Sexual Health Thursday June 9, 2016

Herpes – What are the Facts and Myths?

Herpes is not something people generally like to discuss because there's a culture of embarrassment surrounding the condition. In reality, the condition stays dormant for a significant amount of time and is extremely common. Due to embarrassment and hearsay, there is a culture that has led to a mixture of facts and myths - so let's try to sort a few out.

What is herpes?

Before we delve into what the facts and myths are of herpes it's important to get an understanding of what this STI is. Well, herpes (or genital herpes) is a sexually transmitted infection caused by HSV (herpes simplex virus). It can affect both men and women and is broken down into two forms - HSV-1 (oral herpes) and HSV-2 (genital herpes). HSV-2 is the most common form of herpes and currently can't be cured, although it can be effectively controlled and the virus itself can be made dormant. The virus is exactly the same in both men and women.


Herpes are obvious

No. Breakouts may show up as blisters but for the majority of carriers, there are no obvious symptoms. Many people have the herpes virus and simply don't know about it.

The NHS says at least eight out of 10 people with the herpes virus are unaware, so before you judge someone else - think again!

This myth is further debunked by Marian Nicholson, director of the Herpes Viruses Association who states that "If 5 people catch it, one has symptoms bad enough to go and get diagnosed, one has no symptoms at all, three have really mild symptoms, they don't get diagnosed but the person can be 'educated' to recognise them: a little cut, an itchy/sore place, a tiny spot, an 'infected hair follicle'."

Blisters are the only symptoms

Sorry but no. The painful blisters we associate with herpes are not the only symptoms.

People can suffer from:

  • Nerve pain
  • Tingling
  • Itching
  • Aching muscles
  • Fatigue
  • Flu-like symptoms
  • Pain during urination

A lack of blistering is likely the reason why so many people have herpes but don't realise.

You can only pass it on if you have symptoms

No. Herpes is not transmitted through saliva or blood; it's spread through skin on skin contact. Carriers can shed the virus through their skin even when there are no blisters or sores present.

Some medications can decrease virus shedding. New England Journal of Medicine study found that certain medications decreased genital herpes transmission to uninfected partners by 48%. However, it's not 100% proven and herpes can spread at anytime.

You are more likely to experience other infections

This is extremely unlikely. In the vast majority of cases it is highly unlikely that individuals dealing with herpes will experience other infections as a result. However, in some very rare cases certain people with herpes can develop cellulitis.

Cellulitis is a bacterial infection that is caused by bacteria entering the sores produced at the hands of genital herpes. This infection causes a red rash as well as feelings of tenderness and possibly fever. Cellulitis can be treated with a course of antibiotics.

You can only pass it on if you have symptoms

Absolutely not. This is impossible because the herpes virus dries out when it comes into contact with air and also becomes more fragile. On top of this, there have been no reported cases where herpes has been transmitted to an individual from a toilet seat.

Marian Nicholson also dismisses the legitimacy of this myth by saying "Nope. The virus has to be passed directly from human skin to human skin. So it is NOT caught from towels, baths, cutlery, etc. either."

Now let's take a look at the true facts concerning herpes…


There are different types

Yes. There's the herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) that are related but tend to affect different areas.

  • Herpes simplex virus type 1 (HSV-1) - This is the type that produces a cold sore on the lips
  • Herpes simplex virus type 2 (HSV-2) - This is the type that produces genital herpes

But, the cold sore creating herpes virus can also cause genital herpes through oral sex. That's why condoms and dental dams are important for casual sex and oral with a partner who is known to have herpes.

Herpes is common

Yes. In 2013, 32,279 people in England went to a sexual health clinic with their first attack of herpes. This figure doesn't include those already confirmed with the condition, those who didn't seek treatment and those who don't realise they have herpes. Globally there are estimated to be 536 million people infected with herpes, so if you do in fact have herpes you are certainly not alone.

Herpes makes you more susceptible to HIV

Unfortunately, yes. Those who have contracted herpes are much more likely to get HIV than those who do not have herpes. The reason for this is that during a genital herpes outbreak CD4 cells (cells that battle against herpes) are located at the base of herpes legions and these particular cells are the cells most at risk of being attacked by HIV. Therefore, herpes lesions provide easier access for the transmission of HIV.

Outbreaks vary in terms of severity and frequency

This is true. Generally, herpes are recognized as having clusters of blisters filled with fluid that then eventually become dry and flake off. The amount of outbreaks individuals with herpes have does differ from case to case. Some people have a lot of outbreaks, some only a few and some can experience no outbreaks at all.

Listed below are some additional facts concerning herpes outbreaks:

  • Symptoms of the first outbreak usually last for two to three weeks
  • For women first outbreaks can be particularly severe
  • Outbreaks that occur later tend to be mild and don't last as long
  • It's possible for women to experience internal outbreaks on or around the cervix
  • Men tend to be asymptomatic carriers who don't experience symptoms, but pass it on for many years
  • Individuals who have HSV-1 when they contract HSV-2 aren't as likely to experience symptoms at first
Herpes medication lowers the viral load, so it can keep an outbreak at bay. Brian A. Levine, M.D., and New York practice director for the Colorado Center for Reproductive Medicine

Herpes is incurable

Yes, but it won't ruin your life.

Antiviral medicine can be taken for the first outbreak. Medication prevents the virus from multiplying but it doesn't clear the virus completely. For subsequent outbreaks, you are likely to be advised on self-treatment, such as ice packs and washing with salt water. For severe outbreaks, you may be prescribed medication again. The NHS suggests that if you have more than six outbreaks a year, you may need suppressive medication to control the virus.

Condoms don't always protect against genital herpes, but they go a long way to provide some protection, so always use one. Unfortunately, areas where the penis is not covered are still liable to cause an infection.

If you are worried about herpes, speak to your doctor about treatment. It's a common condition so don't feel embarrassed, there are medications and advice to help you manage the symptoms and prevent you passing on the virus.

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