Do herpes bumps always hurt? What is the difference between HSV-1 and HSV-2? Can you get genital herpes without having visible sores? Get the answers to these burning questions and more.

Understanding the Types of Herpes Simplex Virus

There are two main types of herpes simplex virus (HSV) infections: HSV-1 and HSV-2. HSV-1 is typically responsible for those annoying cold sores that can appear during times of stress or lack of sleep. On the other hand, genital sores are usually caused by HSV-2. However, it’s important to note that HSV-1 can also cause genital ulcers, though these tend to be less severe and less likely to recur.

The Timeline of Herpes Symptoms

It can take as little as a few days and up to a week after exposure before any herpes symptoms appear. The initial symptoms often include redness, tingling, and the development of small, painful bumps that progress into fluid-filled “blisters.” These blisters eventually burst, forming shallow skin ulcers that then crust over and heal gradually over a couple of weeks. An initial genital herpes infection can be quite painful and may also cause fever, body aches, and fatigue. However, recurrent outbreaks tend to be less severe.

The Danger of Asymptomatic Shedding

Can you get genital herpes if your partner doesn’t have any visible sores? The answer is yes. A person can be exposed to the virus and pass it to someone else without ever having symptoms. This is called “asymptomatic shedding of virus,” and it happens more often than you might think. Although there is a higher level of active virus when there are sores, asymptomatic shedding is probably how most people get herpes.

The Importance of Testing and Disclosure

If a person has genital ulcers, it’s important to see a doctor and confirm whether or not it is herpes. Genital herpes outbreaks can be treated with antiviral medications, which can help reduce the number of days of discomfort and have few side effects. Some people even take these drugs daily to prevent outbreaks.

Once someone has been diagnosed with genital herpes, their future partners can have a blood test to determine if they have also been exposed to the same strain of the virus. If the partner tests negative, the person with the infection would be advised to take antiviral therapy daily to help prevent transmission.

The Controversy Around Widespread Screening

If you’ve never had genital ulcers and don’t believe you’ve been exposed, should you get tested for herpes? This is a controversial topic, and the widely followed official guidelines actually discourage widespread screening. The reasoning behind this is that a positive blood test for HSV-2 can be devastating, as it carries a significant social stigma and may lead to false-positive results. Additionally, taking daily antiviral medication for a condition you may or may not have and may or may not spread can seem unreasonable.

However, not all experts agree with the official guidelines. Except for the uncommon case of a false-positive blood test for HSV-2, a seropositive test means one of three things: the person has had herpes with symptoms, the person has had herpes with symptoms but didn’t realize the cause, or the person has the herpes virus and may shed virus from time to time in genital fluids. The only way to know if a person is shedding the virus is with daily tests, which is not practical.

Who Should Consider Getting Tested?

According to some experts, people who should strongly consider getting a blood test for herpes include those with any other sexually transmitted infection. The reasoning behind this is that the presence of another STI may indicate a higher risk of exposure to herpes as well.

The Bottom Line

Genital herpes is a complex and often misunderstood condition. While it’s true that visible sores are a hallmark of herpes, the virus can also be transmitted through asymptomatic shedding, putting many people at risk of infection without their knowledge. Understanding the different types of herpes, the timeline of symptoms, and the importance of testing and disclosure is crucial for reducing the spread of this common, yet often stigmatized, sexually transmitted infection.