By Cassie Shortsleeve, Prevention
Herpes sounds like a sexually transmitted infection (STI) you’d be able to spot easily (cold sores and below-the-belt blisters, anyone?). But most people who have herpes simplex virus don’t show any symptoms and have not been diagnosed with herpes, according to the Centers for Disease Control and Prevention (CDC).
And the virus is extraordinarily common. “About 60 to 70 percent of the population is positive for herpes simplex virus type 1, herpes simplex virus type 2, or both,” says Eric Ganz, MD, an assistant professor of gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai.
Herpes is broken up into two types: Herpes simplex virus type 1 (HSV-1), also called oral herpes, which primarily affects the mouth and lips; and herpes simplex virus type 2 (HSV-2), or genital herpes.
Signs of herpes you shouldn't ignore
Unlike other STIs like chlamydia, herpes can’t be cured. That means once you have it, your best bet is to be able to spot the symptoms, treat them, and practice safe sex. Here, the signs to look out for and what to do if you think you’re infected.
Flu-like symptoms
The first herpes outbreak that someone gets tends to be brutal, says Monica Svets, MD, an ob-gyn at the Cleveland Clinic. “You feel very sick all over and might have very intense flu-like symptoms.” Body aches, extreme fatigue, and swollen, tender lymph nodes in your groin area are all common in primary outbreaks, she notes.
Think of it like chicken pox: You have an initial phase of an active infection that wipes you out. There are high amounts of a virus you’ve never seen before coursing through your body, and thus, a higher immune system response. Herpes outbreaks tend to get less severe over time, says Dr. Svets.
Painful blisters
One of the classic symptoms of genital herpes is intensely painful blisters around the genital area, says Dr. Svets, who adds: “No blister is a good thing.” Unlike other bumps or sores you might notice around your vagina, herpes sores are extremely painful, says Dr. Ganz.Blisters pop up because the skin is likely the area of transmission (through sex or oral sex), explains Dr. Svets. Vaginal tissue and the skin surrounding the vagina are also easier to injure, disrupt, and thus pick up a virus, she adds.
And remember: Just because you see your first blister doesn’t mean the incidence is a sign of your first infection. “The herpes virus is kind of like an evil little family—they go to sleep and lie dormant in your cells,” says Dr. Svets. “Different things can wake them up, such as high stress or other illnesses.”
Intense itching
Don’t notice a blister? You might feel some intense itching around a “hot spot” or one particular area of your vaginal region, notes Dr. Svets. It’s another reaction of the virus coming into contact with your skin.
Tender red spots
Herpes doesn’t always show up as a classic blister. Sometimes, it looks like red spots that might appear to have pus in the middle of them. “You can have minor ulcers that are hard to see in pubic hair,” notes Dr. Ganz.But when you take a closer look, these marks are usually “angry” which makes them red, and are very, very tender (remember: herpes sores are painful). “They’re not subtle,” says Dr. Svets.
Cold sores around your mouth
Oral herpes, usually caused by HSV-1, can lead to cold sores on or around your mouth instead of your lady parts. These will look similar to the blisters you might notice in your genital area, appearing to have a pussy filling, and they might crust or scab when they’re healing. (Here’s how to get rid of a cold sore—and prevent it from coming back.)
Numbness or tingling
Dr. Ganz notes that herpes tends to have an “unusual” feeling about it—like numbness or tingling on the mouth or in the genital region, even shooting through the legs, hips, or butt area—before sores even show up. That’s because while other STIs might affect just skin tissue herpes can impact nerve tissue, too. This can even lead to nerve damage in rare cases, says Dr. Ganz.
How to treat herpes
Herpes is diagnosed either by a sample of a sore itself or a blood test that IDs antibodies. Remember—it can’t be cured. But if you’re suffering from outbreaks, oral antiviral medications such as Zovirax, Famvir, or Valtrex are often prescribed to decrease severity and length, says Dr. Svets.
Sitting in a shallow, cool-water bath (known as a sitz bath) can also help alleviate sore pain. Just avoid any heavily fragranced soaps or bath products that could further irritation.
Since the likelihood of passing herpes on is high (even if you don’t have any symptoms you can still pass the virus), it’s crucial to tell any sex partners that you have herpes and use condoms, says Dr. Svets. For people with recurrent outbreaks, you can also use antiviral medications on a daily basis to suppress the virus and lower the risk of transmission to under 10 percent.
