There are two strains of the herpes virus. Oral herpes (herpes simplex I) may appear as cold sores or fever blisters around the mouth in the aftermath of a cold or when you are rundown. It's extremely common and not really considered an STD. Genital herpes (herpes simplex II) is another story--it's definitely an STD. This kind of herpes is characterized by painful, itchy, blisterlike sores anywhere in the genital region. What's confusing, though, is that oral herpes can appear on the genitals and cause similar symptoms to genital herpes.
The genital herpes virus occupies nerve centers at the base of the spinal column and lives there permanently. People with this virus have sporadic outbreaks; some have very few after the initial (usually the most severe) outbreak. Some have them more frequently. Outbreaks can be triggered by fatigue and stress, among other factors.
How you get it
Through oral, genital, or anal contact with an active herpes sore. When the sore is active, it is said to be shedding. You can get it through skin-to-skin contact. Vaginal fluid and sperm can also carry it from the sore to another location.
Symptoms
The first time, usually one or more blisterlike sores appear in the genital region. These may break, ooze, and itch, but they dry up in 7-14 days. Sometimes the outbreak is preceded by flu-like symptoms (headaches, body aches, fever, and fatigue) and difficulty urinating. Symptoms can appear up to several months after exposure. Subsequent outbreaks are usually milder and can be mistaken for other things that cause genital itching. Outbreaks can also happen without any visible symptoms.
Prevention
Always use condoms plus spermicide, since there is some risk of transmission even between outbreaks when sores are not visible. Female condoms are even better than male condoms because they cover more genital surface.
Treatment
Topical ointments can reduce the discomfort of a herpes outbreak, reduce itching, and speed the drying-up process. Sitz baths and anesthetic creams may also help reduce discomfort. Some prescription oral antiviral medications can reduce the severity and frequency of outbreaks. Eating right and getting plenty of sleep also help.
Long-term implications
Once you get herpes, you'll have to live with it forever, and you'll need to manage it carefully. Wash your hands frequently when you have outbreaks, particularly avoiding touching your eyes and face after contact with a sore. Herpes in the eyes is extremely serious and can lead to blindness. The other very serious long-term implication is in childbirth. Vaginal delivery during a herpes outbreak poses a serious danger to the baby. So if you get pregnant, tell your doctor you've got herpes.
