Have you ever noticed the distinction people make between a cold sore and herpes?
When someone mentions cold sores, there is a general feeling of empathy, a double-take at the unsightly sore, or reassurance that it’s a mere association with a cold or the flu.
When kids learn about herpes in school, it usually comes with the stigma of a dirty, sexually transmitted disease that can only be avoided through abstinence.
This socially constructed division between cold sores and herpes is evident, and I’ve met many people who balk at the mention of herpes but simply shrug at cold sores, as if there’s a stark difference in the severity, transmission, or cause between the two.
As much as we would like to keep this finite separation between the cold sores and herpes, they are actually one in the same. It’s time to end the herpes taboo and end this perplexing division. Changing the perception of a disease is integral to helping those affected by it to live more normally and confidently, without adversity or shame.
So let’s talk about herpes.
What is herpes?
Herpes is a highly contagious virus related to the chicken pox virus. Herpes comes in two forms called serotypes; these are Herpes Simplex 1 (HSV-1) and Herpes Simplex 2 (HSV-2).
HSV-1 most commonly causes a facial lesion known as a cold sore, which is a painful blister-like bump near the mouth. HSV-2 most commonly causes genital herpes, which is usually a cluster of painful blisters on or near the genitals.
The symptoms for both HSV-1 and HSV-2 can be treated with medication, but there is no cure. Once someone gets herpes, infection is for life.
Just like chicken pox can reoccur later in life as shingles, herpes can reoccur later in life as well. It’s usually reactivated during or after stressful situations like illness, sun burns, or high stress/tension from work or school.
Fortunately, symptoms are usually mild or nonexistent. During symptomatic occurrences of herpes like cold sores and genital herpes outbreaks, people are usually advised to refrain from engaging in usual skin-to-skin contact with other non-infected people to avoid the spread of disease.
However, transmission often occurs without symptoms. The absence of symptoms helps the virus spread to others because the infected person might not even know they are infected! After infection, symptoms might not appear until months or years later, which can make it really hard to pinpoint how one actually got the virus.
How is it related to public health?
Imagine a virus that spreads through normal bodily contact and stays in an infected person for the rest of their life. The virus can move silently through a population while never causing a single symptom, or it can cause multiple outbreaks in an individual. There’s no cure for it, and treatment is the only option for managing the disease.
Sounds like a pretty efficient virus, right? Yes, herpes has been successful for as long as it’s been around. Children used to get HSV-1 on their face through all the dirty, rambunctious child play that attracts strange, contaminated things to their mouths. But thanks to improved hygiene and living environments, less children are getting herpes.
Instead, children are now more likely to grow up herpes-free but tend to encounter it once they become sexually active. The World Health Organization (WHO) estimates that over half a billion people between 15-49 years of age have genital herpes caused by either HSV-1 or HSV-2.
Regardless of whether an individual gets herpes at an early age or once they are sexually active, the peculiar divide between oral and genital herpes still exists, as well as the stigmatization that comes with each.
The WHO estimated that two-thirds of the global population under the age of 50 has HSV-1 alone (that’s about 3.7 billion people). That’s quite a revealing statistic. A person should not be ashamed of having herpes, just like a person is not ashamed of having chicken pox or the flu. It’s simply a virus that gets around, and it will continue to spread as long as people do what people do, like kiss and copulate. And it will certainly continue to spread until we come up with a cure and/or a vaccine to prevent it from occurring (it’s in the works, folks).
Ultimately, a cold sore isn’t better or worse than genital herpes. They are the same virus, just placed in different regions of the body. Stigmatizing someone for having a cold sore or genital herpes is detrimental to their wellbeing, their social and mental health, and their self-confidence.
Educating youth about the entire disease and its symptoms (or lack thereof), could be helpful to end the stigmatization that we see today. Furthermore, education about communicating with partners can help heighten awareness prior to making intimate decisions.
On that same note, communication with health providers should be encouraged in youth and adults. Likewise, health providers should be open to this communication and avoid the immediate assumption of risky behavior. Health professionals need to create a safe environment where they and their patient can communicate freely, without the concern for judgement or chastisement.
Until we have a cure, practicing simple things like acceptance, empathy, and understanding will help to bridge the gaps between this herpetic division. We shouldn’t be the ones to judge or shame anyone. Besides, you never know if you might have the silent master of disguise residing in your own body, just waiting for its opportunity to start with one little lesion, one little blister…
Photo credit to Vivianna Mauro.