Call it a cold sore or a fever blister if you like, but that unpleasant eruption around your mouth, on your lips or even on your face is in fact the byproduct of the herpes simplex type 1 virus, or HSV-1. Even more unpleasant is HSV-2, commonly known as genital herpes. They are the sorts of ailments — HSV-2 is technically a sexually transmitted disease — most people prefer not to discuss. That, in part, is what makes them so widespread.

An estimated 45 million people in the United States above the age of 12 are infected with HSV-2. In Americans between the ages of 15 and 45, genital herpes affects approximately one in every four females and one in every five males. In the past 20 years, the number of genital herpes infections has increased significantly among Americans, particularly among teenagers and young adults

HSV-2 is transmitted by the close, intimate contact of sexual intercourse. The virus enters the body through breaks in the skin or mucous membranes. Cross-infection of HSV types 1 and 2 may occur from oral-genital contact.

An infected person often transmits the virus when skin blisters or ulcers are visible, but the virus also can be spread when there are no symptoms at all; it can even be transmitted by people who are unaware that they are infected and it is a significant cause for concern for pregnant women, who can pass the virus to their babies during delivery.

If you think you’ve been infected with the HSV-2 virus, you might have your suspicions confirmed quickly. The initial attack of genital herpes symptoms is usually the worst, and symptoms tend to develop within a week after contact with an infected person. However you could still be infected even if you don’t exhibit any symptoms, which is the case for most people with HSV-2.

Among people who do exhibit symptoms, about 40 percent experience a second episode, and in some, symptoms reoccur four to six times a year, most commonly after sexual intercourse, after exposure to the sun and during periods of physical and emotional stress. Other factors that may trigger outbreaks include menstruation, illness, surgery, fatigue, and immune system suppression due to infection, HIV, steroid use or chemotherapy.

If you suspect that you have genital herpes, your physician can perform a physical examination that might include a review of your sexual history, an assessment of your symptoms and a scraping of the affected areas for laboratory testing. Because individuals who have one type of STD are at risk for others, your doctor may wish to test you for other STDs such as syphilis, gonorrhea, chlamydia, trichomoniasis and HIV. People with genital herpes are more likely to be infected with HIV if they are exposed through sexual intercourse.

There is no cure for the recurrent infection of genital herpes. It is a “lifetime illness” whose symptoms may return periodically. The pattern of outbreaks is different for every person and individual outbreaks may be treated, shortened or even made less severe and less frequent with the use of oral antiviral medications such as acyclovir, famciclovir and valacyclovir. In many cases, the frequency of symptom recurrence often decreases with time.

If you have genital herpes, you can still lead a life with sexual relationships, however if you have an active HSV infection, you should avoid having sex, and keep the sores clean and dry. Avoid touching the sores and wash your hands after contact with the sores. Remember that the virus can spread even when no symptoms are present. Wait until all the sores are completely healed before resuming sexual activity, always use latex condoms to reduce the chance that you will infect your partner, and it is always recommended that you communicate with your partner about the potential for spreading the disease. Just because most people prefer not to discuss herpes doesn’t mean you should be one of them.

Symptom Check

HSV-2 symptoms are usually mild and can include:
• Itching, burning, soreness, and small blisters in the genital area
• Small ulcers (skin sores) when the blisters break
• Local pain if urine touches the genital ulcers
• Enlarged or painful lymph nodes (swollen glands) in the groin
• Headache, fever and a general malaise

In some people with genital herpes, ulcers can also erupt around the mouth.