Herpes simplex 1
-1) is the virus that typically causes cold sores. Most adults have antibodies to hsv-1, which means that they have been exposed and likely have the virus laying dormant in the nerve
cells where they were infected. Some of these people will get cold sores (aka fever
blisters) some won't. Some will get recurrent outbreaks regularly and others won't.
Herpes simplex 2 (hsv-2) is the virus that typically causes genital lesions. A slightly lower percentage, but still around 20-40%, of adults have antibodies to hsv-2, and it acts the same way on the genitals as hsv-1.
One can still get a cold sore
from hsv-2 and genital lesions from hsv-1. However, when this occurs, repeat outbreaks are much less likely, because hsv-1 has evolved to prefer infecting human mouths, and hsv-2 has a predilection for human genitalia.
Some things to remember here:
1. One can have herpes (1 or 2) and shed virus (meaning transmit the infection to others) without ever having any overt symptoms himself.
2. Herpes infection (particularly type 2) can increase one's risk for acquiring hiv
, even if one never has an outbreak or other signs of infection.
3. Herpes infection is incredibly common, and for many infected people, it's not something they even realize they have, or they'll have one outbreak and never have any issues with it again.
4. People vary widely in their response to herpes infection. A person can be infected without knowing it, and transmit it to a sexual partner who will then go on to have severe recurrent blistering outbreaks, which can be very painful.
5. Most authorities, like the United States preventive medicine
task force, recommend against the routine testing for herpes virus
antibodies in people without symptoms of herpes. So many people have these antibodies, and they likely have asymptomatic
infections that don't require treatment, so testing them wouldn't change anything. When someone is entering into a long-term monogamous relationship and wants to start having unprotected sex
, that is one possible reason to do antibody
testing for herpes, but even that is controversial.
6. Any skin lesion that persists for more than a few days or is troubling to you, should be evaluated by a physician. It may look like the pictures of herpes on the internet, but who took those pictures?