Infections - Bacterial & Viral
Herpes Simplex (HSV-1 / HSV-2)
Cold sores; genital herpes
Very common; most adults carry HSV-1
Yes — through direct skin and mucous contact
Not curable, but very manageable
What Is It?
Herpes simplex is a common viral infection that causes clusters of small, painful blisters. HSV-1 usually causes cold sores around the mouth; HSV-2 usually causes genital sores — though either type can appear in either place. After the first infection the virus stays dormant and can reactivate, causing recurrences that are usually milder and shorter.
Signs & Symptoms
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Tingling or burning before blisters appear
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Clusters of small, painful blisters that crust over
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Cold sores on the lips (HSV-1) or genital sores (HSV-2)
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First episode may include fever and swollen glands
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Recurrences are usually milder and heal in about a week
Why Does It Happen?
HSV spreads through direct contact with a sore, saliva, or genital secretions — and can spread even when no sores are visible. After infection, the virus lives quietly in nearby nerves and can reactivate with triggers like stress, illness, sunlight, or a weakened immune system. It is very common and NOT a reflection of hygiene.
Treatment Options
Antiviral medicines shorten outbreaks and can be taken at the first sign of a flare or daily to prevent recurrences. Treatment also lowers the chance of spreading the virus.
EPISODIC ANTIVIRALS
Started at the first tingle to shorten an outbreak.
SUPPRESSIVE ANTIVIRALS
Taken daily to reduce frequent recurrences and lower spread.
COMFORT CARE
Pain relief, cool compresses, and gentle skin care.
REDUCE SPREAD
Avoid contact with sores; don't share utensils or lip products.
Tips for Managing It at Home
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Start antivirals at the first tingle for best effect
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Avoid kissing or oral/genital contact when sores are present
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Use sunscreen/lip balm if sun triggers your cold sores
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Tell partners and use protection; spread can occur without visible sores
When to Call Your Provider
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Frequent or severe outbreaks affecting daily life
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Sores near the eyes or eye pain (urgent)
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A first genital outbreak, or outbreak during pregnancy
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You have a weakened immune system or eczema with spreading sores
Sources & further reading
The information in this handout is based on general dermatology guidance from the reputable organizations below. These links are provided for patients who wish to read more from trusted sources.
American Academy of Dermatology (AAD). Herpes Simplex. https://www.aad.org/public/diseases/a-z/herpes-simplex
Centers for Disease Control and Prevention (CDC). Genital Herpes. https://www.cdc.gov/sti/about/about-genital-herpes.html
DermNet. Herpes Simplex. https://dermnetnz.org/topics/herpes-simplex
This handout is for general education and does not replace advice from your own provider. Always follow your provider’s specific instructions.
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