Differentiating the two can be important as the treatment approach for each can differ significantly.
Beyond the location of the outbreak, the symptoms of HSV-1 and HSV-2 are largely indistinguishable.
This can only be done with diagnostic testing.
Illustration by Tara Anand for Verywell Health
One key difference between HSV-1 and HSV-2 is the risk of recurrence.
All herpes viruses tend to recur (repeat) after the initial outbreak, often within the first year.
In contrast, recurrence is common with HSV-2.
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If left untreated, some people may experience recurrent outbreaks anywhere from one to 12 times per year.
As with VZV, HSV-1 and HSV-2 are never cleared from the body after the infection.
It is then that the virus can be transmitted (passed) to others through close physical contact.
This is known as asymptomatic shedding.
With HSV-2, high rates of shedding can occur years after the first outbreak.
Shedding with HSV-1 tends to wane quickly, and it becomes less transmissible.
How Common Is HSV-1 and HSV-2?
The prevalence of both increases with age.
HSV blood testing may be useful if:
Treatment
HSV-1 and HSV-2 are both treated withantiviral drugs.
The same may not be true if you have genital herpes.
Condoms provide only partial protection as the virus may be shed through skin not covered by the condom.
Even so, HSV-1 is increasingly linked to genital herpes due to oral sex.
While the symptoms of HSV-1 and HSV-2 are indistinguishable.
HSV-2 is more likely to recur and cause high levels of viral shedding years after the initial infection.
This is why screening is recommended for all people with genital herpes symptoms.
The differentiation of HSV-1 and HSV-2 can influence the treatment plan, especially when there are frequent recurrences.
Frequently Asked Questions
Yes.
World Health Organization.Herpes simplex virus.
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Sauerbrei A.Optimal management of genital herpes: current perspectives.Infect Drug Resist.
2016;9:129-141. doi:10.2147/IDR.S96164
Centers for Disease Control and Prevention.Genital herpes CDC detailed fact sheet.
2018;(304):1-8. doi:10.1002/14651858.CD010095.pub2
Centers for Disease Control and Prevention.Fact sheet for public health personnel: condom effectiveness.
