Table of Contents
What is Herpes?
Herpes is a contagious virus that is transmitted between people through physical contact. Herpes is caused by the herpes simplex virus (HSV). There are two different types of herpes: HSV-1 and HSV-2. HSV-1 is known as oral herpes and can cause cold sores or fever blisters around the mouth. HSV-2 is more commonly known as genital herpes.
Herpes is incredibly common in the United States. It is estimated that as many as half of American adults have HSV-1 and around one in eight Americans aged 14 to 49 have HSV-2. The majority of these infections are asymptomatic. This means that many patients may be completely unaware that they have a herpes infection. 
Both HSV-1 and HSV-2 can be treated using anti-viral medications such as Famvir (famciclovir), Zovirax (acyclovir), or Valtrex (valacyclovir). These medications can help reduce symptoms of herpes and can lower the risk of transmitting the virus to others. However, these anti-viral drugs do not cure herpes and symptoms may return. Keep reading to learn more about the causes and symptoms of HSV-1 and HSV-2.
Oral Herpes (HSV-1)
a. What is HSV-1?
Oral herpes (HSV-1) is a highly contagious infection that is common around the world and affects both men and women. Once transmitted, the infection is lifelong. The majority of infections occur during childhood. 
HSV-1 is known as oral herpes and HSV-2 is commonly known as genital herpes. However, HSV-1 can cause outbreaks in both the oral and genital regions. 
As mentioned, many patients are asymptomatic and may be unaware that they have the condition. It can still be difficult to diagnose HSV-1 patients even when they are displaying symptoms. Often, HSV-1 can appear similar to other infections and can only be truly diagnosed with a virus culture test (PCR), blood test, or biopsy. Once it has been diagnosed, the most effective treatment is with anti-viral medications such as Famvir (famciclovir), Zovirax (acyclovir), or Valtrex (valacyclovir). 
b. Symptoms of Oral Herpes
The most obvious symptom of HSV-1 is having oral herpes or cold sores. Cold sores are painful blisters that appear on the lips, under the nose, or inside the mouth. These blisters are filled with fluid. Both the blister and the fluid are highly contagious. These blisters will crust over to become sores and create a scab before going away. Along with sores, there are several other symptoms of HSV-1. These include:
- Redness, swelling, heat, itching, or pain in the affected area before the blister appears
- Severe flu symptoms
- Headaches 
c. What Causes Oral Herpes?
Oral herpes is caused by the HSV-1 virus and can be spread through contact with someone that has the infection. This can be caused by direct physical contact such as kissing but can also be caused by indirect contact like sharing toothbrushes or utensils. 
Once someone has contracted the virus, there are several factors that can trigger an outbreak. This includes general illness, fatigue, stress, menstruation, certain medications, and trauma to the affected area. 
Genital Herpes (HSV-2)
a. What is HSV-2?
HSV-2 is more commonly known as genital herpes and is a common sexually transmitted disease (STD). Similar to HSV-1, this form of herpes is a lifelong condition with no known cure. Anti-viral mediations such as Famvir (famciclovir), Zovirax (acyclovir), or Valtrex (valacyclovir) are recommended to treat HSV-2 to reduce the risk of spreading the infection. Genital herpes can affect anyone but is more common in women. 
b. Symptoms of Genital Herpes
Most patients with HSV-2 are either asymptomatic or their symptoms are so mild that they don’t realize they have an infection. When symptoms do occur, they typically develop between two and twelve days after being exposed to the virus.
The first sign of genital herpes is usually pain or itching in the genital area. This is followed by small red bumps or white blisters. When these blisters burst, ulcers can develop in the area. These ulcers can be very painful but will finally scab over and heal.
Sores can also develop on the buttocks, things, anus, mouth, or internally in the urethra. During the first outbreak, other symptoms may occur, including headaches, muscle aches, and fever. 
Symptoms vary between patients. Some people may experience multiple episodes a year, while others may have longer periods of remission between symptoms. In general, outbreaks may become less frequent over time. 
c. What Causes Genital Herpes?
Genital herpes is primarily a sexually transmitted disease and is spread via sexual contact with someone that already has the infection. The infection can be spread by patients that are asymptomatic and spread by skin in the genital area that looks normal. People that have genital herpes should avoid sexual activity during an outbreak and should wash their hands after touching any sore. Even when there is not an outbreak, HSV-2 patients should use a condom or similar latex barrier during every sexual encounter. 
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