Herpes simplex virus, commonly called herpes or HSV, is one of the world's most common viral infections.
It can cause painful blisters or ulcers around the mouth, genitals or other affected areas, but many people infected with herpes have no symptoms or symptoms so mild that they do not realise they have the virus.
There are two types of herpes simplex virus: HSV-1 and HSV-2.
Once acquired, HSV remains in the body. There is currently no cure that eliminates the virus, but effective antiviral medicines can shorten outbreaks, reduce symptoms and decrease the frequency of recurrences.
Understanding herpes is particularly important because people can sometimes transmit the virus even when they have no visible sores.
How Common Is Herpes?
Herpes simplex infection is extremely common worldwide.
According to the World Health Organization's 2025 estimates:
- approximately 3.8 billion people under age 50, or 64% of that population globally, have HSV-1 infection
- approximately 520 million people aged 15–49, or 13%, have HSV-2 infection
- most HSV infections are asymptomatic or unrecognised.
This means having HSV is not unusual.
A herpes diagnosis should not be used to shame or stigmatise anyone.
What Is HSV-1?
Herpes simplex virus type 1 (HSV-1) is primarily transmitted through oral contact.
It is the main cause of oral herpes, which commonly produces cold sores or fever blisters around the lips or mouth.
Many people acquire HSV-1 during childhood or adolescence through non-sexual contact with saliva.
However, HSV-1 can also infect the genital area.
Oral-genital sexual contact can transmit HSV-1 from the mouth to a partner's genitals, causing genital HSV-1 infection.
Therefore, describing HSV-1 as simply “oral herpes” is not completely accurate.
What Is HSV-2?
Herpes simplex virus type 2 (HSV-2) is primarily transmitted through sexual contact and is the main cause of recurrent genital herpes worldwide.
It can cause sores or ulcers around the:
- genitals
- anus
- buttocks
- nearby skin.
However, many people with HSV-2 experience no obvious symptoms.
A person can therefore have HSV-2 without knowing it.
HSV-1 vs HSV-2
Both HSV-1 and HSV-2 can cause genital herpes.
The important difference is that genital HSV-2 generally causes recurrent outbreaks and viral shedding more frequently than genital HSV-1.
This distinction can be useful when discussing prognosis and treatment with a healthcare professional.
What Happens After Someone Gets Herpes?
After the initial infection, HSV enters nearby nerve cells and remains in the body in an inactive or latent state.
At certain times the virus can reactivate.
Some people then develop another outbreak.
Possible triggers associated with recurrence can include:
- illness or fever
- emotional stress
- menstruation
- injury
- surgery
- sunlight in some people with oral herpes.
Not everyone experiences recurrent symptoms.
Some people may have one noticeable outbreak and few or no subsequent episodes.
Others experience repeated outbreaks.
When recurrences occur, they are often shorter and less severe than the first symptomatic episode.
What Are the Symptoms of Oral Herpes?
Oral herpes commonly affects the lips or surrounding skin.
Before a cold sore appears, someone may experience:
- tingling
- itching
- burning
- discomfort.
Small fluid-filled blisters may then develop.
The blisters can break open and form painful ulcers before crusting and healing.
During an initial infection, some people may also experience:
- fever
- sore throat
- headache
- body aches
- swollen lymph nodes.
Many HSV-1 infections, however, cause no recognisable symptoms.
What Are the Symptoms of Genital Herpes?
Genital herpes symptoms can include:
- small bumps or blisters
- painful ulcers
- itching
- tingling
- burning
- pain around the genitals or anus
- pain when urinating if urine touches sores.
During a first symptomatic outbreak, some people may also experience:
- fever
- headache
- body aches
- swollen lymph nodes.
Symptoms vary greatly between individuals.
Some people experience obvious painful sores, while others have such mild symptoms that they mistake them for a spot, ingrown hair or another minor skin problem.
Can You Have Herpes Without Knowing?
Yes.
This is one of the most important facts about herpes.
Many people infected with HSV have no symptoms or only very mild symptoms.
They may therefore be unaware that they carry the virus.
HSV can also sometimes be present on the skin or mucous membranes without visible sores. This is known as asymptomatic viral shedding.
Transmission can therefore occur even when an infected person appears completely well.
How Does Oral Herpes Spread?
HSV-1 is primarily transmitted through contact with the virus in:
- sores
- saliva
- skin around the mouth.
Transmission can occur through close oral contact such as kissing.
It can also spread from the mouth to the genitals during oral sex.
The risk is highest when active sores are present, but transmission can occur when there are no visible symptoms.
During an active oral-herpes outbreak, avoid kissing and oral sexual contact.
Avoid sharing objects that have recently contacted saliva during an active outbreak.
How Does Genital Herpes Spread?
Genital herpes is primarily transmitted through direct skin-to-skin or mucosal contact during sexual activity.
This can include:
- vaginal sex
- anal sex
- oral sex
- genital-to-genital contact.
Transmission does not require penetration.
A person can acquire HSV from a partner who has no visible sores and may not know they have the infection.
Sex toys can potentially transfer infectious secretions between partners if shared without appropriate cleaning or barrier protection.
Can You Get Herpes From a Toilet Seat?
Herpes is primarily spread through direct contact, not through ordinary contact with objects in the environment.
HSV does not survive well away from the human body.
Getting genital herpes from toilet seats, bedding, swimming pools or ordinary household surfaces is therefore not considered a typical route of transmission.
This is important because myths about casual transmission contribute unnecessarily to stigma.
Can Herpes Spread When There Are No Sores?
Yes.
Both HSV-1 and HSV-2 can be transmitted when there are no visible symptoms.
This happens because the virus can occasionally be released from infected skin even when the person feels completely well.
However, transmission risk is generally greatest when sores or other outbreak symptoms are present.
Is Herpes a Sexually Transmitted Infection?
Genital HSV infection is considered a sexually transmitted infection.
However, not every HSV infection is sexually acquired.
Many people acquire oral HSV-1 during childhood through ordinary non-sexual oral contact.
Later in life, oral HSV-1 can be transmitted to a partner's genitals through oral sex.
Understanding this distinction can help reduce unnecessary assumptions and stigma surrounding an HSV diagnosis.
How Is Herpes Diagnosed?
If someone has a fresh blister or ulcer, a healthcare professional may take a sample directly from the lesion.
Laboratory testing—particularly molecular testing such as PCR or NAAT where available—can determine whether HSV is present and may distinguish HSV-1 from HSV-2.
Testing is generally most useful when a lesion is still fresh.
Blood tests can detect antibodies to HSV, but they have limitations.
A positive blood test indicates previous infection with the virus but does not necessarily identify exactly when the infection occurred or, particularly for HSV-1, where on the body the infection is located.
Should Everyone Be Tested for Herpes?
Routine blood screening of everyone without symptoms is not generally recommended.
For example, the CDC recommends herpes testing for people with genital symptoms but does not recommend routine testing for people without symptoms in most situations because currently available blood tests have limitations and false-positive results can occur.
Testing may be appropriate in particular circumstances.
A healthcare professional can advise whether testing is useful based on symptoms, sexual history and individual circumstances.
Can Herpes Be Cured?
There is currently no cure that eliminates HSV from the body.
Once someone acquires herpes, the virus remains within nerve cells.
However, this does not mean that nothing can be done.
Antiviral treatment can be very effective at controlling the infection.
How Is Herpes Treated?
Common antiviral medicines include:
- acyclovir
- valacyclovir
- famciclovir.
These medicines can shorten outbreaks and reduce symptom severity.
Treatment for recurrent episodes works best when started early—often when tingling or other warning symptoms first begin.
Treatment plans vary according to whether someone is experiencing their first episode, occasional recurrent outbreaks or frequent recurrences.
A healthcare professional can determine the appropriate medicine, dose and duration.
What Is Suppressive Herpes Treatment?
Some people take antiviral medicine every day rather than only during outbreaks.
This is called suppressive therapy.
It may be considered for people who:
- experience frequent recurrences
- have particularly painful outbreaks
- find outbreaks psychologically distressing
- want to reduce the risk of transmitting genital HSV to a sexual partner.
Suppressive treatment can substantially reduce recurrence frequency.
For HSV-2, daily suppressive antiviral treatment can also reduce transmission risk, although it does not eliminate the risk completely.
How Can You Reduce the Risk of Transmitting Herpes?
There is currently no licensed HSV vaccine, so prevention depends largely on reducing exposure.
Helpful measures include:
Avoid Sexual Contact During Outbreaks
Avoid vaginal, anal and oral sexual activity when genital sores or warning symptoms such as tingling or burning are present.
For oral herpes, avoid kissing and oral sex while active cold sores or warning symptoms are present.
Use Condoms Correctly and Consistently
Condoms can reduce the risk of genital herpes transmission.
However, they cannot provide complete protection because HSV can be present on skin not covered by a condom.
Talk With Sexual Partners
People with genital herpes should discuss the infection with sexual partners.
Open communication allows partners to make informed decisions about prevention strategies.
Consider Suppressive Antiviral Treatment
Daily antiviral therapy can reduce transmission risk for some people with genital HSV-2.
Discuss whether this is appropriate with a healthcare professional.
Do Not Share Sex Toys Without Appropriate Precautions
Sex toys should be cleaned appropriately between users according to manufacturer instructions.
Using a new condom on a shared sex toy for each partner can also reduce exposure.
Does Herpes Increase HIV Risk?
Yes.
HSV-2 infection is associated with an increased risk of acquiring HIV.
WHO reports that HSV-2 infection increases the risk of acquiring HIV by approximately threefold.
Genital ulcers and inflammation can make HIV transmission easier.
People with genital-herpes symptoms should discuss appropriate STI and HIV testing with a healthcare professional.
Herpes and Pregnancy
Herpes requires particular attention during pregnancy because HSV can occasionally be transmitted from mother to baby around the time of delivery.
This can cause neonatal herpes.
Neonatal herpes is rare but potentially very serious.
According to WHO, the risk is greatest when a pregnant woman acquires genital HSV for the first time late in pregnancy.
People who already had genital herpes before pregnancy generally have a much lower transmission risk.
Anyone who is pregnant and has:
- known genital herpes
- a new genital lesion
- possible first-time herpes symptoms
- a sexual partner with genital herpes
should inform their maternity or healthcare team.
Management depends on individual circumstances and may include antiviral treatment and decisions about delivery intended to reduce the baby's exposure.
Herpes in Newborn Babies
Neonatal herpes requires urgent medical treatment.
HSV infection in a newborn can affect the skin, eyes, mouth, brain or other organs.
Although uncommon, severe neonatal herpes can cause neurological disability or death.
A newborn who develops concerning symptoms—particularly after possible HSV exposure—needs urgent medical assessment.
Can Herpes Affect the Eyes?
Yes.
HSV-1 can occasionally infect the eye, causing herpes simplex keratitis.
Symptoms may include:
- eye pain
- redness
- sensitivity to light
- blurred vision
- excessive tearing.
Eye herpes can damage the cornea and potentially threaten vision.
Anyone with significant eye pain, redness or visual changes—particularly with known herpes—should seek prompt medical assessment.
Do not put cold-sore creams or unprescribed medicines into the eye.
Can Herpes Affect the Brain?
Rarely, HSV can cause encephalitis, an inflammation of the brain.
This is a serious medical emergency.
Possible symptoms can include:
- severe headache
- fever
- confusion
- behavioural changes
- seizures
- reduced consciousness.
Seek urgent medical care if these symptoms occur.
It is important to keep this risk in perspective: severe neurological complications are uncommon compared with ordinary oral or genital HSV infections.
Herpes in People With Weakened Immune Systems
HSV can cause more severe, persistent or widespread disease in people with significantly weakened immune systems.
This may include some people:
- with advanced HIV
- receiving chemotherapy
- taking strong immune-suppressing medicines
- who have undergone certain organ or stem-cell transplants.
People who are immunocompromised should obtain medical advice if they develop suspected herpes symptoms.
HSV-1, HSV-2 and Shingles Are Not the Same Thing
The word “herpes” can cause confusion because several viruses belong to the herpesvirus family.
Herpes simplex virus types 1 and 2 cause oral and genital herpes.
Shingles, also called herpes zoster, is caused by a different virus—the varicella-zoster virus, which also causes chickenpox.
Having genital herpes does not mean someone has shingles, and shingles is not a form of genital HSV infection.
Is There a Herpes Vaccine?
As of 2026, there is no licensed vaccine against HSV-1 or HSV-2.
Researchers are studying both preventive and therapeutic HSV vaccines, but none is currently approved for routine prevention of herpes simplex infection.
This is different from shingles, for which vaccines are available in many countries.
Living With Herpes
A herpes diagnosis can cause anxiety, embarrassment or fear about relationships.
But HSV is extremely common and manageable.
Having herpes does not define someone's character, cleanliness or sexual behaviour.
Many people with HSV have healthy relationships and normal lives.
Understanding how transmission occurs, communicating with partners and using appropriate treatment can make the condition much easier to manage.
The Bottom Line
Herpes simplex is a common lifelong viral infection caused by HSV-1 or HSV-2.
HSV-1 primarily causes oral herpes but can also cause genital herpes. HSV-2 primarily causes genital herpes.
Many infected people have no noticeable symptoms.
When symptoms occur, painful blisters or ulcers can develop and may recur.
There is currently no cure that removes HSV from the body, but antiviral medicines such as acyclovir, valacyclovir and famciclovir can shorten outbreaks, reduce recurrences and help manage transmission risk.
Condoms, avoiding sexual contact during outbreaks, partner communication and appropriate suppressive antiviral therapy can reduce transmission risk—but no method eliminates the risk completely because HSV can sometimes spread without visible symptoms.
Pregnancy, eye symptoms, severe neurological symptoms and herpes in people with significantly weakened immune systems require particular medical attention.
Medical Disclaimer
This article provides general educational information and is not a substitute for diagnosis, testing or personalised medical advice from an appropriately qualified healthcare professional. Seek medical advice for suspected genital herpes, pregnancy with possible HSV exposure, recurrent or severe symptoms, or concerns about STI testing. Seek urgent medical care for severe neurological symptoms, serious eye symptoms or possible herpes infection in a newborn.
Sources and Further Reading
World Health Organization — Herpes Simplex Virus
https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus
World Health Organization — Sexually Transmitted Infections
https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
World Health Organization — Guidelines for the Treatment of Genital Herpes Simplex Virus
https://www.who.int/publications/i/item/978924154987
U.S. Centers for Disease Control and Prevention — Screening for Genital Herpes
https://www.cdc.gov/herpes/testing/index.html
U.S. Centers for Disease Control and Prevention — STI Treatment Guidelines: Genital Herpes
https://www.cdc.gov/std/treatment-guidelines/herpes.htm
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