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sex, STDs

Herpes 101: the difference between herpes type 1 and type 2

Courtesy CDC

Herpes is a sexually transmitted virus that primarily infects the mouth and the genitals. It is transmitted by bodily fluids – penetration isn’t required for transmission, oral-oral or oral-genital contact will suffice.

There are 2 types of sexually transmitted herpes: herpes type 1 and herpes type 2. Both types cause painful cold sores. It used to be that we (doctors and researchers) thought of herpes 1 as primarily infecting the mouth (“above the belt”) and herpes 2 as primarily infecting the genitals (“below the belt”), but we know now that is just not the case. Fifty percent of new cases of genital herpes are actually herpes type 1.

More than 90% of the population is positive for herpes 1 and about 16% is positive for herpes 2, but many people don’t know they are positive, because most people with herpes do not have outbreaks.

While you can transmit either herpes 1 or 2 while you have a cold sore, with herpes of either type, shedding of the virus (being contagious) when you have no symptoms or sores happens on a fairly regular basis. In fact, 70% of transmission of herpes is believed to occur while someone is shedding the virus but has not obvious outbreak. As many people with herpes don’t know they have it, they are unknowingly passing it along and that is why it is so common.

While both herpes 1 and 2 cause the same type of painful cold sore, the key difference between the two types is recurrence risk. While you can certainly get herpes 2 on your lips and herpes 1 on your labia or penis, this is mostly likely going to be a one shot deal. This is because herpes 1 prefers to be “above the belt” and herpes 2 “below the belt.” In a nut shell, herpes 1 on the genitals is far less likely to shed sporadically or give you recurrent cold sores and the same goes for herpes 2 in the mouth. They thrive best in their native habitat.

That’s one of the reasons to get a lesion swabbed on your genitals, to get it typed to see if it is herpes 1 or 2. If it is herpes 1, you are far less likely to shed the virus and have recurrent outbreaks and are also less likely to transmit it to your partner. That information may just give you some piece of mind. If it’s herpes 2, there are ways to deal, and we’ll review that in another blog later this week.

Discussion

149 thoughts on “Herpes 101: the difference between herpes type 1 and type 2

  1. ok i have a question. What if someone was diagnosed with genital herpes but there doctor never told them what type it was how do you go bout finding out. Also if your first out break is really bad what are the chances of you having another break out? I ask cause i know someone who got the virus back in 2008 had a bad out break and to this day has not had any more out breaks?

    Posted by Jenn | January 15, 2014, 1:04 am
  2. “Herpes is a sexually transmitted virus that primarily infects the mouth and the genitals. It is transmitted by bodily fluids – penetration isn’t required for transmission, oral-oral or oral-genital contact will suffice”.
    Can you please tell me more detail about this?

    Posted by chondry | January 26, 2014, 7:28 pm
  3. “90% of the population is positive for herpes 1 and about 16% is positive for herpes 2”

    I though herpes 2 is more popular than HSV1, hmm interesting

    Posted by Alicia | May 21, 2014, 3:20 am
  4. Well I went to the doctor for painful blisters on my vagina and they cultured it and it says I have herpes type 1. Is that even possible

    Posted by makayla Renae | June 11, 2014, 1:41 pm
  5. okay, even though i read the article, I’m still confused… I didn’ know it until afterwards, but I kissed my friend who has herpes (dont know what type) but there was no spit-swapping and she had no cold sores or anything, and then later that night I kissed my boyfriend… Now we’re both worried we have herpes…
    I am entirely new to this and I have no idea what to think or do.
    Do you think I have herpes or would i be okay because we didnt full on make-out and she didnt have any visible sores?
    Any light shed on this issue would be greatly appreciated.

    Posted by abarbisch | June 23, 2014, 12:46 am
  6. Hi I was just wondering if u have herpies hsv1 should u still be allowed to work in a daycare

    Posted by James | August 14, 2014, 5:59 am
  7. Please help!!I’m worry bcuz I’m only 17 and I have had coldsores on lips as long as I remember. Last week I got one and it bleed and clean the blood with towel. I forgot to wash the towel and I cleaned my biking area with it and still had blood from the day before. I’m really scared I’m a virgin and.I alreaDy have a hard time dealing with herpes labial can it be transmitted? ??in this way?

    Posted by jadee | August 22, 2014, 11:00 pm
  8. You have to tell your partner being honest cause what is in the dark will come to the light i just told my husband a couple of days ago and feel alot better be honest that is the key hideing it and what if you have a out brake then what ? For hideing it

    Posted by Anisha huff | September 10, 2014, 9:07 am
  9. Dear Dr. Gunter,

    I recently began seeing a girl who has HSV-2 in her genital region. Before we did anything more than kiss she told me of her condition, and that she was in the middle of an outbreak. We did not have sex, nor did I giver her oral sex. She, however, did give me oral sex, and my hands were near her vagina for a short period of time. Afterwards she insisted I wash up, and I did (my face, hands, genitals, and thighs just to be on the safe side) and thoroughly. Today I have a sore throat, but no sores anywhere on me. Yesterday I spent most of the day traveling from a cool dry climate to a warm humid climate via airplanes and helicopters; drinking mostly alcohol, and sleeping very little. The little I did sleep was in a crapy hotel, and I also had contact with my father who has been complaining of a sore throat. I first noticed the sore throat today (friday morning), and the last time I had contact with her was Wednesday afternoon. Can the disease even show symptoms, or show up on a test, that soon? Do you think I could have contracted the virus somehow, and it’s showing up in the form of a sore throat as opposed to the typical sores?

    Every part of me tells me this is just a reaction to me being run down, and in changing environments. However, I am justtrying to be on the cautious side May you please offer me some advice on this issue, or answer any of my questions? Thank you.

    Very Respectfully,
    Adam

    Posted by adamklein2011 | October 10, 2014, 9:24 am
    • You sound like you are afraid of catching her germs. What do you thinkwould happen if you had sex with someone with herpes? She told ypu about before sex you took the risk now deal with it. Paranoia isn’t the answer. You were stupid not to think clearly and if you do get herpes I can see you blaming her when its really your fault. She did everything right…you didn’t. Then you freak on her after she finally felt comfortable with you. After you had sex. That’s not fair and I hope you never get herpes because boy are you in for a rude awakening…

      Posted by whateverfloatsyourboat | February 27, 2015, 9:12 pm
  10. Dr. Gunter,
    Can you explain more precisely what you mean by “herpes 1 on your labia or penis, this is mostly likely going to be a one shot deal”, Do you mean that the virus is gone? Do you mean that the symptoms won’t return? Can I still be infectious for others? Do you have any statistics or published papers that you can refer us to?
    Thanks.

    Posted by Serge | November 11, 2014, 11:11 am
    • Don’t try to play that game man…you know very well that neither herpes versions have a cure so keep dreaming. What she is talking about is the frequency of outbreaks. It could be a one shot deal or multiple outbreaks because you never know. Hsv1 typically doesn’t cause to bad of breakouts but I have a friend that gets monthly outbreaks of hsv1 so thats quite subjective. Hsv
      1 also sheds less then hsv 2 in the genitals. So no your not cured but now you know what she meant.

      Posted by whateverfloatsyourboat | February 27, 2015, 9:08 pm
  11. Hello Dr. Gunter,

    First, thank you for giving your time and energy to helping us deal with herpes. I’ve been searching the internet for some reliable information, and it looks like you may be just the source. I was diagnosed with herpes over 30 years ago and, to be honest, I don’t know whether it was 1 or 2. My first outbreak was severe, with less severe recurrences that dwindled in frequency over the years. Until now, my last outbreak was in 2006. All of my outbreaks have been genital. I’m in a monogamous relationship with a man who also has a history of genital herpes. His last outbreak was over 10 hears ago. Both of us thought we were over outbreaks – ha! A couple weeks ago I was a little sore after a bike ride and really didn’t think any more of it than that until I got the tell-tale tingly, painful blisters, accompanied by body aches and pains and flu-like symptoms. I got a prescription of acyclovir and my symptoms improved within 24 hours. Then my partner started feeling achy and developed a large blistery sore on his tongue. His symptoms have snowballed to include intense body aches, crawling skin sensations, sore throat, headache, blisters on his nose and forehead, and the sensation of blisters in his nasal passages. Before now he’s never had oral herpes, and his genital outbreaks were never accompanied by other symptoms. His medical insurance sucks, so he’s trying to ride it out, but I’m getting really concerned because every day seems to bring a new horrific symptom. We’re both wondering why his outbreak is so intense, and why it occurred in his mouth and upper body. Yes, we did have oral sex immediately prior to my breakout. Can you shed any light on this situation and give us any advice in terms of treatment?

    Thanks so much for your help with this,
    Paula

    Posted by Paula Haverty | January 2, 2015, 3:21 pm
  12. As I was very confused and depressed about hsv symptom i have, I found this article very useful, hope it helps you: http://www.herpes.com/hsv1-2.html

    Posted by marcus | January 23, 2015, 9:24 pm
  13. i have the virus for over 10years and it normally out as sores but lately it happens that if i have sex even with condom it comes out like reddish without sores and dry ,when i peel off the upper skin it will look smooth and shiny it as well breaks giving open lines of wounds what can i do i about this.

    Posted by mark anthony | February 4, 2015, 12:23 pm
  14. in 2008 I was diagnosed with type 2 diabetes. Shortly after, I had the worst recurrent cold sore problem you could imagine. Once i got it below the belt, and i didn’t even have sex, talk about being gypped. I’ve had cold sores since i was a kid, but never this bad. Zovirax did nothing at all. I went on 1gram twice a day of Valtrex and it seems to be the only thing that works. The back pain i would have a week before the outbreak i would not wish on an enemy. Last September 2014 my doctor sent me to an endocrinologist because my blood sugar was so out of control. She did a c-peptide test and an antibody test, and come to find out I’m type 1. I’m wondering if the herpes caused this type 1 diabetes, I really wonder. The more i read about this, the more i think that the diabetes wore down my immune system, causing VIRULENT herpes cold sores on my mouth, and the virus caused me to make antibodies that killed my beta cells. But there’s no doubt in any physician’s mind that I am type 1 and not 2.

    Posted by Frank | February 10, 2015, 8:51 am
  15. Firstly, HSV 1 is incredibly common, it’s a who does not have it type of thing, so don’t beat yourself up over it, it’s called the kissing disease, my doctor has it, he told me, “I have HSV 1, it’s not going to kill me”

    HSV 2 – it is a skin condition, take your Valtrex and be done with it. It’s a Cold or Sore Throat, they are the same thing. Don’t let media make myths about how “terrible” it is, when it is NOT.

    I had mine for ages, so long in fact my antibodies did not show up even when I was having a cluster of blisters, I tested 3 times and bang.

    A combination of prednisolone (steroids), antibiotics and inhaler (steroids) brought my immunity down and I had a case of a dormant virus coming to life.

    There are other cases of people taking oral steroids then having their HSV’s wake up.

    Making a mountain of a molehill, or as my doctor said, don’t make a molehill out of a mound.

    It’s not life threatening, (rarely), be cool, you are not going to be alone forever, I had my HSV 1 20 years ago when I was in the military, and 2? That was 10 years ago, I did not even know. In fact my antibodies were negative, for whatever reason they can drop to the “you are negative range”

    It won’t kill you, drop the stigma of something that can’t kill you, unless you want to be a person that has 3 months to live because of cancer.

    After the tests, my wife tested positive for 2, negative for 1, what did the doctor say? (You both don’t kiss enough)

    It’s a skin condition, and that may show up once in awhile.

    Posted by LG | February 27, 2015, 5:25 pm
    • I feel Soo much better… I’ve been crying for days I have both…I literally wanted to die I felt so disgusted and ashamed and dirty… I felt like my life was over…but reading the blogs I feel a little comfort and self worth because I’m not alone as I was feeling….so thank you for easing my mind just little….even though all of u are complete strangers lol you guys helped me….thanks!

      Posted by kayla | February 28, 2015, 6:36 pm
  16. I have been with my boyfriend for 4 years and just a month ago he was forced to tell me he has herpes 2. He has had it for 17 years. I have had unprotected sex for the last 3 1/2 years. I went and got tested. Luckily my results came back negative for both 1 & 2. He said he has only had 1 outbreak in all these years and it was not bad at all. He does take valtrex half a pill daily. Is it normal after all these years to not ever have another outbreak? Its hard enough dealing with his miltiple lies and deception let alone feeling that he took my choice away but I have been doing alot of obsessive research and have yet to come across an answer to this question. Thank you

    Posted by Kelly | March 26, 2015, 5:35 am
  17. I just found out I have hsv2 and I just want to die. I’m completely have lost motivation to live. This hsv2 will ruin my life. I won’t every marry, have kids. I feel like my life is over. I how this is a mistake!! I could live with hsv1 but hsv2 ruins lives I think. Especially for a single person.

    Don’t know what to do!

    ~Hopeless~😭

    Posted by Shellby | April 2, 2015, 9:22 am
    • You need to step your pussy or dick up if you let herpes stop you from living life. If the only reason someone would date you is because raw sex was in the future you got bigger problems then herpes…how about a case of low self-esteem.grow up and become the best person you can be. If your fine as hell people won’t care but if your average your life is over.

      Posted by whateverfloatsyourboat | April 2, 2015, 5:57 pm
  18. my doctor said i have stage 1 …can j still spread it t my daughter by sharing drinks of food with her?

    Posted by lisa | April 8, 2015, 11:03 pm
  19. My bf was recently diagnosed with herpes 1 and 2. He doesn’t want to touch not even a hug because he doesn’t want me to get infected. He is depressed. What can I say or do to make him feel better. I love him and even if I’m not infected I do not want to leave him.

    Posted by Teresa | April 23, 2015, 3:11 am
  20. I’m beginning to beleive no one really knows the real ins and outs of either types of herpes! I was diagnosed with HSV1 genitally about 2 years ago. I was not online at the time and know really nothing about it. We have just recently signed back up and I have read way to many contridicting articles on this and I’m not sure what to beleive. Chicken pox is like the herpes virus as they both hide in the nervous system. So after you reach about 60 years old, it is said you can get shingles from having had chicken pox. What’s the difference? If you are diagnosed with herpes, it is just a shame. You have had sex with someone who had it. OMG!! You are a skank!! You have shingles, ” I’m so sorry you are in so much pain”. Sounds like the same virus to me. I can’t kiss my 2 smallest grandchildren any where on the face or their hands. I see their other grandparents kiss them on the lips. Their other grandmother just recently had the shingles. Is it safe for her to continue to kiss them in the mouth?

    Posted by Wanda | May 23, 2015, 2:54 pm
  21. Dear Doctor,
    I had one genital outbreak a year ago and nothing since. It happened 2 weeks after sleeping with someone after a year of being sexually inactive. He had no signs , no cold sores or anything else , although he did speak of being very ill with flu a few months previous to our meeting. He’s had nothing in the past year.

    Initial blood tests have shown negative but from what I have read, I think I must have H1 below the belt.
    If so, how does H1 pass? Can it be from genital to genital or must there be oral contact involved?
    I am also trying to think of the best way to explain this to any future partner and would like some clarification on how likely this is to be passed on.
    Thank you.

    Posted by Clarity | June 12, 2015, 4:47 am
  22. Looking for the blog on dealing with herpes 2 mentioned at the end of this post, and the fact that this is all Greek to me. I was diagnosed with HSV-2 but have no symptoms. Had a full panel testing, at 60, single and divorced for 23 years, no dating, not sexually active and bam surprise everything came back negative but the HSV-2. Absolutely no symptoms and had this test done after a 21 day full body detox (DHerbs)… My head is spinning…

    Posted by Irene408 | July 15, 2015, 11:48 pm
  23. HI, I recently found out I have type one but on my genital area not on my mouth where it’s commonly found. I had swabs taken the second day I had sores occur down there. Because they were so fresh they were able to determine that it is intact type 1. I was told that this is easier to deal with an Handel then if I were to have type 2 in the genital Area. How is this true if it intact is. I’m just looking for second opinions as I’m 23 an pregnant 21 weeks with my first baby. I’m just concerned because the first outbreak was so painful an unbearable I would like to know if this will keep occurring on a regular basis or if because it’s the first time it was the worst. Thank you for any help. I appreciate any feedback.

    Posted by kaily | July 24, 2015, 8:28 am
    • Everyone is different.
      some people have break outs often and some people have never broke out. I have had 1 breakout but it is almost always tender. I have the same type as you and also in the genital area. Thank God I am past the child bearing years. I have no idea how this will affect your baby but keep your doctor appointments and be sure to ask them how this will affect your baby. I have heard it is hader on babies than adults.

      Posted by wandarhodes2015 | July 24, 2015, 11:33 pm
  24. I have oral herpes on my tongue and have test positive for Type-2 but have not had any symptoms related to it or on my genital area. I’ve read oral herpes is type 1 so a bit confused. Does this mean I will only have breakouts in my mouth?

    Posted by Ernesto Miranda | August 19, 2015, 2:31 pm
  25. I have type 2 ,I’m called a rapid cycler, having outbreaks on a monthly basis,but recently started getting the sore one tongue and inside cheek,about the same time I’m having a vaginal outbreak. …so how do I know if it’s 1or 2,or just a canker sore,very confused.

    Posted by janet | August 26, 2015, 5:37 pm
  26. Thank you for the great information doctor!!

    Posted by Jon s | August 29, 2015, 2:10 pm
  27. At the very least this is such an unexact science! I have been tested and diagnosed with hsv2, a couple of years ago. Since the, I have had to man up and disclose to all I have dated. I have never seen an outbreak to my memory. Several women, who seemed to be very interested in a relationship at first, all but ran from me. I recently became reunited with a hometown GF and we were all about a new life together. She even seemed unaffected at first after a I told her, but that changed in a few days. I honestly am very down right now, I want another chance at a stellar relationship and to be in love again.
    I need to know how to reassure her that there is a way to have a life together and not infect her as well. IS THIS A POSSIBILTY???

    Posted by Kent | October 3, 2015, 6:11 pm
  28. I’m a African American women and I have 1 n 2, my question is why does my lips turn black when I have an outbreak?

    Posted by blavkgirl | December 15, 2015, 7:58 pm
  29. Hello, when i got pregnant i was diagnosed with herpes and by reading this blog i guess i have herpes type 2, i was really devastated but i learn to. Accepted myvquestion is i was on medication during pragnancy to stop the outbreaks should i still be on the pill to prevent the out break or when i have the outbreak i should get the medication??

    Posted by Maria martinez | December 19, 2015, 4:32 pm
  30. I wAS recently diagnosed with herpes 1 on my vaginal area…we have not had oral sex in almost a year…however he used his spit for lube one night…omg he’ll for me 8 days later… He used his spit many times in the past years and I never had a problem. Why all of the sudden? Now I feel like I’m some gross person. We haven’t made love now for over 2 months since. We were going to the other night again no lube and he doesn’t want to use anything else now…he blames himself as I have never even had a cold sore…I was actually happy to hear it was type 1…so was he but our sex life is totally non exsistent now.

    Posted by Pam | December 29, 2015, 8:17 pm
  31. This didnt really help me at all so thanks for nothing

    Posted by Fuck you | January 5, 2016, 3:41 pm
  32. auuk

    Posted by louia adams | January 28, 2016, 1:19 pm
  33. Can you have genital type 1 and type 2?

    Posted by Graeme | February 2, 2016, 8:58 am
  34. I was diagnosed with HSV2 3 days ago.. Since then I’ve been stressing horribly.. I havent seen anything on my bottom. But I see it on my eyes little white pimples. My eyes aren’t running they’re dry.. I’m confused because I don’t know how it’s affecting my eye

    Posted by Libb | March 12, 2016, 9:09 am
  35. I wrote an article on cold sores and getting fewer outbreaks. Hopefully, this helps someone. https://krystalbrownblog.wordpress.com/2016/03/27/fewer-and-more-comfortable-cold-sore-outbreaks-at-every-price-range/

    Posted by krystalbrownblog | April 1, 2016, 9:55 pm
  36. I have hsv genital 1&2 what does that mean for me more out breaks? more shedding?

    Posted by Amanda | April 12, 2016, 8:25 pm
  37. I used to have real bad outbreaks doctor. Told me to keep stress level down.. Take the acylovir pills when u can and. Viaderm cream worked well . Blisters were painful was nightmare have been clear for a year with very minor outbreaks some tingling.But was worried and stressed for long time. Much more manageable dont get discouraged ..good luck all!

    Posted by David | July 13, 2016, 1:47 am
  38. My have hsv 1 my genitals for the first time. My boyfriend has HSV-1 In his mouth. Want to know if I could give him hsv 1 on his genitals if he already has ages he one of his mouth???

    Posted by Sam | July 17, 2016, 7:17 am
  39. Is it cureable?

    Posted by tenzing norbu | July 19, 2016, 7:43 am

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