Is That a Cold Sore? All You Need to Know About Herpes

Remember that episode from The Office in which the character Michael Scott comes to work wearing a fake moustache to hide his cold sore? His situation gets even more hilarious (and pitiful) when he starts reaching out to all of his ex-girlfriends (who end up insulting him in some way or the other) to inform them to get tested for herpes. While that certainly was a great piece of painfully creepy TV comedy, the story aptly pointed at how herpes can be a difficult topic to discuss.

Herpes, a common yet often misunderstood infection, can bring about discomfort, emotional distress, and stigma. Let's take a new look into the world of herpes, blending medical insight with real-life experiences and lifestyle tips.

What is herpes and its types?

Cold sores, also known as fever blisters, which appear around your mouth or on your lips, result from the herpes simplex virus. This viral infection is quite widespread, affecting millions of people globally.

Now, there are two main types of herpes infections that we humans deal with — oral herpes and genital herpes. Herpes Simplex Virus type 1 (HSV 1) is the cause of oral herpes.

You might recognise this condition in the form of cold sores or fever blisters, appearing as fluid-filled blisters or clusters around the lips or mouth.

On the other hand, genital herpes, caused by the herpes simplex virus type II (HSV-II), is mainly spread through sexual contact, making it a sexually transmitted disease (STD). As implied by its name, it primarily affects the genital regions.

How common are herpes infections?

Herpes infections are widespread globally. Around 3.7 billion people under 50 have oral herpes (HSV-1), and approximately 491 million aged 15–49 have genital herpes (HSV-2). In a revealing 2005 study, 63% of individuals in India tested positive for herpes simplex virus (HSV) antibodies. Notably, there was a higher incidence of HSV-2 infection among men and an increasing seroprevalence associated with age.

How does someone get a herpes infection?

Ever wondered how someone can catch herpes? Well, it's pretty contagious and usually passes from one person to another through close contact. Whether it's a kiss on the cheek from grandma or an intimate moment, herpes can be transmitted through skin-to-skin contact, saliva, or even genital fluids.     

Picture this: Grandma, with all her love, giving kisses on the cheeks to her adorable grandchildren during family get-togethers. Little do they know, this affectionate moment could lead to the transmission of oral herpes. HSV-1, the culprit behind cold sores or oral herpes, spreads easily through saliva or skin contact. So, sharing kisses, utensils, or even touching a cold sore, and then the mouth can unwittingly pass on the virus. It's a reminder that even the sweetest gestures can carry a risk, highlighting the importance of being mindful of our actions to protect our loved ones. 

Perhaps, in some cases, people might mistake a cold sore for acne and try to pop it or add a topical cream on it without thinking that it could be something entirely different.

Genital herpes, caused by the HSV-2 virus,  is mainly spread through sexual activities such as vaginal, anal, or oral intercourse. Similar to oral herpes, this virus can also be transmitted even when no apparent symptoms are present.

Practising safe sex by using a barrier contraceptive like condoms or by simply avoiding sexual contact when an outbreak happens are crucial steps in preventing HSV-2 transmission.          

While herpes can be challenging to prevent entirely, being mindful of potential transmission routes and taking proactive measures can significantly reduce the risk. By maintaining proper hygiene and staying informed, we can protect ourselves and others against the transmission of HSV.

Just how serious is herpes?

Herpes generally doesn’t cause any serious health issues or death, yet it can occasionally lead to serious complications in immunocompromised patients, such as those affected by HIV. The risk of contracting HIV is tripled by an HSV-2 infection.

“Oral herpes is quite common. In 90% of the cases, it is self-limiting, and no treatment is required. In symptomatic cases, we prescribe specific drugs, and after that, it does not cause much trouble,” says Dr Rehyanath P, a practising dentist at Firstcare Medihub in north Kerala.

Herpes during pregnancy can cause foetal infection; therefore, one needs to be properly evaluated and treated at this stage.

Herpes symptoms

Herpes symptoms vary depending on the infection site.

In oral herpes, the initial infection resembles a flu-like illness, followed by painful blisters in the mouth. Recurrent outbreaks start with redness, swelling, and itching, progressing to painful blisters that crust over within four to six days.

Symptoms may be mild or absent in genital herpes, yet the virus can still spread. Common symptoms include pain, itching, and sores around the genitals, anus, or mouth. Sores may appear in multiple genital areas, and symptoms typically surface 2-12 days after exposure.

Early symptoms of outbreaks might manifest as fever, headaches, body pains, and enlarged lymphatic nodes. Generally, these signs tend to disappear after a period of 2-3 weeks.

Initial outbreaks are often severe, with painful blisters in the genital area that typically heal within 5-7 days. Other symptoms may include tender, swollen lymph nodes, joint pain, fever, headache, and painful urination.

How is herpes diagnosed?

Generally, a healthcare provider can diagnose herpes through a physical examination. To confirm, they may take a sample from an active sore and conduct special tests.  

Testing is recommended for evaluating high-risk individuals, determining lesion risk, identifying pregnant women at risk of neonatal transmission, and assessing susceptibility to infection from a partner with genital herpes.

Herpes treatment

There is no cure for herpes. But its symptoms can be managed. Doctors may prescribe medications to control herpes symptoms, while over-the-counter pain medications can soothe them.

Here are some tips to help sores heal faster:

1. Gently wash the sores with soap and water, then pat them dry.
2. Avoid bandaging sores to allow air to aid in healing.
3. Refrain from picking at sores to prevent infection and promote quicker healing.
4. Use ointment or lotion on sores only if prescribed by your healthcare provider.
5. Opt for loose-fitting cotton underwear and avoid synthetic materials like nylon. Additionally, avoid tight-fitting pants.

Tips for preventing herpes and lifestyle measures

To prevent oral herpes, it's essential to avoid touching someone's sores during an outbreak and refrain from sharing items like utensils, glasses, or lip balm with them. If you or your partner has oral herpes, it's best to abstain from oral sex, especially if blisters are present, as this can transmit the virus to the genitals. It's essential to distinguish between cold sores and acne, and one should refrain from popping them to prevent spreading the virus.

To prevent contracting genital herpes, practising safe sex is recommended. While condoms can reduce the risk of genital herpes, they may not provide complete protection. These simple precautions can help minimise the chances of acquiring herpes.

Understanding herpes underscores the importance of taking precautions to prevent its transmission and effectively manage its symptoms. If you discover that you have herpes, try not to panic. There are several ways to prevent its spread to partners and other parts of your body:

1. Avoid touching herpes lesions to prevent the transmission of the infection to other body parts or people. If contact occurs, wash hands thoroughly with soap and water.
2. Avoid wetting contact lenses with saliva to prevent the spread of oral herpes to the eyes.
3. If a cold sore is present in or around the mouth, refrain from kissing anyone, particularly babies, children, or pregnant women.
4. Follow safe sex practices.
5. Consider taking herpes medication daily under the guidance of a doctor, which can reduce the risk of spreading the virus.
6. Identify early symptoms of an upcoming outbreak, like a sensation of burning, itching, or tingling, and avoid sexual contact as soon as these signs appear.
7. Always inform sexual partners about your herpes status before engaging in sexual activity, allowing for collaborative efforts to prevent transmission. While disclosing an STD can be challenging, it's essential to remember that herpes is common and rarely leads to serious health complications.

Hang on to hope

Herpes may seem overwhelming, but remember, millions of people have it, and most lead perfectly normal lives. By adopting measures such as engaging in protected sex, maintaining proper cleanliness, and steering clear of direct interaction during flare-ups, you can reduce the odds of transmitting the virus. Be informed and stay safe.

Frequently Asked Questions

1) Is herpes serious?

Herpes is not a life-threatening disease. But it can cause serious complications in pregnant women and immunocompromised patients.

2) Is herpes simplex infection contagious?

Yes, herpes infection is highly contagious. One should avoid close contact with infected individuals to avoid contracting this infection.

3) How can I lower the risk of getting a herpes infection?

To minimise the risk of transmitting HSV, it is essential to adopt safe sex measures, ensure proper hygiene, and refrain from direct contact with the affected regions during flare-ups.

4) How to avoid herpes?

To avoid herpes, it's essential to take some precautions: 

1. Abstain or be monogamous: Refrain from sexual activities or engage in a monogamous partnership with someone who is herpes-free and exclusively intimate with you.
2. Use condoms: Going for condoms can lower the chances of contracting herpes, although they do not provide absolute safety since not all areas are covered.
3. Avoid contact: Don't touch herpes sores if someone has an outbreak, and avoid sharing items like utensils, glasses, or lip balm with them. 
4. Oral sex precautions: If you or your partner have oral herpes, it's better to avoid oral sex, especially during outbreaks, as this can spread the virus to the genitals. 
5. Stay informed: Educate yourself about herpes, its symptoms, and transmission methods to make informed decisions about sexual activity and protection. 

5) What is the main cause of herpes?

Herpes is triggered by the herpes simplex virus (HSV). HSV-1 causes oral herpes, while genital herpes is due to HSV-2.

6) What is the best diet for herpes?

A diet with high antioxidant content is preferred to recover from herpes. Also, make sure to drink plenty of water.

7) How often does someone get herpes infections?

Cold sores caused by oral HSV-1 may appear several times annually or once every few years, varying between individuals. Genital herpes outbreaks, primarily caused by HSV-2, tend to occur more frequently, with an average of four outbreaks per year experienced by 70-90% of affected individuals.

8) How soon after exposure to herpes can an outbreak occur?

The timing of herpes outbreaks varies among individuals. For oral herpes, also known as cold sores, symptoms typically appear three days to one week after exposure. In the case of genital herpes, lesions usually show up around four days after contracting the virus, although this timeframe can range from 2-12 days. Interestingly, for certain individuals, outbreaks may not occur until months or even years after the initial genital herpes infection, and some may never experience symptoms at all.