Living With Herpes

No one looks forward to telling a sexual partner, “I have herpes.” But this widespread virus isn’t a life-threatening disease, and you have lots of options for treating it successfully.

“Herpes is so common that most people have been exposed to the virus by the time they’re 8 years old,” says Toni Brayer, M.D., an internal medicine doctor with Sutter. “It’s annoying, but unless you’re severely ill or immune-compromised it isn’t dangerous.” Get the facts before you freak out.

Common and Permanent

Herpes has two types: Herpes Simplex 1 (HSV-1), called oral herpes, and Herpes Simplex 2 (HSV-2), or genital herpes. According to current estimates, as many as 85 percent of adults have HSV-1 and one in six people carry HSV-2, though many never exhibit symptoms.

Currently there’s no cure or vaccine. Once contracted, these viruses persist in your body forever.

Hidden or Active

Your immune system likely determines whether herpes regularly erupts on the skin or lies dormant and unseen for years. “Some people don’t ever get an outbreak and yet if tested they have the virus — their immune system just keeps it at bay,” says Dr. Brayer.

Oral herpes typically produces cold sores or fever blisters on or near the mouth, while genital herpes may cause small blisters on the genitals, along with itching, pain and flu-like symptoms. However, either virus can break out in either location.

Be alert to triggers, such as stress, fever, too much sun and excessive wind, that activate herpes.

How You Got Herpes

Close physical contact spreads herpes. You can’t catch it through the air, like the cold virus. Most people pass oral herpes by sharing personal objects, such as toothbrushes, forks or razors, or by kissing — even a nonsexual greeting between friends or family.

Genital herpes transmits through sexual activity. A key fact: you can become infected even if your partner shows no symptoms. 

“Safe sex using barrier methods like condoms is the best prevention for anything that is passed through mucous membranes,” Dr. Brayer says. “But it’s really important to note that you can’t tell where you got genital herpes, because it lies dormant. It’s not like other venereal diseases where you can say, ‘Oh, I didn’t have it and now I have it, so I got it from you.’ You could have been exposed a long time ago — so you can’t really point fingers.”

How to Treat Herpes

When managing herpes, respond quickly. “People generally can feel early on when an outbreak is going to occur — they feel a tingling or sometimes an aching sensation, and a little tiny start of a blister,” Dr. Brayer says. “If you treat it right away you can sometimes block it from coming.”

When you first sense a herpes outbreak, immediately:

• Take aspirin. “It’s an anti-inflammatory and will lessen the virus,” she says.
• Apply ice to the area for 10 to 15 minutes to slow the virus and lessen pain.
• Start an antiviral medication. “If you’ve had several outbreaks, ask your doctor for specific prescription meds that you should keep on hand,” Dr. Brayer says. “If you catch an outbreak early enough, sometimes you can take just one pill and it will stop.”

Special Care During Pregnancy

If you’re pregnant and you know you have herpes, tell your doctor; the virus can lead to miscarriage or early delivery. If you’re having an outbreak of genital herpes near your delivery date, you’ll need a C-section to avoid infecting your child with neonatal herpes, which can be deadly.

Life Goes On

In everyday life, Dr. Brayer encourages the same safe practices for both oral and genital herpes: Don’t share personal care items. During outbreaks, avoid infecting others. For genital herpes, forgo sex or use condoms from the first signs of an outbreak until the sores clear up.

Also consider your communication options. “People always want to know, ‘Do I have to divulge this information at the beginning of a potentially sexual relationship?’” says Dr. Brayer.

It’s a tough question with practical implications. “First of all, you should be using protection anyway,” she says. Second, “because it’s health related it’s important, but you don’t have to lead with that. The best thing is to be talking about all sorts of important issues in the context of getting to know the person.”

Finally, don’t feel like a pariah if you test positive for herpes. “I always want to help patients not feel like they have a terrible disease — it’s such a common virus,” says Dr. Brayer. “Use common sense. Know your partners and use condoms to protect yourself and others.”