however as many as 90 percent are unaware that they have the virus
Anyone who is sexually active can contract genital herpes.

Any person who is sexually active can get genital herpes.
Herpes is transmitted through direct skin-to-skin contact. This occurs when a contagious area comes into contact with a mucous membrane, primarily the mouth and genitals.
Most skin on the body is too thick for the virus to go through.
If a person with oral herpes performs oral sex, it is possible for the partner to get genital herpes.
If a person with genital herpes has sex, it is possible for his or her partner to get genital herpes.
Herpes can be transmitted when there are no symptoms present.
There are several days throughout the year (called asymptomatic reactivation, asymptomatic shedding or sub-clinical shedding) when a person can be contagious without having a symptom.
There are no documented cases of a person getting genital herpes from an inanimate object such as a toilet seat, bathtub or towel. Herpes is a very fragile virus and does not live long on surfaces.

What are the symptoms of herpes?

While some people realize that they have genital herpes, many do not. It is estimated that one in five adults in the United States has genital herpes, however, as many as 90% are unaware that they have the virus. This is because many people have very mild symptoms or no symptoms at all. Because symptoms can vary a great deal, we recommend that an individual see a health care provider to obtain a culture of the symptom.

A person may show symptoms within days after contracting genital herpes, or it may take weeks, months or years.
Some people may have a severe outbreak within days after contracting the virus.
Some people may have a first outbreak so mild that they do not notice it.
It can be difficult for people to know when and from whom they may have contracted the virus.

What are the signs or symptoms of genital herpes?

Outbreaks of genital herpes can vary greatly from person to person. They can be mild for one individual and severe for another. Symptoms may last for up to 3 to 4 weeks, but they usually heal within 2 to 12 days. Symptoms may include the following:

One or more sores, blisters, cuts, pimples, bumps or a rash
Itching, burning or tingling in the genital area · Aches or pains in the genital area
Flu-like symptoms (headache, fever, swollen glands in lymph nodes near groin)
Painful urination and a discharge (vaginal or penile) are possible, but uncommon, symptoms for genital herpes

Many people have outbreaks that heal quickly, cause no pain or occur in an unnoticeable spot. People sometimes mistake herpes outbreaks for:

- Insect bites	- Jock itch
- Yeast infections	- Ingrown hair follicles
- Abrasions or razor burn	- Hemorrhoids

Where do symptoms of genital herpes appear?

When a person has genital herpes, the virus lays dormant (sleeps) in the bundle of nerves at the base of the spine. When the virus reactivates (wakes up), it travels nerve paths to the surface of the skin, sometimes causing an outbreak. The nerves in the genitals, upper thighs and buttocks are connected; therefore, a person can experience outbreaks in any of these areas. Such areas include:

The amount of outbreaks someone has varies from person to person.
The average number of outbreaks per year is four to five.
The first outbreak may be the most extreme outbreak a person will have.
Usually, there are more outbreaks during the first year.
Many people find that recurrences tend to lessen in severity and frequency with time.
Illness, poor diet, emotional or physical stress, friction, surgical trauma and steroidal medication (such as asthma treatment) may trigger a herpes outbreak.
The frequency of outbreaks can often be managed through effective stress management, and getting adequate rest, nutrition and exercise.

If symptoms of genital herpes appear, they can vary widely from person to person. If a person does experience visible symptoms, we recommend obtaining a culture test within the first 48 hours after symptoms appear. Beyond 48 hours, there is a risk of receiving a false negative test result because symptoms may have begun to heal and there is not enough of the virus left on the skin to culture.
Blood tests can be used when a person has no visible symptoms but has concerns about having herpes. Blood tests do not actually detect the virus; instead, they look for antibodies (the body’s immune response) in the blood.

How can I reduce my risk of getting herpes?

Any sexually active person may contract genital herpes. Ways to reduce risk include:

If someone has a symptom around the mouth (oral herpes), she or he should not perform oral sex until all signs have healed.
If someone has signs or symptoms around the genital region (genital herpes), he or she should not have sexual activity until all signs have healed.
When there are no symptoms present, using latex condoms for genital-to-genital contact reduces the risk of transmission.
One antiviral medication for herpes, valacyclovir (Valtrex®), has recently been shown to reduce the risk of herpes transmission. When taken daily by a person with a history of recurrent genital herpes, valacyclovir can reduce the risk of transmission to a partner who does not have the virus by 50%. It’s likely that a combination of suppressive valacyclovir and condoms provides greater protection than either method alone.
Microbicides/Spermicides have not been proven to reduce the risk of transmission. If used, they should be used with a condom, not in place of one.
Partner communication. It is important for both partners to become educated about herpes and to make decisions together about which precautions are best.

Currently, there is no treatment to cure herpes; however, there is no cure for any virus at this point.
There are three antiviral medications (in pill form) approved by the Food and Drug Administration (FDA) that are available for the treatment of herpes: Zovirax® (acyclovir), Famvir® (famciclovir) and Valtrex® (valacyclovir).
Each of these medications can be used during a recurrence to help speed the healing process of an outbreak.
All three drugs are FDA approved for daily, suppressive therapy to help reduce the frequency of outbreaks.
Zovirax is also available in the form of an ointment, but the medication has been proven to be much more effective when taken orally.
Valtrex, when taken daily (suppressive therapy) by a person with recurrent genital herpes, can reduce the risk of transmission to a partner.
According to the manufacturers, the most common short-term side effects reported were nausea and headaches. These medications have never been noted to cause any long-term side effects.
Using medication to treat genital herpes is not required. However, if a person would like to use an antiviral medication, speaking with a health care provider can help determine which treatment may be right for them.
You can speak to your doctor about the proper medications for you.
Over-the-counter creams and/or ointments are not recommended for genital herpes.

In a new relationship there is always risk. Usually this risk is emotional. When a partner has herpes, there is additional risk that you could get it, too. You may have concerns about risking infection for a relationship that may not last. You’ll want to understand how to lower the risk for infection and ways to talk with your partner. Remember, if you have been sexually active you may already have been at risk for herpes. You may have it and not know it. Because herpes can be spread without symptoms (asymptomatic shedding) it can be hard to know when a person became infected and who infected them. In fact, if you and your partner have had sex, it’s possible your partner got herpes from you.

In an intimate, sexual relationship with a person who has herpes, the risk of contracting the infection will never be zero. Some couples have sexual relationships for years without transmitting herpes just by avoiding sexual contact during outbreaks, using condoms regularly and using suppressive antiviral therapy to reduce outbreaks. Couples deal successfully with herpes all the time. For many, it is a minor inconvenience. Since herpes does not pose a serious health risk, some couples choose not to use condoms in a long-term relationship. If you’re not sure about the relationship or you’re uncomfortable with the risk, consider delaying intimacy for a while. Get to know your partner better and give yourself time. Remember, all relationships face challenges, most far tougher than herpes. Good relationships stand or fall on far more important issues--including communication, respect and trust.

For most people, the social and emotional impact of herpes is greater than the physical distress, at least in the beginning. Society tends to have a judgmental attitude about sexually transmitted diseases. Many people feel embarrassed or isolated after they are diagnosed. With time, accurate information and support, most people put herpes in perspective. A diagnosis of herpes can challenge our personal view of sexuality and health. Many people can be uncomfortable talking about it. Once you or a partner has more facts and information, you may find your views changing.

Some people don’t tell, or don’t tell every partner. Some don’t tell until after they’ve had sex. It’s important that herpes does not become a secret--for many reasons.

Telling your partner allows this person to make an informed choice. When you tell, you are showing respect and concern for his or her well being. Your honesty may build intimacy and trust.
Telling your partner helps prevent transmitting herpes. If you keep herpes a secret, you might invent lies and half-truths to postpone sex during outbreaks. And, you give your partner a shared stake in making decisions together about how to reduce risk.
Telling your partner can begin an important discussion about sexual health. Herpes is one of over 20 sexually transmitted infections. Others have more serious health consequences. Your honesty encourages your partner to share sexual history and health information with you.
Telling your partner can prevent future misunderstandings or threat of legal action.

First, have you come to terms yourself with having herpes? If you haven’t, then it’s unrealistic to expect another person to understand. How well informed are you? Do you know the basic steps to reduce the risk to your partner? Do you know the facts about herpes? You want to feel confident and knowledgeable before you can explain the infection to someone else. Have educational materials on-hand for your partner to read. Be prepared to answer questions. If you don’t know the answer to a question that isn't already answered on this site, find out here.

This can be a sensitive topic and knowing when to raise it is important. It’s best to let the friendship develop first, but it’s best not to wait until after you’ve become sexually intimate. Then, the issue can become tangled in feelings of anger and mistrust. Remember, telling a partner about herpes is only a small part of relationship building. This disclosure can enhance your honesty and openness, and demonstrate your ability to have and maintain an intimate relationship.

Words can be clumsy and awkward. Choose your own words and your own way of telling a partner. You’ll find the way that’s most comfortable for you.

"I want to talk with you about something that’s important to me. Have you ever had a cold sore or fever blister? A type of virus causes cold sores and fever blisters. I have this virus. Only, instead of getting the sores near my mouth, I get them in my genital area."
"I really feel I can trust you and I want to tell you something very personal. Last year, I found out I have genital herpes. It’s not as serious as it sounds. Can I tell you about it?"
"I really like you and enjoy being with you, and I want to get closer to you. Let’s talk about safer sex.

How Will a Partner React?

Some may overreact. Some won’t bat an eye. Since many people have genital herpes or have heard about it, many people won’t be shocked or surprised. Whatever happens, try to be flexible. Give your partner time to respond, think about what you’ve said and absorb the information. Remember when you first found out? It took you time to adjust, too.

You don’t have to be overly concerned about protecting a partner’s feelings. And, you may want to reconsider a relationship where you have to do all the emotional work. A safer sex discussion might help you find out if this partner is a good candidate for your love and attention.

A few people are going to react negatively. It won’t matter what you say or how you say it. Remember, these people are the exception not the rule. If a partner decides not to pursue a relationship with you because you have herpes, it is best to know this now. There are many people who will be attracted to you for who you are--with or without herpes.

Most people react well. They appreciate your approach, honesty and maturity in addressing an important health issue. Remember to put herpes into perspective: it is an annoying, recurrent skin condition that is treatable and manageable--no more, no less.

It is rare for infants to contract herpes.
Twenty percent to 25 percent of pregnant women have genital herpes.
Less than 0.1 percent of babies contract genital herpes.
A mother helps the baby by passing her antibodies to the infant during pregnancy.
Women who acquire genital herpes before becoming pregnant have a low risk of passing the virus to their baby.
A woman who contracts genital herpes during the third trimester of pregnancy is at a higher risk of passing herpes to the baby because she has not had time to build up antibodies to the virus.
Most mothers with genital herpes have normal vaginal deliveries.
The doctor should do a thorough visual exam at the onset of labor.
If a woman has symptoms at the time of delivery, a Caesarean section is recommended.
If an infant does contract herpes during delivery, the symptoms tend to show within two to three weeks after birth.
Herpes can be life threatening to an infant.
Medication may help prevent or reduce the lasting damage to an infant if treated early.
After birth, herpes can be passed to a baby by receiving a kiss from someone with a cold sore on the mouth (oral herpes).

If You're Pregnant and You Have Herpes:

Talk with your doctor or health care provider.
Be examined at labor to see if there are any symptoms.
Notify the doctor if you think you have symptoms during labor.

If You're Pregnant and Your Partner Has Herpes:

It is important to avoid contracting herpes during pregnancy.
Using condoms for sexual activity and not having sex while symptoms are present will reduce the risk of transmission.

Herpes simplex virus can cause small blisters or sores on the mouth or genitals.
About 80 percent of American adults have oral herpes (cold sores).
An estimated 25 percent of adults in the United States have genital herpes. Most don’t know it because their symptoms are too mild to notice.
Herpes is most easily spread during an active outbreak or during prodrome --the few days just before an outbreak.
Herpes can be uncomfortable but it is not considered to be a dangerous virus.
Herpes does not affect the immune system. It is rare to have any health problems from herpes.
Herpes can be spread even when no symptoms are present.

More Information on herpes and other STD's

For additional questions about this or any other STD's and other diseases, CDC (Centers for Disease Control) provides several toll-free hotlines for public use. The hotlines provide referrals and more answers to your questions. Be sure to request free printed information when you call the hotlines.

CDC National STD and AIDS Hotlines:
1-800-342-2437 or 1-800-227-8922. The hotlines are open 24 hours a day, seven days a week. For Spanish call 1-800-344-7432, 8:00 a.m. to 2:00 a.m. eastern standard time, seven days a week. For the deaf and hard-of-hearing call 1-800-243-7889, 10:00 a.m. to 10:00 p.m. eastern standard time, Monday through Friday.
CDC National Immunization Information Hotline:
English 1-800-232-2522 Spanish 1-800-232-0233 8 a.m. to 11 p.m. eastern standard time. For the deaf and hard-of-hearing call 1-800-243-7889. Monday through Friday 10 a.m. to 10 p.m. eastern standard time.
CDC Public Response Hotline (CPR):
English 1-888-246-2675 span 1-888-246-2857 Monday through Friday 8 a.m. to 11 p.m. eastern standard time 10 a.m. to 8 p.m. Saturday and Sunday. For the deaf and hard-of-hearing 1-866-874-2646 10 a.m. to 1 p.m. eastern standard time Monday through Friday.