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.