You know senior superlatives in the yearbook? Most Popular, Best Dressed, Class Clown, etc.? OK, imagine if every sexually transmitted disease or infection (STD/STI) was given a superlative, too. Herpes would be named Most Mysterious—as in, there’s a ton of confusion about what the herpes simplex virus actually is and how it affects the body.
For answers to the biggest questions, we turned to a top expert: H. Hunter Handsfield, M.D., a professor emeritus of medicine at the University of Washington Center for AIDS and STD and former member of the American Sexual Health Association’s board of directors. Here, he breaks down what you need to know.
I have a cold sore. Does that mean I have herpes?
In a nutshell, yes. Having a cold sore does mean that you are carrying the herpes simplex virus. You’re not alone: More than half the U.S. population has a form of herpes, too!
See, the herpes virus comes in a couple of strains, and they’re both super common. The first type, HSV-1, is the main cause of cold sores in the mouth area. (That’s why some people call it "oral herpes.") HSV-2 is its cousin, known for triggering sores on or near the genitals. Though the two strains tend to behave a little differently from each other, both types can cause sores in both places.
Wait, so is herpes an STD? How did I get a cold sore if I've never had sex?
That’s the thing about the herpes virus: It spreads through all kinds of activities. In fact, lots of people pick it up when they’re kids, just from sharing cups and utensils with others. Kisses from infected relatives are a major pathway, too. So while both herpes strains can be transmitted through sexual contact (including oral sex), that’s definitely not the only way the virus spreads.
I had a cold sore years ago, but I haven't seen one since. Do I still have herpes?
Right now, the herpes virus has no cure. So once you have it, it basically hangs out in your body for life. Everyone’s experience is different, though. Some people get flare-ups on the regular. Others go years between sores. In fact, about 40 percent of people with HSV-1 experience no more than one outbreak in their lives.
How can I tell a cold sore isn't just a giant zit?
Cold sores usually look and feel a little different from pimples. Before a cold sore hits the surface, you might feel a sharp shooting pain or burning sensation that hurts more than a zit. And cold sores generally crop up right near the mouth, on the outer edge of the lips. Appearance-wise, most cold sores start out looking blistery—red and fluid-filled—before breaking and scabbing over. They last for about a week. Still, not every cold sore looks exactly like this. Sometimes an outbreak can look more like a really chapped area on your lip.
Ok, so what can I do for the sore I have right now?
If this is your first outbreak, you’ll want to make an appointment with a doctor or a clinician to get tested. (Figuring out what type you have is essential to determining the best path of treatment and can help set expectations for how often future outbreaks might occur.) You can go about your regular life—it’s not like staying home from school to avoid passing the flu to your classmates—but in the meantime...
If the sore is on your face: Try holding a cool damp on the area for a few minutes several times a day. This can help soothe any pain, dial down redness and keep scabbing under control. If the sore still stings or feels uncomfortable, applying a dab of Vaseline might help. Oh, and it’s totally OK to cover the area with makeup. In all instances, just be sure to wash your hands and any tools with hot soapy water after touching a sore. And avoid picking (hard as that may be!) because it can slow down healing.
If an outbreak is severe—or if you get cold sores really often—consider asking your doc if medicine makes sense. One option is Valtrex, an over-the-counter pill that can help shorten and prevent flare-ups. Finally, keep in mind that the herpes virus is most contagious in active sores. So until your skin clears, skip shared mouth activities like kissing, performing oral sex and sipping from your BFF’s Frappuccino.
If the sore is below the belt: Just like with cold sores, cool compresses are your friend. Holding a damp cloth on the area a few times a day can bring relief and speed healing. If it hurts to pee, urinating in the shower can sometimes dilute the fluid and stop the sting. Failing that, an over-the-counter anesthetic cream like Benzocaine might help.
I think I might have herpes. Do I need to get tested?
Yes. If you’re currently experiencing an outbreak, it’s important to get tested as soon as you can. All it takes is a quick blood test or swab.
If you’re not experiencing an outbreak, but you’re sexually active, you might have heard that it’s smart to get screened for a few common STIs (like chlamydia) once a year, or anytime you think you might have been exposed through unprotected sex. At your appointment, just ask your doctor or clinician to screen you for herpes, too.
Testing also makes sense if you’re experiencing frequent or severe outbreaks (whether or not you’re sexually active). Figuring out which strain of herpes you have can help your doctor map out the best treatment plan.
Do I need to tell the people I hook up with that I have herpes?
If you have current, recent, or frequent outbreaks, you should tell your partner before kissing or sex, Dr. Handsfield says. Here’s one way to start the conversation: "Hey, before we go any further, let’s talk. I have herpes. The risk of passing on the virus to you is low, especially if we use a condom, but I just want to let you know."
That said, If you’ve only gotten the occasional cold sore at this point—and you don’t have any at the moment—your risk of passing on herpes is really, really low. For this reason, some people who fit this description don’t see the need to share. In most cases, partners remain uninfected.
But while dealing with the occasional cold sore might not be a big deal to you, half of all new genital herpes cases happen when people who have cold sores perform oral sex. To prevent that, some people disclose before oral sex, but not necessarily before kissing.
If your partner has questions, try sharing this article or feel free to check out some expert resources together. It’s all about communication!
This article originally appeared on Cosmopolitan.com. Minor edits have been made by the Cosmo.ph editors.