Why Herpes Can Recur and How to Prevent and Treat It

Herpes is a common sexually transmitted disease (STD) that can cause a variety of uncomfortable symptoms. While herpes is not curable, it can be managed with antiviral medications. Treatment can help improve your quality of life, prevent herpes recurrences, and help prevent you from spreading it to sexual partners. 

However, many people experience recurrences, sometimes years after the initial infection.  

What Is Herpes?

Genital herpes is a common STD caused by the herpes simplex virus (HSV). HSV is categorized into two types: herpes simplex virus-1 (HSV-1) and herpes simplex virus-2 (HSV-2).

Herpes affects millions of people worldwide. In the United States, about 47% of people aged 14–49 have HSV-1, while 11% of the same group have HSV-2, as estimated using 2015–2016 data from the National Health and Nutrition Examination Survey (NHANES).

There are some important differences between HSV-1 and HSV-2:

Herpes symptoms can be managed with antiviral medication. When left untreated, herpes can cause serious complications, such as aseptic meningitis—inflammation of the membranes that cover the brain and spinal cord.

Why Does Herpes Cause Repeated Outbreaks?

Herpes can’t be cured, meaning the virus is always present in your body. It can remain dormant—or inactive—for long periods of time, sometimes years. However, triggers like menstrual periods, infections, stress, and even sunlight can cause the virus to become active again. This is called herpes recurrence. For this reason, periodic outbreaks of HSV are common, especially HSV-2 infections. 

Recurrent infections are usually milder than the initial infection and tend to become less frequent over time. People with weakened immune systems are especially at risk of herpes recurrences. 

How to Prevent a Herpes Recurrence

According to the American Sexual Health Association (ASHM), HSV-2 infections recur about four to five times per year on average while HSV-1 infections usually recur less than once per year.

Although herpes isn't curable, medication and self-care measures can help reduce your risk of a herpes recurrence. They include:

• Antiviral medications (suppressive therapy): Antivirals are medications used to treat viral infections. They work by attacking the herpes virus, preventing its ability to multiply. Common antivirals used to treat herpes include acyclovir, famciclovir, and valacyclovir.
• Avoiding known triggers: If there are certain factors that trigger your herpes, such as UV light, avoid or limit your exposure to them if possible. 
• Reducing stress: Too much stress can trigger herpes recurrence and can affect your body’s ability to fight the infection.
• Getting enough sleep: The CDC recommends getting at least 7 hours of sleep per night in order to manage stress levels and promote optimal immune function.

How to Manage a Herpes Recurrence

The prevention steps above can also be used to manage a herpes recurrence. Additional steps include:

• Counseling: Talking to a licensed therapist or joining a support group can help you manage the emotional stress you may experience during a herpes recurrence. 
• Care for sores: Washing sores with warm, soapy water and then patting them dry may provide soothing relief to the infected area and help sores heal. Cool compresses can help soothe the area.
• Take pain-relievers: Pain-relievers like acetaminophen or aspirin can help relieve symptoms like swelling and pain. 
• Wear-loose fitting underwear: Wearing loose-fitting, breathable cotton underwear can help reduce herpes-related pain. Wearing loose-fitting clothing can help, too. 
• Avoid direct skin-to-skin contact during outbreaks: You are most contagious when you have sores and can easily pass the virus to your partner. You should also avoid sharing personal care items like towels when you have an active infection.
• Avoid sexual contact: If you have open sores, it’s important to refrain from sexual contact, including oral, anal, or vaginal sex.

Taking care of your health by following a nutritious diet, getting enough sleep, managing stress, and staying active can help keep your immune system strong and help you feel better both physically and mentally during a herpes recurrence.

A Quick Review

Herpes is a common sexually transmitted disease (STD) caused by the herpes simplex virus (HSV).

Once you contract herpes, it never goes away. The virus lies dormant in your body but can be reactivated by triggers like illness, having your period, sunlight exposure, and stress. This is why herpes recurrences are common.

Although herpes isn't curable, antiviral medications and self-care measures like managing stress can help prevent a herpes recurrence. You can also manage a herpes recurrence by caring for open sores and getting emotional support from a therapist. 

Avoiding direct skin-to-skin contact during outbreaks can help protect others and prevent the spread of herpes.