Sexual Health STDs Herpes Herpes Guide Herpes Guide Symptoms Causes Diagnosis Treatment Prevention Prevention of Herpes Keeping Safe From Genital Herpes and Cold Sores By Elizabeth Boskey, PhD Elizabeth Boskey, PhD Facebook LinkedIn Twitter Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. Learn about our editorial process Updated on October 17, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Anju Goel, MD, MPH Medically reviewed by Anju Goel, MD, MPH LinkedIn Anju Goel, MD, MPH, is a board-certified physician who specializes in public health, communicable disease, diabetes, and health policy. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Preventing Genital Herpes Preventing Cold Sores Prescriptions Frequently Asked Questions Next in Herpes Guide Recognizing Herpes: Signs and Symptoms to Be Aware Of 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. Verywell / Ellen Lindner 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. Herpes Symptoms Can Go Unnoticed Many people with HSV-2 have no symptoms. If you are sexually active you should be aware of the risk and take steps to reduce it. 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%. 10 Best Condoms to Buy 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. Barriers should also be used for oral sex since genital herpes can be spread to the mouth and oral herpes can be spread to the genitals. 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). The herpes virus is found in open sores and blisters, so it is best to abstain from sexual contact—even with a condom—when active lesions are present. 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. Verywell / Emily Roberts Kissing can spread cold sores, even when lesions are not present. So, too, can any object that comes into contact with a sore. One of the best ways to avoid oral herpes is to avoid sharing cups, utensils, lipstick, lip balm, toothbrushes, pipes, hookahs, cigarettes, e-cigarettes, or any other items that go into your mouth and touches your lips. 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. Clinical Trials for Herpes Vaccines Ongoing While there have been some promising trials of herpes vaccines, to date, no human trials have shown high enough efficacy to bring a herpes vaccine to market. 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. Frequently Asked Questions Can you kiss someone with HSV-1? It depends. If the person has a visible cold sore in or around their mouth, you should not kiss them unless you are also an HSV-1 carrier. When symptoms are not present, HSV-1 is less likely to spread. However, asymptomatic transmission is still possible. Can you get herpes while using condoms? Yes. Condoms help to prevent the spread of herpes, but the herpes virus may be present outside of the area covered by the condom. Condoms provide some protection against herpes, but they don’t offer total prevention. Can you sleep with someone with herpes and not get it? Yes, it is possible to not contract herpes from an infected partner, but you shouldn’t take a chance. The herpes virus is spread by contact with sores, so avoid sex during outbreaks and use a condom every time you have sex. If you are in a relationship with someone who has herpes, talk to your healthcare provider about antiviral medications you may be able to take prior to sexual contact to prevent catching the virus. What Does a Herpes Rash Look Like? Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 9 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. U.S. Centers for Disease Control and Prevention. Genital Herpes - CDC Fact Sheet. Centers for Disease Control and Prevention. Genital herpes - CDC Fact Sheet Magaret AS, Mujugira A, Hughes JP, et al. Effect of Condom Use on Per-act HSV-2 Transmission Risk in HIV-1, HSV-2-discordant Couples. Clin Infect Dis. 2016;62(4):456-61. doi:10.1093/cid/civ908 American College of Obstetricians and Gynecologists. Genital Herpes. Mayo Clinic. Cold Sore. U.S. Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines. MMWR. American Sexual Health Association. Herpes treatment. World Health Organization. Herpes simplex virus. Nemours Foundation: Teens Health. If someone with herpes has no sores, can it still be passed on? Additional Reading Carvalho CG, Medeiros-Filho JB, Ferreira MC. Guide for health professionals addressing oral care for individuals in oncological treatment based on scientific evidence. Support Care Cancer. 2018 Feb 22. doi: 10.1007/s00520-018-4111-7. [Epub ahead of print] Sénat MV, Anselem O, Picone O, et al. Prevention and management of genital herpes simplex infection during pregnancy and delivery: Guidelines from the French College of Gynaecologists and Obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol. 2018 May;224:93-101. doi: 10.1016/j.ejogrb.2018.03.011. Epub.