Causes feelings of depression.

Creates worry about current relationships.

Makes starting new relationships difficult.

Patients average 3 to 4 recurrances annually.

 Valtrex significantly shortens time to healing and reduces pain.

What Is Herpes?

Herpes simplex virus (HSV) is spread by skin-to-skin contact with an infected area, usually through kissing or sexual contact. There are two types of herpes that are most common in humans: HSV-1 usually refers to "oral herpes" and HSV-2 usually refers to "genital herpes," but the two types can occur in either area. Many people have no symptoms but are still infected with the virus and can spread the infection. Others infected with herpes experience small, painful lesions that crust and heal after about two weeks. Even though the symptoms may heal or disappear, herpes can still come back. This is called a recurrence, or outbreak. Herpes is most easily spread when lesions are present and right before and after an outbreak. There is no cure for herpes but certain medications can reduce the severity and number of outbreaks. Herpes can increase the risk of becoming infected with other STDs including HIV, the virus that causes AIDS. Herpes may be severe in people with weakened immune systems and may also be harmful to a fetus in pregnant women.

WHAT'S THE DIFFERENCE BETWEEN HERPES TYPE 1 (HSV-1) AND HERPES TYPE 2 (HSV-2)?

HSV-1 is associated with "oral herpes" because this type of the virus is often found in lesions on the lips, mouth or face. These lesions are often called cold sores, canker sores, or fever blisters. HSV-2 is associated with "genital herpes" because this type of the virus is often found in lesions on the external genitals, anus, cervix, vulva, buttocks or thighs. However, HSV-1 and HSV-2 can cause herpes infections in either area. Between 1 and 30% of all genital herpes outbreaks are caused by HSV-1. In other words, HSV-1 has been found in lesions on the genitals and HSV-2 has been found in lesions on the lips, mouth or face, but when this happens infections tend to be less severe with fewer recurrences. If you have HSV-1, the first genital outbreaks of HSV-2 tend to be less severe.

HOW IS IT SPREAD?

• Vaginal Sex
• Anal Sex
• Oral anal sex (rimming)
• Oral vaginal sex (going down on a woman)
• Oral penile sex (going down on a man)
• Kissing
• Direct skin-to-skin contact
• During childbirth

Both HSV-1 and HSV-2 can be transmitted between partners through kissing, oral, anal, or vaginal sex, rimming, and dry-humping without clothes. HSV-1 is usually spread by saliva while HSV-2 is usually spread through direct skin-to-skin contact during sex. It is possible to transmit herpes when no symptoms are present, especially in the days immediately before or after an outbreak. Herpes can also be spread from the genitals or mouth to other parts of your own body if you don't wash your hands thoroughly with soap after touching an infected area. It is also possible for lesions to appear on other parts of the body, such as the fingertips. This is called herpetic whitlow (hur-PEH-tick · WIT-loh).

Men are more likely to spread the infection because they have outbreaks more frequently and they experience less discomfort when lesions are present and are therefore more likely not to abstain from sex.

It is easier to become infected with herpes if your immune system is compromised. HIV, drug use, stress, and other illnesses can compromise your immune system. Also, a previous herpes infection at any site provides some protection against future re-infections.

IS IT VERY COMMON?

• Throughout the world, 50 - 90% of all adults are infected with HSV-1, the virus that causes oral herpes.
• According to the Centers for Disease Control (CDC), in the United States, 45 million people are infected with HSV-2. This means 1 out of every 5 people is infected.
• HSV-2 infection is more common in women (1 out of every 4).
• Herpes is more common in blacks than whites, lower socioeconomic groups, those with multiple sex partners, those who are immunocompromised, and those who do not have access to healthcare.
• Only 10% of people with infected partners contract herpes if they do not have sex during outbreaks.

YOU MAY NOT KNOW YOU HAVE IT!

Many people do not know they are infected with herpes because they do not have or notice symptoms. At least two-thirds have no symptoms or symptoms too mild to notice. About 25% of people who experience their first outbreak of genital herpes already test positive for the infection. This means that 1 of every 4 people who have their first herpes lesions had the infection but had no symptoms.

HOW DO YOU KNOW IF YOU HAVE IT? (SYMPTOMS)

Symptoms of herpes usually show up within 2-14 days after sexual contact, but may not appear for months or years. Some people may notice a red patch of skin, a tiny sore that is easily confused with a pimple or in-grown hair, a small slit or fissure in the skin of the genitals or oral cavity, irritation around the anus or vulva, or pain with urination. Many people experience headaches, fever, swollen glands, or fatigue usually within the first 3-4 days that lesions appear. Herpes is not usually associated with discharge but it has been noticed in some patients. Any combination of these symptoms may be referred to as an outbreak. Lesions crust and heal about 2 weeks after first appearing. Regardless of symptoms, herpes can cause distress on the person infected as well as their partner(s). There are hotlines and support groups that can help..

Persons who contract HSV-2 for the first time can expect an average of five outbreaks in the first year after exposure. The number of outbreaks usually decreases over time. Five to ten years after initial exposure, a person may not have any outbreaks. When a person experiences outbreaks they may have pre-outbreak symptoms. These early signs of an outbreak can be a highly individual experience. Some people notice a tingling or itching in the affected area, others may notice a backache or pain in the legs. Many people do not experience anything at all.

Between 1 - 30% of all genital herpes outbreaks are caused by HSV-1. HSV-1 occurring on the genitals is much less likely to recur, or come back.

Symptoms of oral herpes:

• Small, painful lesions on the lips, mouth, or face.

Symptoms of genital herpes in women:

• Small, painful lesions on the external genitalia, cervix, vulva, anus, buttocks, or thighs. Pain is usually most intense between days 7 and 11 of the infection.
• Pain during urination
• Itching
• Vaginal discharge
• Swollen glands in the groin
• Flu-like symptoms

Symptoms of genital herpes in men:

• Small, painful lesions on the penis, scrotum, anus, thighs or buttocks. Pain is usually most intense between days 7 and 11 of the infection.
• Pain during urination
• Itching
• Discharge from the penis
• Swollen glands in the groin
• Flu-like symptoms

IS HERPES VERY SERIOUS? (COMPLICATIONS)

The first outbreak of herpes is usually the most severe. In the first year of infection, a person can expect to have 4 - 5 outbreaks, but this decreases over time. If a person has already been infected with herpes and experiences an outbreak later, the outbreak may not be as severe. In general, infection with herpes can vary for different people. Some people may never notice symptoms and may not know they are infected with the virus. Others have outbreaks quite frequently and can take medication to decrease the number of outbreaks.

There is a greater chance of becoming infected with HIV during herpes outbreaks because HIV can enter the body through the open lesions. It is important to avoid sexual contact with partners of unknown HIV status during outbreaks. Herpes can also be more severe in people with weakened immune systems. HIV infection, stress, and IV drug use can be factors that increase risk for herpes outbreaks. In extreme cases herpes may spread throughout the body, causing meningitis (affects the central nervous system), arthritis (inflammation of the joints), or hepatitis (inflammation of the liver).

Herpes can be a serious factor during pregnancy. A woman is more likely to transmit herpes to the baby if she is experiencing an outbreak at or near the time of delivery. 50% of women with herpes infections at the time of delivery pass the infection to their babies. 70% of babies born with herpes infection have mothers without symptoms of herpes. Genital herpes is associated with spontaneous miscarriage and premature delivery.

GETTING TESTED

Herpes is usually diagnosed by a visual exam by your health care provider or a lab test. To get tested, your health care provider can take a culture with a cotton swab, but lesions must be present. This test can distinguish between HSV-1 and HSV-2. There is also an anti-body blood test for herpes, however most people will test positive for herpes antibodies since most of the adult population has been exposed to HSV at some point in their lives. Therefore, this test is not as useful.

GETTING TREATED

The most common treatment for genital herpes is the anti-viral drug Acyclovir (Zovirax®). Acyclovir is usually taken orally but is sometimes given intravenously to persons with compromised immune systems. It is occasionally given topically as well. Acyclovir can decrease the number and severity of recurrences, reduce pain, accelerate healing, and decrease viral shedding (a person's ability to spread the virus to others). If individuals do not respond well to Acyclovir, they may be given Valacyclovir (Valtrex®) or Famciclovir (Famivir®) but these medications are more expensive.

HOW CAN YOU AVOID HERPES?

• Avoid kissing, or sexual contact when sores are present. If possible, it is also best to avoid sexual contact a few days before and after an outbreak. Remember, only 10% of people with infected partners contract herpes if they do not have sex during outbreaks.
• Condoms should be used during vaginal, oral and anal sex. They are not always 100% effective in preventing the spread of STDs but they are the best source of protection. But since herpes can be spread through skin to skin contact, condoms are not completely effective.
• Avoid touching sores on your body during outbreaks as to avoid spreading the infection to other areas.
• Limit your number of sex partners. The more people you have sex with, the greater your risk of getting an STD. But remember, it only takes one encounter to become infected with an STD.
• If you are infected with herpes, taking certain medications can reduce the number of outbreaks.