What Is Herpes and How Do I Know if I Have It?
You might already be familiar with common STDs like chlamydia, gonorrhea, and syphilis, which are all easily curable and temporary. But when it comes to herpes, things are a little ~trickier~ as it's a disease that stays in your body forever. However, regardless of people's misunderstanding of the STD, herpes is completely manageable and so common. Seventeen spoke to Dr. Natasha Bhuyan, family physician at One Medical, to find out everything you need to know about herpes.
What exactly is herpes?
Herpes is a virus that causes painful sores on your mouth or genital area. According to Dr. Bhuyan, though herpes is actually a collection of eight different viruses, the two most common strains are HSV-1 and HSV-2. While HSV-1 is commonly referred to as the oral herpes (aka cold sores) that 90 percent of people have, HSV-2 is typically the genital STD. But confusingly, you can actually get either strain on the genitals or orally.
Though it's true that herpes lives in your body forever once you contract it, don't freak out - this doesn't mean that you'll be experiencing pain for the rest of your life. Dr. Bhuyan explains that once you contract herpes, while the first outbreak will probably be very painful, future outbreaks - if you even have any - are not as distressing. Outbreaks can last anywhere from two to 20 days, but she usually tells her patients to expect an average of two weeks.
How can I get herpes?
Herpes is spread through direct skin-to-skin contact, whether that's through kissing, oral sex, or sharing lip balm. Dr. Bhuyan says this means that even if you have a cold sore on your mouth that's a source of HSV-1, it's possible for you to transfer that virus to your partner's genitals through oral sex.
Though one might have the HSV-1 or HSV-2 virus in their system, the only way they can transmit the virus is if they have a blister or sore that you come into direct contact with. So if you contract herpes and have any sores, Dr. Bhuyan advises patients to be super careful when it comes to any skin-to-skin contact. "You're most contagious when there's liquid that's oozing," she says.
How do I know if I have it?
According to Dr. Bhuyan, before you're about to have an outbreak, you'll get a "tingling or burning sensation" on the mouth or genital area, as well as pain when peeing. Plus, some people will also get flu-like symptoms, such as tiredness, aches, and swollen glands and lymph nodes in the pelvic area and neck. Usually, you'll start seeing painful sores after a day or two of experiencing these symptoms.
These painful lesions present as blisters or sores that will have fluid or erupt, Dr. Bhuyan says. They often show up in a cluster of sores, rather than just one or two on their own. But if you find painful bumps, particularly in your vulvar area, instead of guessing and speculating, it's probably safe to just see your primary care provider for a test - especially if you get that tingling sensation or burn when urinating. "The way we diagnose herpes is pretty simple," she says. "A lot of times, clinicians can just look at the sore, and we'll know exactly what it is. Sometimes we'll do a swab of the sore and send it into the lab to confirm the diagnosis."
How do I treat herpes?
Dr. Bhuyan explains that there are two ways physicians approach treatment for herpes. For genital herpes, they'll always prescribe an antiviral medication, such as Valacyclovir or Acyclovir. "Some patients get an initial outbreak and we treat them with the antiviral medication, and although the virus will forever be living in their system, it can sometimes just remain dormant on the nerves," she says. "It's not active or transmittable, it's just living there, and they might not have an outbreak ever again."
However, others might get additional outbreaks after the initial one. In this case, Dr. Bhuyan says that physicians will prescribe daily suppressive antiviral medications to prevent them from getting future outbreaks. Sometimes these flare-ups are triggered by stress, a weak immune system, or an illness, but it's ultimately impossible to predict whether or not you'll get a future outbreak after the first.
How do I prevent contracting herpes?
The key is to avoid skin-to-skin contact with anyone who has sores present - that means both sexually and non-sexually. Remember that cold sores can also be transmitted through sharing drinking cups or chapstick, not just sex! But the most important thing is to use barrier methods such as condoms and dental dams, to really reduce (but not totally eliminate) the risk of transmitting and contracting herpes or any other kind of STD.
In addition, Dr. Bhuyan advises becoming more in tune with your own body to prevent spreading or contracting any STDs. "Be aware of when you might have symptoms and what things are (ingrown hairs vs. lesions)," she says. "Get comfortable with using mirrors and knowing what your genital area looks and feels like!"
Can you get tested for herpes specifically?
Something that many people don't realize about STD tests is that generally, physicians don't test for herpes. In a general STD panel, they check for HIV, syphilis, gonorrhea, and chlamydia, but not herpes, says Dr. Bhuyan.
While there is a blood test for herpes, it's not recommended - it can detect antibodies, so it shows up positive even if you had a prior infection you've already fought. This means that it can't test for an active infection, so it might cause unnecessary stress to you. So if you suspect that you might have a herpes-related lesion, specifically let your doctor know, so that they can do a swab test for herpes instead.
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