Herpes, also called HSV, is a STI that infects approximately 1 out of 4 adults in the United States. Approximately 50% of those infected are unaware that they even have the virus. HSV is spread by skin to skin contact with an infected person, usually through sexual contact. HSV may occur on the mouth (also called fever blisters or canker sores) and anywhere on the genital skin. HSV can be transmitted through hand/genital, mouth/genital, and genital/genital contact.

Important: Having oral sex with someone with a history of oral HSV can put you at great risk. You do not have to have a HSV lesion to transmit it to someone else!

Approximately 3-7 days after exposure to an infected person, the initial signs and symptoms of HSV may occur. This may include one or more painful blisters located on the mouth, lips, or on any genital skin. These blisters may make urinating painful. One can also have flu-like symptoms, including headache, fever, and/or tender, enlarged, inguinal (groin) lymph nodes. The first outbreak may take up to 14 days to heal but usually resolves without scarring.

After the first outbreak, the infected person may have future HSV outbreaks. Generally, these outbreaks tend to be more common in the first year after exposure. Future outbreaks tend to be less severe than the initial outbreak. Outbreaks are sometimes preceeded by what is referred to as a “prodrome”. Prodromal symptoms can include feelings of a tingling or itching sensation in the oral or genital regions between 30 minutes to two days before the next outbreak occurs. Future outbreaks may be triggered by prolonged exposure to the sun (especially true for oral HSV), stress, the menstrual cycle, vigorous intercourse, and possibly changes in the diet.

Unlike gonorrhea, chlamydia, and syphilis, there is not a cure for HSV at the current time. Treatment of HSV usually consists of making an outbreak more comfortable for the infected person. This can include application of cool compresses to the area and use of pain medications, like Tylenol. All irritants should be avoided, including bubble baths, douching, tight fitting clothes, and synthetic/nylon underwear. Antiviral oral medication can also be prescribed which may shorten the length of the outbreak. Episodic or reoccurrences usually last 5-10 days. When infected a person has six or more outbreaks a year, daily suppressive therapy, including oral medication, may be initiated.

People with HSV are extremely likely to infect others through sexual contact, especially when they have a blister, either on their mouth (through oral sex) or on their genital region. If your partner has HSV, you should avoid any sexual activity, including genital rubbing or touching, from the time of the first prodromal symptoms until the blisters have completely healed. There is also growing evidence that HSV can be spread even when a blister is not present. This is referred to as a period of asymptomatic (no symptoms) viral shedding. The best protection against contracting HSV includes using male or female condoms with each and every sexual encounter. Dental dams placed over the external genitalia, which can be made by cutting a latex condom or glove or using saran wrap, can be used to help reduce transmission of HSV during oral sex.

Women’s Health does not recommend routine testing for HSV among asymptomatic students. However, if a visible blister is noticed by the student or the provider during an exam, the lesion will be tested for the herpes virus. Women’s Health does provide symptomatic and prophylactic therapy/medication for students with HSV. If you would like further information on HSV, please contact a healthcare provider from Women’s Health.