Asymptomatic Herpes: What You Need to Know

Whether it happened during the kissing and cold sores portion of Sex Ed or several bases later during your first outbreak, most people never forget learning the herpes simplex virus is incurable.

Look, our immune systems are incredible things — they can take an STI (sexually transmitted infection) and fight pretty hard against whatever ulcers or lesions come with it. But so-called recurrent genital herpes (also known as an HSV-2 infection or genital HSV infection) isn’t going anywhere.

Luckily, suppressive therapy can help protect your sexual partners. Antiviral medications and antiviral therapy can reduce your incidence of outbreak and your risk of transmission. But even if the meds are working, and even if you have no symptoms, you can still spread herpes simplex virus (HSV) type 1 and 2.

Worried about getting herpes? Just had your first episode and scared you’ll never be intimate again? Relax. We’ve covered the facts about asymptomatic herpes below, including how common it is, how contagious it is and what to do if you think you have it.

Herpes is, unfortunately, one of the most common viral infections in people — more than half of adults under 50 are infected with the HSV-1 type of herpes. On top of that, an estimated 13 percent of people aged 15 to 48 are infected with the HSV-2 virus, according to WHO (World Health Organization) data.

Symptoms of herpes typically occur in an initial outbreak, followed by subsequent outbreaks.

Initial herpes and cold sore outbreaks are often characterized by itching and burning around the genitals or mouth. Blisters can form in the affected area within 24 hours and develop open, fluid-filled sores at the site of the herpes outbreak.

But here’s the thing: Not everyone with herpes will experience symptoms.

According to research on neonatal herpes simplex virus infection passed from pregnant women to babies, 75 to 90 percent of people with genital herpes aren’t actually aware they’re infected. Why? They never develop visible herpes sores and suffer very mild symptoms — if any.

One of the most common herpes-related questions is whether it’s possible to be infected with the herpes virus without ever experiencing symptoms. We think this really speaks to how surprised many people are to hear about asymptomatic shedding.

Genital herpes and oral herpes are contagious without active sores or symptoms of the virus. And since many people don’t even know they’re carrying the virus, it’s arguably more common not to experience any symptoms of herpes than it is to have a symptomatic infection.

While some folks mistake this as an immunity to herpes, that’s not how it works.

Those with asymptomatic herpes infections may not experience symptoms, but they’ll still likely test positive for the virus and can spread it to other people through oral-to-oral or sexual contact. Though the risk of virus transmission is lower in asymptomatic people, “shedding episodes” can occur.

And for the record, there’s no “How to prevent viral shedding” guide here — because you can’t. There’s always a chance of viral shedding from herpes, even if you’re an asymptomatic carrier of the virus.

If you think you might have asymptomatic herpes, speak to your healthcare provider about testing options and find out as soon as you can.

Your healthcare provider will schedule a blood test or another test based on when you think you were exposed to the virus.

The most accurate testing method for asymptomatic patients is an IgG (immunoglobulin) test. The IgG test checks for IgG antibodies in your blood, which can signal a herpes infection. These antibodies can take months to form after a herpes infection, so you’ll typically need to wait at least 12 to 16 weeks before testing to ensure accurate results.

In the meantime, you may be wondering whether a condom is adequate protection. Though you may not spread the disease while wearing a condom, herpes often spreads to and from other parts of the genital area.

The best solution is a combination of condoms and medication, according to the CDC (Centers for Disease Control and Prevention).

Treatment medications like valacyclovir and famciclovir can treat genital herpes by reducing the virus’s ability to reproduce.

Learn more about how fast valacyclovir works, the valacyclovir transmission rate and the difference between valacyclovir and acyclovir on our blog.

We also have tips for safely having sex with herpes.

A genital herpes infection can feel like the end of the world for your sex life. But the reality is, the prevalence of sexually transmitted infections is pretty high, and — as long as you’re careful and honest — you can still have a rewarding and happy sex life.

That said, it’s crucial to carefully manage sexually transmitted infections like  herpes before, during and after sexual activity.

Here’s what to remember:

• The oral and genital herpes simplex virus types are extremely common, as are asymptomatic genital herpes and oral herpes.

• Various antiviral medications can help minimize the severity and frequency of outbreaks. But they don’t reliably prevent HSV-1 infection or HSV-2 infection, according to the CDC.

• To protect your partners and yourself, medication, condom use and testing are the best triple-threat defense.

• If you think you might have contracted herpes from penetrative sex, oral sex or another type of sexual activity, contact a clinician or another healthcare provider to schedule a test.

Want more help? Our sexual health resources are a great way to learn the difference between HSV-1 and HSV-2 and how herpes medication like valacyclovir works.