Herpes Simplex: Genital, Oral, Symptoms & Treatment

Herpes simplex is a virus that causes skin infections. The infection lasts your lifetime, and it causes painful or itchy sores and blisters that come and go. Herpes simplex virus typically doesn’t cause severe problems. But it can be dangerous in infants and people with weakened immune systems. There are two types of herpes simplex:

Sometimes a herpes infection can affect other parts of your body, such as your eyes or other parts of your skin.

HSV-1 spreads through contact with the virus in saliva or skin. It usually affects your mouth and face. HSV-2 spreads through sexual contact and usually affects your genitals. Either form of HSV can show up on any area of skin that comes into contact with the virus.

People of any age can contract herpes simplex. You are more likely to get the virus if you:

Anyone can get HSV-1. Most people contract HSV-1 during childhood. It spreads when an adult who has the virus has close contact with a child, such as when a family member kisses a child.

Genital herpes affects sexually active teens and adults of all genders and races. It can spread if you have multiple sexual partners and don’t use condoms or dental dams.

People assigned female at birth (AFAB) are more at risk. Delicate vaginal tissue can tear, making it easier for the infection to get in. Black people who were AFAB are especially vulnerable, with an estimated 1 in 2 people AFAB between the ages of 14 and 49 infected with HSV-2.

Herpes simplex is widespread around the world. About 2 in 3 people worldwide (and up to 80% of Americans) contract HSV-1 by age 50. About 15% of 15- to 49-year-olds contract HSV-2.

Herpes spreads through close contact with a person who has the infection. The virus can be found in skin and saliva. If you have herpes simplex, you are most likely to pass the virus to another person when you have sores. But you can infect someone else even if you have no symptoms. Healthcare providers call this asymptomatic viral shedding.

You can’t get genital herpes from objects like toilet seats. But you could pass genital herpes through shared sex toys. (To stay safe, wash sex toys before and after using them, and don’t share them. If you do, protect them with a condom.)

Many people with the infection never experience any herpes symptoms. If you do notice symptoms, you’ll experience them differently depending on whether you’re having your first herpes outbreak or a repeat outbreak. Recurring symptoms are usually milder than the first outbreak. Symptoms don’t last as long with later outbreaks. Some people may only have one or two outbreaks during their lifetime. Others may have as many as four or five outbreaks a year.

People who do have herpes symptoms may experience:

If you’re infected with HSV-1, commonly known as oral herpes, you may notice tingling or burning around your mouth in the days before a cold sore appears. These blisters break open and ooze fluid before forming a crust. Usually, sores last for seven to 10 days.

If you’re infected with HSV-2, commonly known as genital herpes, your first outbreak may last between two to four weeks. Recurrent outbreaks usually last between three to seven days.

Once you have the herpes virus, it stays in your nerve cells forever — even if you never have symptoms. It is usually dormant (inactive).

A trigger may activate the virus. This activation, called an outbreak, causes symptoms, such as sores.

Common outbreak triggers include:

Healthcare providers may diagnose herpes simplex based on how the sores look. Your provider may take a sample from the sore. Laboratory analysis of the sample can confirm or rule out the herpes virus.

If you don’t have sores, your healthcare provider can use a blood test to check for HSV-1 and HSV-2 antibody, a marker showing you’ve been exposed to the virus. The blood test doesn’t show an active infection (especially in the absence of open sores or lesions). But it informs your provider whether you’ve been exposed to the herpes virus in the past. If this is your first infection, you may not test positive for herpes if there hasn’t been enough time for your body to develop antibodies. The HSV-1and HSV-2 antibody test may be repeated in eight to 12 weeks.

Some people have few to no herpes outbreaks and choose not to have treatment. But many people prefer to use medications that shorten outbreaks and reduce symptoms.

During an outbreak, you may use an antiviral ointment or cream to help lessen your symptoms and help them go away faster, but it only works if you start it soon after you start an outbreak. Many people with HSV-2 take daily oral medications to keep outbreaks at bay.

Your provider may prescribe a topical (applied to the skin) medication or oral medication such as:

Avoiding known triggers, such as illness or stress, can help reduce how often you have herpes outbreaks.

People who have open sores from genital herpes are twice as likely to get HIV compared to people without herpes. This risk is yet another reason why it’s important to use condoms.

You can reduce your risk of contracting HSV-1 by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores aren’t present, but it’s less likely.

If someone has an active HSV-1 infection, avoid:

If you’re sexually active, you can take these steps to protect yourself and others from the herpes virus and other STIs:

Wash your hands often if you have an outbreak or are around someone with symptoms.

If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:

There is no cure for herpes simplex. Once you have the virus, it’s a lifelong infection.

For many people, the first herpes outbreak is the most severe. Many outbreaks are less frequent and milder after the first year of infection. Some people may have only one outbreak and never have another again.

Herpes infection doesn’t usually pose a serious health risk. The risk of a health complication due to herpes is higher in infants and if you have HIV/AIDS, cancer or an organ transplant.

Many people who find out they have herpes feel depressed knowing they'll always have the virus and can give it to others. But you aren’t alone. Herpes is one of the most common STIs, both in the U.S. and worldwide. If you have herpes, you should:

If you have herpes, you can still:

If you have herpes, you should also get checked for HIV (AIDS) and other STIs (such as syphilis, gonorrhea and chlamydia).

Some people feel distressed or embarrassed about their herpes simplex infection. It’s important to understand that the herpes virus is common. For most people, herpes doesn’t significantly interfere with daily life.

To cope with negative feelings, you may consider:

You should call your healthcare provider if you experience:

You may want to ask your healthcare provider:

Herpes simplex virus doesn’t affect fertility or your ability to conceive. Pregnant women diagnosed with HSV-2 (commonly known as genital herpes) should start a daily antiviral at 36 weeks of pregnancy as prescribed, to prevent outbreaks during delivery. If you have an active infection at the time of childbirth, you can pass the herpes virus to your baby. Neonatal (at birth) herpes puts a baby at risk for blindness, brain damage, skin infections and death. Your healthcare provider will perform a cesarean section to lower this risk.

Neonatal herpes can be a very serious infection. Babies generally contract the virus from their birthing parent during childbirth even if the parent doesn’t have active lesions. They may also get HSV-1 if an adult with an active cold sore kisses them. Breastfeeding (chestfeeding) babies can also get HSV-1 from the breast if there are lesions present. But babies can’t get herpes from breast milk, so it’s safe to pump and feed.

Herpes simplex can be more dangerous for young babies because they don’t have a fully developed immune system. But most babies with neonatal herpes can recover fully with treatment.

The dangers of neonatal herpes are much higher if the infection spreads to the baby’s organs. If you’re pregnant and have herpes, speak with your healthcare provider about how to lower the risk of passing the infection to your baby.

Yes — as long as there isn’t an open lesion on your chest or breast. If you have an active outbreak while breastfeeding, it’s possible to spread the infection to your nipples through touch. Careful hand-washing can prevent this spread. You shouldn’t nurse from a breast that has herpes sores. You can pump breast milk until the sores heal. Don’t give your baby expressed breast milk if the pump comes into contact with an open sore.

Herpes simplex and the varicella-zoster virus (VZV) are related, but they aren’t the same. VZV causes chickenpox and shingles.

Like HSV-1 and HSV-2, shingles can cause a painful, blistering rash. The shingles rash usually shows up on the back, side, abdomen (belly), neck and face. It is often only on half of your body, following the pattern of your nerves. See your healthcare provider if you have a new rash and suspect you may have shingles.

A note from Cleveland Clinic

Herpes simplex is a virus. Once you have herpes, it’s a lifelong condition. A herpes infection can lead to outbreaks (periods of symptoms), but you’ll also have times when you have no symptoms. The main sign of herpes is sores that appear on the infected skin. Some people choose not to treat herpes, especially if symptoms are mild. Others take antiviral medications to reduce the severity and frequency of outbreaks.

Last reviewed by a Cleveland Clinic medical professional on 05/17/2022.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy