When people think of sexually-transmitted diseases (STDs), they usually think of chlamydia and HIV, but not herpes. Among the 8 most common STDs, it is true that herpes is not curable. Unlike gonorrhea, chlamydia, trichomoniasis and syphilis that can clear up fairly easily with the help of antibiotics, there is no effective treatment for herpes.

Herpes is caused by herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) and the disease is categorized into genital herpes and oral herpes. Oral herpes is mainly caused by HSV-1, while genital herpes can be caused by both virus types. As with other sexually-transmitted diseases, many people have herpes without knowing it because they show no symptoms. In some cases, symptoms are truly mild and often go unnoticed. Even without the presence of symptoms, herpes is contagious and can spread to sexual partners. The most common symptoms of oral herpes are sores and clear blisters filled with fluid around the nose and on the lips. Sometimes, these blisters can be mistaken for acne, but these blisters cause itchiness and pain. As for genital herpes, people suffering from it can experience painful and itchy genital blisters and sores as well as other symptoms such as painful urination and flu-like symptoms.

Oral herpes

Oral herpes is a bit tricky to diagnose since it can be mistaken for other infections such as allergic reactions. To diagnose it accurately, medical professionals make use of several methods such as blood tests, biopsies and PCR. The telltale signs that might indicate a person having oral herpes include painful sores on the lips, tongue, gums, roof of mouth and inside the cheeks.

80% of oral herpes are caused by HSV-1 and the disease is mainly spread through oral-to-oral contact. According to the World Health Organization (WHO), in 2016, around 122 to 192 million aged 15-49 years have HSV-1 infections worldwide. What is more, oral herpes frequently occurs during childhood. This disease can be contracted through touching infected saliva, mucous membranes or skin. People can also catch the disease after making contact with sores and blisters around the infected skin. Even when a person’s skin seems perfectly fine with no blisters or sores, they can be suffering from herpes. However, it is true that contagion is more likely to happen when there is an active outbreak. Engaging in intimate contact such as kissing and oral sex is also one of the ways oral herpes can be transmitted.

Genital herpes

Most cases of genital herpes result from HSV-2. Similar to oral herpes, it is highly possible to contract the disease from a person who appears fine because herpes is often asymptomatic. Genital herpes is transmitted through saliva, semen and vaginal fluids. Some ways this disease can be spread include:

• Sexual intercourse (anal, vaginal-vaginal and penile-vaginal)
• Oral sex (whether you are giving or receiving, if done with an infected person, there is a chance for contagion)
• Skin-to-skin contact 
• Making contact with open sores or blisters
• Childbirth (if a mother has an active infection, the baby can also be infected)

Genital herpes cannot be passed on through objects such as toilet seats. However, be mindful of transmission through shared sex toys. So, make sure to always wash them and if possible, do not share them. Genital herpes can also be spread through people who have cold sores. That being said, you can get herpes sores on your genitals if you receive oral sex from a person infected with HSV-1.

How dangerous is herpes?

The most common misconception circulating around is that because herpes is incurable, it means it is hazardous. Although it is true that herpes is a lifelong condition and will stay in a person’s body once they contract it, according to Yale Medicine, herpes is not deadly, but can be dangerous for pregnant women. This disease does not reduce a person’s lifespan despite complicating social and sexual life. People living with herpes, however, are more prone to getting HIV.

Herpes might be the least understood STD. The truth is, even though the virus stays in a person’s body, the first flare up or outbreak is usually the worst.

• Primary herpes or primary infection/flare up: This is the time when the virus enters your system and reproduces. During the primary infection, people may or may not develop sores and blisters. Other symptoms such as fever may also develop. They normally appear 2 to 20 days after infection takes place. The primary herpes outbreak may last for 2 to 4 weeks. Primary infections are usually the worst and the most annoying. They can affect your day-to-day activities and cause extreme discomfort.
• Recurrence: People with herpes are not always going to experience active outbreaks. The virus does live in a person’s nerve cells, but when inactive, it will stay dormant. Recurrences, unlike primary flare ups, are not as severe and annoying. Outbreaks usually last from 3 to 7 days. Recurrences may occur due to several factors such as stress, other illnesses, things affecting the immune system, surgery and menstruation.

Treatment for herpes

There is no effective cure for herpes, but herpes treatment include antiviral medications that can help suppress and lessen outbreaks. It is believed that overtime, the body develops antibodies and outbreaks will occur less than they do in the first year of contracting the disease.

• Oral herpes: treatments for oral herpes may include antiviral oral medication (which is deemed the most effective), but symptomatic cases may require antiviral ointment, over-the-counter topical anesthetics and anti-inflammatory agents
• Genital herpes: for genital herpes, antiviral medication can be administered or consumed as a pill or injection. If taken daily, this medication can reduce the risks of transmitting the virus to others and prevent outbreaks. Other forms of treatment may include applying ice packs to genitals, taking NSAID, bathing in warm water and applying topical analgesic.

Preventing herpes

A sexually active person is likely to experience an STD once in their life, and the simplest activity such as kissing can spread it. To fully prevent yourself from getting herpes means you have to avoid direct and physical contact with a person that has an active infection. The other form of prevention is to fully abstain from any sexual contact because we are always at risk for being exposed to sexual diseases when we are sexually active.

A happy life begins with being fully updated with your health, and knowing your sexual health status is equally important. Shim Clinic is a sexual health clinic in Singapore focused on STDs. We provide reliable diagnosis and treatment. We also specialize in STD prevention methods such as HPV vaccination (Gardasil 9) and preventive medications such as HIV PrEP and HIV PEP.