Herpes: Symptoms, Treatments, and Facts

There's a good chance you already have herpes.

Now, granted, this is a big "probably." We don't know your sexual history. But just going by the numbers, your odds are statistically better of having herpes than not having it.

A recent report by the World Health Organization revealed that more than two thirds of the global population—an estimated 3.7 billion people—have Herpes Simplex Virus 1 (commonly known as oral herpes or cold sores) and 11 percent, or an estimated 417 million people, have HSV-2, or genital herpes.

Bryan Cullen, the director of the Center for Virology at Duke University, notes that the infection rates get higher closer to home. "About 75 percent of all US residents, or two out of every three people under the age of 50, have Herpes Simplex Virus 1," he says. "And about 22 percent are HSV-2 infected."

Don't freak out. Whether you already have herpes or you're just paranoid about getting it, here are the answers to your most burning questions.

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Who's most at risk for getting herpes?
Some studies suggest that women are two-thirds more likely to become infected. Which shouldn't put you at ease if you're a man, especially if you're a man who enjoys having sex with women and you've ever said, "I don't have a condom, but I'm sure it'll be okay."

For genital herpes, anybody who has unprotected sex with an infected partner is at risk. Given the staggering number of people with herpes, anytime you take off your pants with somebody new, you're essentially playing STD Russian roulette. With oral herpes, it's not just personal contact that increases your risk. You can contract the virus by sharing personal items like razors, lip balms, towels, or eating utensils.

Weirdly, you might be more susceptible to genital herpes if you've never had oral herpes. That's according to a 2013 study by the Centers for Disease Control and Prevention, which examined the prevalence of herpes among across several generations. People who were never exposed to oral herpes as kids or teenagers—who practiced better hygiene, and probably turned away when aunts with visible cold sores tried to kiss them—were more likely to contract genital herpes as an adult.

Why? Because they never developed the immune system antibodies that would've helped them fight against the sexually transmitted virus as adults. As it turns out, oral herpes isn't just common, it's actually pretty helpful in teaching your body how to protect itself.

Can you get genital herpes from somebody who has oral herpes?
Absolutely you can, and you can probably guess how it happens. "While HSV-1 is historically oral and HSV-2 genital, oral sex has confused this as they can both infect both areas," Cullen says. If you've got sores on your mouth, or your partner has sores on their mouth, or you both have sores on your respective mouths, then maybe tonight isn't a "69" kind of night.

How do I know it's a herpes sore and not something innocuous, like a canker sore?
Canker sores always occur inside the mouth, or on the tongue, cheeks, or throat. They're a white membrane-coated center with a red outline. A herpes' cold sore, however, usually appears outside the mouth, on or around the lips, and sometimes on the nose or—very rarely—near the eyes. They look like small pimples or blisters, and they eventually burst and then scab over.

If there's something that resembles a sore or blister on your genitals, it's definitely not a canker sore. But it could be a host of other things. If you have redness or a rash, it could be contact dermatitis, which is often mistaken for herpes, or a yeast infection. It could also be syphilis or chlamydia, which share many of the same symptoms. Let's not self-diagnose, shall we? Get to a doctor post-haste.

Herpes seems easy enough to avoid. Just don't have sex with somebody with sores on their lips or genitals. How does it keep spreading anyway?
Because infected people don't always have sores on their lips or genitals. Most people with genital herpes "don't know they have it," says Gail Bolan, director of the CDC's Division of STD Prevention. "Many studies have shown that most people who are infected have no noticeable signs or symptoms of herpes." But they can still pass along the virus, even without those telltale bumps.

It's called "asymptomatic shedding"—when the virus exists in genital fluids without any visible ulcers—and it's how most people get infected with herpes. The best way to protect yourself isn't by examining your partner's genitals like you're a jeweler with a loupe. Even if you see nothing alarming down there, that doesn't mean you're all clear. Use a condom.

Is herpes curable?
No, although a lot of people seem to think it is. There are several dozen books currently available on Amazon with the words "herpes cure" in the title, but according to Cullen, "none of them work." At least for now, if the CDC is to be believed (and we tend to believe them), there's no cure for herpes.

Vaccines are regularly being developed and tested. A promising one in 2012 crashed and burned, and the latest vaccine, called GEN-003, is currently in Phase II trials, although the latest developments aren't encouraging. Another experimental drug, pritelivir, could be a major step forward, Cullen says, "if it can ever get approved by the FDA. It totally blocks lesions and viral shedding. But it is still not a cure."

So if I've got herpes, I'm just screwed?
Not screwed. You still need to have it treated. If you're infected, your doctor will prescribe an antiviral drug like Zovirax, Valtrex, or Famvir, which should make the symptoms disappear in a few days to up to a week.

You can still have sex, but make sure your partner knows about the risks (see above) and you always use a latex condom, or a dental dam during cunnilingus and analingus. You're not a leper now. You don't have to wear a scarlet H on your chest like some Nathaniel Hawthorne character. But you need to be responsible and not an asshole. If you want to have sex with somebody, tell them about your history, and take the necessary precautions.

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