Herpes Simplex Virus: What You Need to Know about HSV-1 vs HSV-2

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The
herpes simplex virus impacts a significant portion of the worldwide population.
According to the World Health
Organization,
3.7 billion people younger than 50 have HSV-1 and over 417 million have HSV-2.^[1] Since it’s so common, there should be more awareness about the differences
between herpes virus type 1 (HSV-1) and herpes virus type 2 (HSV-2), symptoms,
and treatment. Herpes can impact various parts of the body: people experience
symptoms on the anal region, external genitalia, mucosal surfaces, and skin.
They appear as cold-sores, turn into blisters, and heal within a week. This is
what’s known as experiencing an “outbreak.” ^[2]Although there is no
permanent cure for herpes, a lot of people infected with the virus will never
experience physical symptoms. Here’s what you should know about HSV-1 vs HSV-2.

HSV-1 infection is the most common form of herpes. It’s highly contagious, and people usually get infected with it during their childhood. If you are diagnosed with HSV-1, you are far from alone.

The National Institute of Health
estimates that by the time they turn 50, 90 percent of adults will have been
exposed to it. ^[3]
In the United States, 50% of adults
have HSV-1. ^[4]
The Center for Disease Control found
that the older you are, the more likely you will have the infection. ^[5]

HSV-1 symptoms tend to manifest themselves on the mouth but they can also happen on other parts of the face, tongue, and skin. ^[6] However, you can still get HSV-1 on your genitalia through oral sex. Part of what makes prevention tricky is that people without visible symptoms can still spread it.

Pain
and itching.
Tender,
enlarged lymph nodes.
Cold
sores around the mouth.
Painful
blisters or open sores called ulcers in or around the mouth.
Red
blisters on the skin.

Oral
herpes can last anywhere between 2 to 3 weeks. If you’re experiencing any of
these symptoms, it’s best that you consult with a doctor to get a proper
diagnosis. Despite not being that severe in people with healthy immune systems,
HSV-1 can still lead to some difficulties for people who are suffering from a
weakened immune system. In those cases, it can become fatal through spreading
to the liver, brain, lungs and other organs. ^[7] Specifically, people with
atopic dermatitis — eczema — and HIV are at serious risk of this condition
becoming detrimental.

Though HSV-1 is more common, HSV-2 is still significantly prevalent amongst the population. HSV-2 is generally sexually transmitted and is the cause for genital herpes. Although treatment can help lessen its severity and frequency of symptoms, there’s no cure and it’s a lifelong condition. HSV-2 is more prevalent amongst women. In the United States, amongst 14-49 year olds, 15.9% women and 8.2% men, have been infected with HSV-2. This is because it’s easier for men to give women genital herpes in penetrative sex.

In
2012, 417 million people around the world were living with the infection.
Prevalence of HSV-2 infection was estimated to be highest in Africa (31.5%),
and the Americas (14.4%). ^[8]
15.5
% of people in the U.S. aged 14-49 have been infected with HSV-2. ^[9] ^[10]
10-20%
of people diagnosed with HSV-2 have noticed the symptoms before they are
diagnosed. ^[11]

Vaginal
discharge
Experiencing
pain while urinating.
Fever
Generally
feeling unwell.
Blisters
and ulcers on genitals, vagina, and the cervix area.

Outbreaks
last anywhere between 2-4 weeks and initial symptoms can manifest anywhere
between 2-10 days after the virus enters the body. During the first year after
infection, recurrent outbreaks are common. In the course of one year, someone
can experience four to five outbreaks. ^[12]Usually, outbreaks decrease
over time as their immune system becomes used to the virus. Before an outbreak,
individuals with HSV-2 may experience itching or a burning sensation in the
area that was initially infected.^[13] Both HSV-1 and HSV-2 can lead to the fatal condition of neonatal herpes, the
transference of herpes from a mother to her child when giving birth. ^[14] Though this is very severe, it’s quite rare and only happens in one in every
3000 births.

While
there isn’t a long-term cure for herpes, there are various medical treatments
that can help alleviate symptoms and shorten healing time. These treatments are all antiviral drugs,
meaning they stop viruses from growing in your body. Instead of outright
eliminating the virus, they just control it from spreading. These medications can also help people who
don’t have symptoms reduce the chance of them passing the virus to other
people.

Acyclovir (ACV)

ACV
has been used as a genital herpes medication since the late 1970s. It can be
effective for chicken pox, both types of Herpes, and shingles. The medication
is taken for both treatment and preventative purposes. Typically, ACV should be
consumed anywhere between two to five times daily for a duration of 5 to 10
days. As a preventative measure to stop outbreaks from occurring, ACV is
consumed for 12 months for two to five times daily. ^[15]

Here
are some ACV side effects^[16]:

Swelling
and pain in an infected area
Reduced
appetite
Nausea
Vomiting
Tiredness

Famciclovir

Famciclovir is an antiviral drug that’s prescribed for
herpes infections and is primarily used for shingles and chickenpox. However,
the drug can be beneficial for patients with compromised immune systems who
have HSV-1 or HSV-2.

Here
are some Famciclovir side effects^[17]:

Diarrhea
Headache
Stomach
aches and nausea
Bleeding

Valacyclovir (generic Valtrex)

Valacyclovir,
popularized under the brand name Valtrex in the US, has been a leading herpes
treatment since 1995. When valacyclovir is consumed, it helps mitigate the
symptoms of herpes through converting into ACV and subsequently stopping the
virus from spreading. Valacyclovir can cut down healing periods after an
outbreak. ^[18] In
addition, it also reduces the likeliness of you infecting someone else with the
virus. ^[19] One
study estimated that people who take Valacyclovir for suppressive herpes
therapy are 48% less likely to give their partners herpes. ^[20] Though it has similar
effects to ACV, Valacyclovir stays in your body for a longer time and assists
in reducing your outbreak. On top of that, a smaller dose of Valacyclovir is as
effective as a larger dose of ACV. ^[21] Today, valacyclovir is available online in addition to traditional medical practices.

Here
are some side effects of Valacyclovir^[22]:

Muscle
pain
Muscle
stiffness
Bleeding
Cramps
Sore
throat
Ear
congestion
Congestion
Sneezing
Losing
voice

Ultimately, it will be up to you and your physician which
medication works best for your condition. Having herpes doesn’t prevent one
from being generally healthy. That being said, it can still be a serious
inconvenience. There are various ways in which you can prevent getting HSV-1
and HSV-2. The easiest way to prevent contracting HSV-1 and HSV-2 is being
cautious and not coming into contact with cold-sores. If you do, wash your
hands immediately and thoroughly. In addition, you should use condoms or latex
barriers during oral and penetrative sex. Although condoms aren’t full-proof
and there’s always a risk, condoms can help you not contract the virus.

For people who have herpes, there are things you can do to
mitigate your chance of spreading it to other people. In addition to taking the
aforementioned medications, a weakened immune system and irritation in the
affected area can lead to outbreaks. ^[23] Take the proper
precautions, eat healthy, and get a good amount of sleep to keep your immune
system in check. Studies have shown that stress leads to a weakened immune
system.^[24] If
you have herpes and want to prevent outbreaks, reducing your stress and anxiety
can help boost your immune system and reduce your chance of having an outbreak.
Here are a few things you can do to reduce your stress and anxiety:

Exercise
Sleep
Socialize
Seek therapy
Develop productive coping mechanisms

Having
HSV-1 or HSV-2 can have an impact on one’s self-esteem. It’s important that
people who have herpes are transparent and honest with their partners about
their condition. Explain to your partners that despite the stigma, this is a
very common condition and it’s manageable as long as one is taking antiviral
medications and not engaging in sex during outbreaks. Over time, your body’s immune
system will become stronger and more resistant to both HSV-1 and HSV-2. Hence,
it’s a condition that will get less severe with time. With Valtrex, you can not
only prevent outbreaks but reduce the risk of spreading it to your partners. If you suspect that you have either HSV-1 or
HSV-2, it’s critical that you consult with a physician for a diagnosis. The CDC
suggests that people only get tested if they are experiencing an outbreak or if
they have recently have come in sexual contact with someone who has herpes. ^[25] Your doctor might also give you a herpes test if you have unprotected sex with
multiple people. Regardless if you have HSV-1 or HSV-2, just know that there
are medications out there that can help.