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The Different Types of Herpes

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While herpes cases arise because of the herpes simplex viruses HSV-1 and HSV-2,1,2 the disease can manifest in various ways in different areas of your body. There are actually many types of herpes that you should be aware of.

Genital herpes is commonly triggered by the HSV-2 virus, although the HSV-1 virus may also be the culprit.3 As its name implies, this infection shows up on the skin and mucous membranes of the genital area of both men and women.4

Women are said to be more prone to get genital herpes compared to men. Data from the World Health Organization in 2012 showed that 267 million women versus 150 million men were infected with genital herpes.

Why the higher numbers for women? It’s said that the transfer of the virus is more efficient from men to women than from women to men.5

Pain, itching and the appearance of sores called lesions are common symptoms of genital herpes. Lesions may appear inside or outside the vagina, and on or around the penis. In both women and men, these sores may appear in and around the anus.6

Lesions typically appear two days up to two weeks after you first get infected with the virus, and heal for seven to 14 days or more.7

Other symptoms of genital herpes include fever, body aches, swollen lymph nodes and decreased appetite.8,9 However, a patient might not know right away if he or she has herpes or not, because most HSV-2 cases are asymptomatic or show mild symptom only.10

Recurrent outbreaks of genital herpes may happen, with some patients having four to six outbreaks in the span of a year. Compared to the first infection, these recurrences are less painful and occur in shorter periods than the first infection. There are some patients, however, who don’t have another outbreak in years or during their lifetime.11

The HSV-2 virus is known to be dormant in your body after you first get infected and can be triggered again.12 According to Johns Hopkins Medicine, several factors play a role, namely:13

Lengthy or intense sunlight exposure


Emotional stress


Physical injury

On the other hand, oral herpes, also called herpes labialis, first appears on the lips, mouth or gums, leading to the formation of small and painful blisters known as cold sores or fever blisters. It’s caused by the HSV-1 virus, but in some cases, the HSV-2 virus can move to the mouth during sexual intercourse, leading to this disease.14

Cold sores are small and red with a clear and yellowish fluid inside. Sometimes, these small blisters may band together and develop into a larger blister. Once the blister heals, it becomes yellow and crusty, and returns to a pinkish color.15

You’ll begin to feel the symptoms of oral herpes one to three weeks after being infected with the virus. Burning and tingling sensations, and itchiness around your lips and mouth are the first signs of oral herpes. Fever, sore throat, swollen glands and difficulty swallowing may also be felt before the blisters become visible.16

The HSV-1 virus in oral herpes becomes dormant in the nerve tissues of your face, but can be reactivated and lead to the formation of cold sores that are triggered by factors such as:17,18



High-stress events


Hormonal changes

Extreme temperature

Upper respiratory infection/s

Weakened immune system

Recent dental work or surgery

Compared to people with the HSV-2 virus, those who have the HSV-1 virus experience fewer outbreaks, as studies have shown that only one recurrence is recorded per year.19 If a patient with oral herpes experiences another outbreak, the pain is less severe with reduced frequency of these outbreaks.20

At least 80 to 90 percent of people in the U.S. have already been exposed to the HSV-1 virus.21 Meanwhile, around 3.7 billion HSV-1 infections were recorded in 2012 all over the world, according to the World Health Organization. Africa was home to the highest number of cases, with 87 percent of occurrences coming from the continent.22

Although it’s not caused by either the HSV-1 or HSV-2 virus, herpes zoster falls under the umbrella of herpes diseases. Also known as shingles, it’s an infection caused by the varicella-zoster virus, and is characterized by the development of painful skin rashes on one side of the face or body.23 These rashes are red patches of fluid-filled blisters that tend to crack easily.24,25

At least 1 out of 3 Americans are said to get shingles in their lifetime.26 While anyone from any age group can have shingles, there are risk factors that should be considered, such as:27

Being 60 years old and above

Having chickenpox before age 1

Having an immune system weakened by different medications or diseases

Undergoing chemotherapy or radiation treatment28

The U.S. Centers of Disease Control and Prevention explains that pain, itching or tingling in the area where the rashes will eventually appear will occur at least one to five days before the rashes are seen. Once these rashes are visible, they scab for around seven to 10 days and heal within two to four weeks.29 Aside from rashes, symptoms of shingles include fever, chills, headaches, fatigue, and an upset stomach.30,31

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