Herpes Viruses: HSV, Varicella-Zoster, and Their Lifelong Impact

Herpes viruses are a group of highly contagious viruses that stay in the body for life after infection. The most well-known are Herpes Simplex Virus (HSV) and Varicella-Zoster Virus (VZV), which cause conditions like cold sores, genital herpes, chickenpox, and shingles. These viruses can remain dormant in the nervous system and reactivate under stress, illness, or immune suppression.

Types of Herpes Viruses

1. Herpes Simplex Virus Type 1 (HSV-1) – Causes cold sores (oral herpes) but can also infect the genitals.
2. Herpes Simplex Virus Type 2 (HSV-2) – Primarily causes genital herpes but can also infect the mouth.
3. Varicella-Zoster Virus (VZV) – Causes chickenpox (Varicella) and later shingles (Herpes Zoster).

Other herpes viruses exist, but HSV and VZV are the most common in daily life.

How Do You Get Herpes Viruses?

Herpes viruses are highly contagious and spread through direct contact.

HSV-1 (Oral Herpes) Spreads Through:

• Kissing or close skin contact
• Sharing drinks, utensils, lip balm, or razors
• Oral sex (can cause genital herpes)

HSV-2 (Genital Herpes) Spreads Through:

• Unprotected sexual contact (vaginal, anal, or oral sex)
• Skin-to-skin contact with infected areas
• From mother to baby during childbirth

Varicella-Zoster Virus (VZV) Spreads Through:

• Airborne transmission (coughing, sneezing from chickenpox patients)
• Direct contact with chickenpox or shingles blisters
• Mother-to-child transmission during pregnancy

Once infected, the virus never leaves the body and can reactivate later.

What Happens If You Get a Herpes Virus?

Each herpes virus behaves differently in the body.

Herpes Simplex Virus (HSV-1 and HSV-2) Symptoms:

• Painful blisters or sores on the mouth (cold sores) or genitals.
• Tingling or burning before an outbreak.
• Flu-like symptoms (fever, swollen lymph nodes) in first-time infections.
• Recurring outbreaks triggered by stress, illness, or fatigue.

Varicella-Zoster Virus (VZV) Symptoms:

• Chickenpox (Primary Infection): Itchy red spots that turn into blisters, fever, fatigue.
• Shingles (Reactivation): Painful rash on one side of the body, nerve pain, burning sensation.

After chickenpox, VZV remains dormant in nerve cells and can reactivate years later as shingles.

Complications of Herpes Viruses

While usually mild, herpes infections can cause serious complications in certain people.

• Neonatal Herpes – A life-threatening condition if HSV is passed to a newborn.
• Herpes Encephalitis – A rare but deadly brain infection.
• Shingles Complications – Postherpetic neuralgia (long-term nerve pain).
• Increased Risk of Other STDs – Genital herpes makes it easier to contract HIV.

How Are Herpes Viruses Diagnosed?

Doctors diagnose herpes based on symptoms, physical exams, and lab tests.

• PCR Test – Detects herpes virus DNA from a sore or blood sample.
• Blood Test (HSV IgG Antibody Test) – Identifies past herpes infections.
• Tzanck Smear Test – A skin test for active herpes lesions.

Shingles is usually diagnosed based on rash location and pain symptoms.

Can Herpes Viruses Be Treated?

There is no cure for herpes viruses, but antiviral medications can reduce symptoms and outbreaks.

For HSV (Cold Sores & Genital Herpes):

• Acyclovir, Valacyclovir, Famciclovir – Reduce outbreak severity and frequency.
• Lysine supplements & stress management – May help prevent outbreaks.
• Topical creams (Docosanol, Acyclovir ointment) – Speed up healing for cold sores.

For Varicella-Zoster Virus (Chickenpox & Shingles):

• Acyclovir, Valacyclovir – Shorten shingles duration if taken early.
• Pain relievers & numbing creams – Help manage nerve pain from shingles.

How Can You Prevent Herpes Infections?

While herpes viruses cannot be completely prevented, you can reduce the risk of infection.

Preventing HSV-1 & HSV-2:

✅ Use condoms & dental dams to reduce genital herpes transmission.
✅ Avoid kissing or oral contact during outbreaks.
✅ Don’t share drinks, lip balm, or utensils.
✅ Pregnant women with herpes should talk to their doctor to prevent newborn infection.

Preventing Chickenpox & Shingles:

✅ Get the Chickenpox (Varicella) Vaccine – Highly effective in preventing chickenpox.
✅ Get the Shingles Vaccine (Shingrix) – Reduces shingles risk by 90%.
✅ Avoid close contact with people who have active chickenpox or shingles.

Myths vs. Facts

❌ “You can only get herpes from sex.”
✅ HSV-1 can spread through casual contact like kissing and sharing drinks.

❌ “If you don’t have symptoms, you can’t spread herpes.”
✅ Many people shed the virus without symptoms (asymptomatic shedding).

❌ “You can’t get herpes from oral sex.”
✅ Oral herpes (HSV-1) can spread to the genitals through oral sex.

❌ “Only old people get shingles.”
✅ Anyone who had chickenpox can get shingles, even in their 30s or 40s.

Final Thoughts

Herpes viruses are highly contagious and lifelong, but manageable with medication and prevention. While HSV-1 and HSV-2 cause painful sores, they don’t affect overall health in most people. However, shingles can be painful and lead to complications, so vaccination is recommended for older adults.

If you experience frequent cold sores, genital herpes outbreaks, or signs of shingles, talk to your doctor about treatment options.

Want to Learn More?

• CDC – Herpes Simplex Virus – Facts about oral and genital herpes.
• CDC – Varicella-Zoster (Chickenpox & Shingles) – Vaccine and prevention info.
• WHO – Herpes Viruses – Global herpes research and data.