So, if you're reading this, it's likely that you or someone you care about may have herpes. Well, first, we want to remind you that HSV-1 and HSV-2 are exceptionally manageable viruses, and that the anxiety and fear you're experiencing right now, while normal, are mostly unwarranted. Depending on the type of herpes virus you’re infected with and your symptomatic status, your herpes outbreak frequency can be a common occurrence or something you’ll rarely, if ever, have to deal with.
In this guide, we’ll look at the statistics for herpes outbreaks. We’ll also look at how outbreaks can differ between HSV-1 and HSV-2, as well as whether or not people with an asymptomatic herpes infection need to worry about outbreaks at all.
Finally, we’ll cover some of the treatments you can use to make treating and managing herpes outbreaks an easier process.
If you’ve been infected with HSV-1 or HSV-2, you’ll usually go through an initial outbreak. Your first herpes outbreak is also known as a “primary outbreak,” and it tends to be the most severe physical experience from the virus.
Not everyone with HSV-1 or HSV-2 will have an initial outbreak. Some people are completely asymptomatic, which means they can be infected with the virus without experiencing any real herpes symptoms.
During a first herpes outbreak, most people experience the physical effects of herpes (in the case of an oral HSV-1 infection, cold sores, or genital herpes lesions for genital HSV-1 or HSV-2), plus additional cold-like symptoms, including fever, chills, sore throat and general body aches.
Herpes outbreaks usually start within one to two weeks of exposure. If you’re worried that you’re going through an initial outbreak of herpes, the best thing to do is check your symptoms and talk to your doctor about testing and treatment options.
People with symptomatic HSV-1 usually experience one outbreak or less per year, although this can vary depending on a number of factors. Outbreaks tend to be worse during the early stages of the infection, as the body hasn’t had time to produce its own immune response to herpes.
HSV-1 outbreaks usually involve the development of cold sores around the lips and mouth. The sores usually begin as an itching, burning sensation before forming into open sores over two to five days.
When cold sores caused by HSV-1 are open, they can “weep” out infectious fluid, leading to a high risk of transmission. It’s best to abstain from kissing or sexual activity if you have an open cold sore, as there’s a risk of infecting your partner with HSV-1 through direct oral contact. If your question is, "When is herpes contagious?" the answer is, "All the time." Open cold sores are highly contagious, but even if you're not experiencing an outbreak, it's still possible to transmit herpes.
Our guide to kissing and cold sores goes into more detail about how you can reduce your HSV-1 transmission risk during an outbreak.
By acting quickly and treating a cold sore in the itching/burning stage, you may be able to limit its development and speed up the healing process. Our guide to how to get rid of a cold sore as quickly as possible covers simple tactics that you can use to quickly control an HSV-1 outbreak.
All in all, it usually takes two to three weeks for an HSV-1 outbreak to completely heal. While the average person only experiences one outbreak per year, it’s possible for outbreaks to occur on a more frequent basis if you have a weak immune system or other health issues.
The most popular treatment for dealing with HSV-1 outbreaks is the use of antiviral drugs such as valacyclovir, which can play a role in speeding up cold sore healing and suppressing HSV-1 within your body.
On average, people with symptomatic HSV-2 experience four to five outbreaks per year. Just like with HSV-1, this can vary. Some people may experience more than five outbreaks, while others with HSV-2 may rarely experience outbreaks or be completely asymptomatic.
Also like with HSV-1, HSV-2 outbreaks tend to be worse during the first year of infection, as the body’s immune response often requires time to fully develop.
Outbreaks of HSV-2 involve the formation of herpes lesions on and around the genitals, on the upper thighs, and on the buttocks. Outbreaks can be “triggered” by external factors such as sun exposure, stress, illness or even the use of unrelated medication.
If you have symptomatic HSV-2, you’ll likely be able to recognize your triggers and risk factors over time. For many people, avoiding common herpes triggers is enough to make outbreaks a less frequent occurrence.
It’s important to know that not all genital herpes is caused by HSV-2. HSV-1 can also spread to the genitals through oral sex, meaning that if you have infrequent outbreaks of genital herpes, it could potentially be the result of an HSV-1 infection.
Like HSV-1, outbreaks of HSV-2 heal faster if they’re treated early. Most outbreaks last for two to three weeks, with early treatment and your body’s immune response reducing the amount of time required for the herpes sores to close over and completely heal.
Just like it’s best to avoid kissing when you have an outbreak of oral herpes, it’s best to abstain from sexual activity during an HSV-2 outbreak, as this is, by far, when you're most contagious. Our guide to sex with herpes covers everything you need to know about limiting your risk of infecting others with genital herpes.
As with other forms of the herpes virus, the most popular treatment for outbreaks of HSV-2 is the use of oral antiviral medication like valacyclovir, which can manage herpes symptoms and reduce your risk of transmitting the virus to other people.
The majority of herpes infections, of both HSV-1 and HSV-2, are asymptomatic. This means that you can be infected with the herpes virus and have viral DNA in your body without any visible or detectable symptoms.
People with asymptomatic herpes can still spread the virus to others, but they don’t experience any cold sores or genital herpes lesions.
Sometimes, people with asymptomatic herpes might experience an initial outbreak of cold sores or genital herpes, only to have the virus “disappear” after the first outbreak. In this case, herpes is still present in the body, but simply remains inactive and doesn’t produce further outbreaks.
It can be hard to know whether or not you have asymptomatic HSV-1 or HSV-2, or simply have infrequent herpes outbreaks. However, if you’re confident you have herpes but haven’t had an outbreak for several years, it’s likely that you have an asymptomatic infection.
Even if you’re asymptomatic, it’s still important to take precautions against spreading herpes to other people. Herpes remains in the body even if you don’t have any symptoms, creating a risk that you could spread the virus through kissing, oral sex or other sexual activity.
If you have asymptomatic herpes, the best approach is to speak to your doctor about treatment options and the use of suppressive therapy to reduce your risk of infecting others.
Herpes outbreaks can range from a minor inconvenience to a major annoyance. Outbreaks of genital herpes can be particularly frustrating, as they can have a major effect on your personal relationship with your partner or partners.
Luckily, herpes is relatively easy to treat using modern medication. Most doctors recommend the use of antiviral medication like valacyclovir, which prevents the herpes virus from growing within the body.
During an outbreak, this can prevent viral replication and speed up healing. Between outbreaks, the use of antiviral drugs can prevent “viral shedding” and reduce your risk of passing on herpes to other people through oral or sexual contact.
Want to learn more about treating herpes? Our comparison of valacyclovir, acyclovir, famciclovir and other herpes drugs explains how modern herpes medicine works, why it’s effective and how you can use it to minimize the negative effects of HSV-1 or HSV-2 outbreaks.