Table of ContentsView AllTable of ContentsCausesOutbreaksRisk of InfectionRisk of RecurrenceNext in Herpes GuideHow Herpes Is Diagnosed
Table of ContentsView All
View All
Table of Contents
Causes
Outbreaks
Risk of Infection
Risk of Recurrence
Next in Herpes Guide
Herpes simplex virus type 1 (HSV-1) is the type commonly associated with oral herpes (cold sores). Herpes simplex virus type 2 (HSV-2) is the type commonly associated with genital herpes. Even so, HSV-1 can be passed to the genitals and HSV-2 can be passed to the mouth viaoral sex.
This article describes the different causes and risk factors for HSV-1 and HSV-2. It also explains who is at high risk for herpes and how to protect yourself.
What Causes Herpes?
HSV-1 and HSV-2 are similar but distinct viruses that can bepassed from person to personthrough physical contact or contact with fluid from a sore.
Once you are infected, the virus remains in your body for life. It embeds itself in nerve cells where it mostly remains in a latent (dormant) state.
Occasionally, the virus can reactivate, causing oral herpes when it develops on the mouth and genital herpes when it develops on the genitals or anus.
Not everyone who has HSV-1 or HSV-2 experiences outbreaks. In fact,most people with herpes do not have symptoms but can still pass the viruswhenever it reactivates. This is referred to as asymptomatic shedding.
As such, a person can pass the herpes virus on without even knowing they have it.
HSV-1
HSV-1 is the type most commonly associated with oral herpes, also known as a cold sore, fever blister,orolabial herpes, orherpes labialis. The infection istypically spread between people through non-sexual contact, such as kissing or touching.
However, it can also be spread to the genitals through oral sex, including oral-vaginal sex (cunnilingus), oral-penile sex (“blow jobs”), or oral-anal sex (“rimming”).
In fact, according to a 2013 study published inClinical Infectious Diseases,HSV-1 has become the most common cause of genital herpes in young women, accounting for roughly 60% of all cases.
The same is not necessarily true for an HSV-1 infection on the mouth or lip. In some people, symptoms can recur over many years.
HSV-2
Despite its association with genital herpes, the rate of HSV-2 genital infections has been dropping in recent years as rates of HSV-1 genital infections appear to be increasing.
According to the Centers for Disease Control and Prevention (CDC), because the rate of HSV-1 oral herpes in the United States has been dropping, many people have no immunity to the virus and may only be exposed to it for the first time through oral sex.
While it is possible for HSV-2 to be passed to the mouth via oral sex, it is considered uncommon.
How Herpes Outbreaks Occur
OnceHSV enters a cell, typically epithelial cells andkeratinocytesof the skin, it begins the process of replication. While some people may experience symptoms at this stage, most do not.
On occasion, the virus will suddenlyreactivate. When this happens, the virus will travel back through the nerve to the surface of the skin. This causes herpes blisters and sores in some people and no symptoms in others.
It is during this period of reactivation that the virus can be passed from person to person.
Once reactivation occurs, the immune system will kick in and bring the infection under control. With time, the virus will go back into hiding and return to its dormant state.
What Triggers a Recurrence?
Certain triggers can cause HSV to reactivate. This is known as arecurrenceand can happen even if you have a healthy immune system.
Common triggers include:
What Is the Risk of Herpes Recurrence?Where HSV-2 differs dramatically from HSV-1 is that the majority of people who get an HSV-2 genital infection will experience recurrence. Recurrences for HSV-1 are less frequent.
What Is the Risk of Herpes Recurrence?
Where HSV-2 differs dramatically from HSV-1 is that the majority of people who get an HSV-2 genital infection will experience recurrence. Recurrences for HSV-1 are less frequent.
Risk Factors for Getting Herpes
Herpes is a common virus, and there are a number of risk factors than can exponentially increase your risk of getting infected, including:
Risk Factors for Herpes Recurrence
Certain people are at greater risk of HSV recurrence, including more severe or frequent outbreaks. Chief among these are people with weakened immune systems.
When the immune system issuppressedorcompromised, the body has fewer defenses when HSV reactivates. At the same time, the immune system will produce fewer proteins, calledantibodies, that serve as sentinels against future outbreaks.
Risk factors for severe or frequent HSV recurrence include:
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Genital herpes - CDC fact sheet (detailed).Bernstein DI, Bellamy AR, Hook EW, et al.Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women.Clin Infect Dis.2013;56(3):344–51. doi:10.1093/cid/cis891Government of Canada.Genital herpes guide: risk factors and clinical manifestations.New Zealand Herpes Foundation.Herpes myths vs facts.Sauerbrei A.Optimal management of genital herpes: current perspectives.Infect Drug Resist.2016 Feb;2016:129-41. doi:10.2147/IDR.S96164American Academy of Dermatology.Herpes simplexCenters for Disease Control and Prevention.Genital herpes.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Genital herpes - CDC fact sheet (detailed).Bernstein DI, Bellamy AR, Hook EW, et al.Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women.Clin Infect Dis.2013;56(3):344–51. doi:10.1093/cid/cis891Government of Canada.Genital herpes guide: risk factors and clinical manifestations.New Zealand Herpes Foundation.Herpes myths vs facts.Sauerbrei A.Optimal management of genital herpes: current perspectives.Infect Drug Resist.2016 Feb;2016:129-41. doi:10.2147/IDR.S96164American Academy of Dermatology.Herpes simplexCenters for Disease Control and Prevention.Genital herpes.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Genital herpes - CDC fact sheet (detailed).Bernstein DI, Bellamy AR, Hook EW, et al.Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women.Clin Infect Dis.2013;56(3):344–51. doi:10.1093/cid/cis891Government of Canada.Genital herpes guide: risk factors and clinical manifestations.New Zealand Herpes Foundation.Herpes myths vs facts.Sauerbrei A.Optimal management of genital herpes: current perspectives.Infect Drug Resist.2016 Feb;2016:129-41. doi:10.2147/IDR.S96164American Academy of Dermatology.Herpes simplexCenters for Disease Control and Prevention.Genital herpes.
Centers for Disease Control and Prevention.Genital herpes - CDC fact sheet (detailed).
Bernstein DI, Bellamy AR, Hook EW, et al.Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women.Clin Infect Dis.2013;56(3):344–51. doi:10.1093/cid/cis891
Government of Canada.Genital herpes guide: risk factors and clinical manifestations.
New Zealand Herpes Foundation.Herpes myths vs facts.
Sauerbrei A.Optimal management of genital herpes: current perspectives.Infect Drug Resist.2016 Feb;2016:129-41. doi:10.2147/IDR.S96164
American Academy of Dermatology.Herpes simplex
Centers for Disease Control and Prevention.Genital herpes.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
