How can herpes be transmitted?

The facts about herpes transmission are clear:

Herpes is passed directly from the affected area of skin (which could be the genitals, face or hands), by direct skin to skin contact, with friction, when the virus is present. (See also asymptomatic shedding, below.) It may come back at or near the place the virus was caught. That means that when you catch it genitally, It does not travel through your body and appear on your face; it won’t be in your saliva.

Herpes simplex gets in easily through mucous membranes, i.e. the moist skin inside the mouth and genital-anal area. Sometimes it gets into ordinary skin, on other parts of the body, if there is a cut or break in the skin. This can be on the fingers/hands, knees, etc. But this is only if these come into direct contact with the affected area of another person. A finger sore is called a herpetic whitlow.

Click on: Transmission the basics

Oral sex, when the virus is active on the face, allows the virus to be passed from the face of one person to the genitals of another. Or if one person has it genitally, oral sex will mean it is possible for a partner to catch it on the face.

You can pass it on from the affected area, when the virus is present on the skin surface. This means herpes transmission is possible from the first warning signs that a recurrence is starting. They can be tingles, burning skin sensations, aches, stabbing pains. And on, until the time when there are sores or blisters, until they have healed and fresh skin has grown back.

This two-page summary covers the basics.

About six in ten adults by age 25 carry herpes simplex virus type 1 ^{[4] [5]} and one in ten carries type 2.^{[6] [7]} Even more people carry herpes simplex virus in older age groups – but most don’t know. Only around one in three of those infected – with either type – is aware of this.

It is rare for people to re-catch a virus that they already have for a second time – even on a different part of the body. Their immune system defends them against this. The virus does not travel through the body.

I have genital herpes, can I do oral sex?

A person with a genital infection can kiss or perform oral sex – there is no risk of infecting a partner by doing this; the virus will not travel inside the body from the genitals to the mouth.

How can I protect my new partner? My partner has oral herpes and I have genital herpes. How likely am I to infect my new partner? See the video clip on transmission when a partner has it, further down.

Already, you are a safer partner than many others because you have been diagnosed so you will avoid sex from the moment you notice the start of an outbreak, until the time when it has totally cleared up. A man with genital herpes can protect a partner easily if his outbreaks appear in the area covered by a condom. (See next section.)

A woman with genital herpes can tell a man that he is half as likely to catch genital herpes from a woman, compared to the chance of a woman catching it from a man. This information can be useful for diagnosed women when talking to a new partner.

Antiviral tablets taken daily should prevent outbreaks, make a big reduction in asymptomatic shedding and make passing the virus to a partner very unlikely

Herpes simplex infections are common. Many new partners will have one or both types already but not know. See the government’s statistics for new genital herpes infections diagnosed in clinics in 2019 – and add a further 53,000 cases which how many are probably diagnosed by GPs each year.

Don’t have sex from the first warning signs that a recurrence is starting (tingles, burning skin sensations, aches, stabbing pains).  Wait until the skin has healed and fresh skin has grown back.

How can I protect my partner from herpes? Can using a condom prevent herpes transmission?

Yes, it can make a big difference. Herpes simplex virus cannot get through a condom. Put the condom on the penis before it touches the partner’s sensitive (genital) skin. If the virus is active on the skin outside the area covered by the condom, herpes transmission may still happen.

And you might choose to take antiviral pills to prevent recurrences and shedding. See the page on Treating herpes.

This sometimes happens but is not likely. When the virus is inactive (dormant) inside the nerve cells it cannot be caught by a partner. If there is virus on the skin surface where you get your symptoms, it may be passed on.

Click on: Asymptomatic shedding

Before the outbreak begins, there may be a tingly or itchy feeling at the place where this will happen. This tells you to stop having sex. And this means that diagnosed people are less likely to pass it on when there is nothing to see on the skin, because they are usually well aware of these prodromes (the warning feelings). Whereas undiagnosed people often ignore highly infectious and obvious symptoms, because they do not know what these are. When you have these sensations, you are not “asymptomatic” as you can feel something: you should not have sex at this time.

Asymptomatic shedding means “without sensation” and a scientific test can find virus on the skin when the person feels nothing. This applies to type 2. Type 1 doesn’t ‘like’ the genital region and is less likely to recur and to shed asymptomatically. This happens only in some people, mostly in the first six months. After a year or so, if a person is not having many episodes, they will rarely have virus on the skin without symptoms. “Many episodes”: expert doctors say this is more than 6 recurrences a year.

Will a blood test detect herpes?

An antibody test (blood test) might show that your partner has already caught one of the herpes simplex viruses. But all these tests, whether you get them from a clinic or off the internet, are very unreliable and results should be treated with caution. The Food and Drug Aministration, the governement organisation in the USA tasked with authorising medicines and tests, has asked doctors not to use an antibody test.

the If the test shows your partner has antibodies, there is a 1 in ten chance this is wrong. If it correct, it means the partner will have either total or partial protection against herpes transmission. Subscribers can request our leaflet explaining the antibody test in full.

We often hear that “I have genial herpes and my partner has facial herpes, what does this mean for us?”

When you and your partner have the same virus you will not give it back to each other – even on a different part of the body, you will not catch it back yourself on a different part of your body. [It’s like: “If you had chickenpox with a few spots on your face, you don’t need to worry that your legs will catch chickenpox.”]

Click on: Transmission – if my partner has it already?

If you have caught a genital infection from a partner’s genitals, they will not catch the virus back on their face.

If you have caught a genital infection from a partner’s facial cold sores, they will not catch the virus back on their genitals.

And also:

If you have caught it on your face from your partner’s genitals, then they will not catch it on their face if they do oral sex on you.

If you have caught it on your face from your partner’s facial cold sores, then they will not catch it on their genitals if you do oral sex on them.

Read more about protecting a partner from genital herpes in the herpes transmission leaflet, free to subscribers. The information is posted or sent by email.

A two-page summary on herpes transmission is available.

If your new partner has had cold sores in the past, this either means that they have the same herpes virus as you, or will have the other type (there are only two types of herpes simplex). When you both have the same type, it is highly unlikely that either of you will reinfect the other – anywhere on the body. If you have different types and either of you catches a second type, symptoms will probably be slight or non-existent. This is because the antibodies for one type will have some immediate effect on the other type as well. It is called ‘partial protection’.

Your partner could be one of the ‘two out of three’ people with herpes simplex who have it so mildly they do not realise. So they could have sex when the virus is active. Mild symptoms can appear as a pimple, a little cut or an itchy bit of skin and yet these are very infectious. In fact, this is often when herpes transmission occurs. When people with these mild symptoms learn to recognise them, then they can avoid sex at these times. Another possibility is that your partner does not have herpes simplex and you caught it from a previous partner. It is possible to have a ‘first’ outbreak many years after first catching it.

No, you will not catch it off anything. The virus is caught from the skin, not from objects. It is a delicate virus and dies quickly when away from the skin where the sore is. There is more about transmission in our “Transmission” leaflet – choose it when you subscribe. This statement is taken from the guidelines for doctors produced by the British Association for Sexual Health and HIV.

Click here for a video of Marian’s comments.

No – this will not happen. Parents do not need to worry about passing on their genital herpes to children because it is caught through direct skin contact with the affected place when symptoms are present and not from hands or objects. Even sharing a bath with small children is not a problem because herpes simplex virus is not transmitted in water. (See here for pregnancy and childbirth – which is a different issue.)

Parents do not pass on genital herpes to their children through the normal activities of family life. Do not allow a fear of herpes transmission to get in the way of ordinary family touching, hugging, sharing, etc.

Beds: herpes simplex virus is never transmitted on sheets.

Is herpes on my laundry? No – it dies too fast. You can wash clothes together in the same machine, even when a person has a recurrence.

Bathing or showering together will not transmit herpes simplex virus – the same is true for Jacuzzis and swimming pools. A child brushing against your upper thighs or abdomen while you have a recurrence won’t catch the virus.

Even if you have used the toilet or you have touched the genital area and forgotten to wash your hands, this is not a problem. This virus is fragile and dies when it leaves living cells.

Washing with ordinary soap and water is clean enough – there’s no need to use any special hand or toilet seat sanitisers.

Children do all sorts of odd things that you can’t anticipate, but even if they put your worn knickers on their head they are not going to contract the herpes virus – relax and laugh with them. (We thank the New Zealand Herpes Foundation for this last example!)

If a person with a cold sore on the mouth does oral sex he or she can give his/her partner ‘cold sores on the genitals’ which is genital herpes. Also, cold sores on the face may be caught from someone with genital herpes through oral sex.

Only the face of a person with cold sores is infectious – so they can have sex, but should not kiss or do oral sex when they have a cold sore. See the description of the two types.

You will find Herpes Simplex – the Guide booklet (16 pages, 6,000 words) useful too.

Mouth to mouth kissing cannot give anyone genital herpes.

Studies have shown that virus may sometimes be found on an infected area, even when there are no visible symptoms. This is called asymptomatic shedding. If enough virus is present when direct skin contact (sexual contact) takes place, a partner may become infected.

The fewer recurrences a person has, the less chance there is of asymptomatic shedding.

Asymptomatic shedding tends to decline with time. It may happen during the first year and is much less likely after that.

The virus most often transmitted during the first months of a new relationship. But partners can be together for years without the virus passing from one to the other. Studies have shown that a majority of people catch it from someone who does not know that he or she has got this virus. Asymptomatic shedding is something that people find difficult to understand – there is a lot more detail in the transmission leaflet you can choose when you join (you decide if you want it sent by post or by email).