Prevention of Herpes

Genital herpes is a sexually transmitted infection (STI) that is caused by one of two viruses - herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Cold sores, which are associated with oral herpes, can be spread sexually but are more often spread through non-sexual contact as early as childhood.

Several approaches, including safe sex practices, can help prevent the spread of herpes, while antiviral medications can help prevent or reduce flareups in those already infected. Learn more about these essential strategies below.

Preventing Genital Herpes

It is especially important to prevent oral or genital HSV infections if you have an immune deficiency. These conditions can be more severe if your immune system is not functioning as it should.

If you are pregnant or thinking about becoming pregnant, you should be vigilant about preventing genital HSV infection because it can be transmitted to your baby during vaginal delivery, potentially causing serious problems.

The following are specific prevention and treatment strategies for HSV-1 and HSV-2:

Barrier Method

Unlike many other sexually transmitted diseases, herpes can spread by skin-to-skin contact instead of through bodily fluids. Since condoms don't cover all areas of potentially infectious skin, they cannot completely stop the spread of herpes.

Consistent condom use reduces the risk of herpes transmission from men to women by 96% and from women to men by 65%.

If you or your partner has herpes, or if you are unsure of a partner's status, you need to use condoms correctly every time you have sex, even when no symptoms are present. 

Every unprotected sexual exposure increases the risk of herpes transmission, so the intermittent use of condoms is not effective at prevention. Even if you use condoms, it is best to abstain from sexual contact when you have prodromal symptoms and when you have an outbreak. 

Sexual Abstinence

One of the most important ways to reduce the risk of herpes transmission is to avoid having sex right before an outbreak when prodromal symptoms are present.

Prodromal symptoms include numbness, pain, or tingling in the genital area, and they occur a few days before recurrent lesions appear.

You are most contagious during the prodromal phase when the virus is reproducing, increasing in quantity, leaving its dormant (resting) location, and entering into other areas of the body (a process known as viral shedding). 

While you need to use condoms to prevent the spread of infection, even during asymptomatic intervals, it is recommended to abstain from sex when lesions are present. 

Preventing Cold Sores

It's very easy to pass along the virus that causes cold sores—and to become infected yourself. Knowing this, though, may remind you to think twice about some common practices that can put you (or others) at risk.

Kissing can spread cold sores, even when lesions are not present. So, too, can any object that comes into contact with a sore.

Cold sores can also be caused by HSV type 2 as a result of oral sex. If you or your partner get cold sores or genital herpes, it's important to know that oral sex can spread a genital herpes infection to the mouth and oral herpes to the genital areas.

Spreading the infection can occur whether sores are visible or not, so you should take precautions even when you do not have symptoms. 

Cold sores are likely to recur if you have already been infected. Some preventative methods include avoiding mouth trauma, avoiding sunburns (use sunscreen and lip balm when you are out in the sun), and avoiding excessive stress, as these can all make it more likely for a cold sore to recur.

Prescriptions 

For those experiencing their first episode of genital herpes, the U.S. Centers for Disease Control and Prevention recommends of the three following antiviral medications: Valtrex (valacyclovir), Zovirax (acyclovir), and Famvir (famciclovir). Your healthcare provider will walk you through exactly how to take these medications and how often.

In some cases, providers may prescribe these antiviral medications to manage recurrence. There are two kinds of treatment regimens: episodic therapy and suppressive therapy. Episodic treatment involves taking medications at the first sign of an outbreak to speed healing or prevent a full outbreak from occurring, while suppressive therapy involves taking antiviral medication daily to hold HSV in check so that it’s less likely to flare up and cause symptoms.

People who have recurrent herpes may use the same medications that are recommended for symptomatic outbreaks when characteristic tingling and pain develops. In these situations, the medication course is started immediately to stave off or reduce the severity of an episode.

Suppressive therapy, involving the daily use of antiviral to prevent an outbreak reoccurrence, can reduce one's symptoms and the amount of viral shedding. This can be quite helpful, particularly in combination with reliable condom use.

If you are an adult, the symptoms of herpes are usually pretty manageable and only rarely cause complications. However, herpes can be very dangerous if it is transmitted to a growing baby during pregnancy.

If you have genital herpes and are pregnant, or if you are sexually involved with someone who is pregnant or planning to get pregnant, talk to your healthcare provider about managing the risks.