Worried About Herpes(HSV1,2)? Common Myths That Fuel Your Anxiety

 

Before You Panic: Understanding Anxiety Symptoms

A significant number of people who visit the hospital with symptoms suspected to be HSV-1 or HSV-2 test negative.

If you're currently being tested for suspected HSV-1 or HSV-2 symptoms, or have just been diagnosed, you may be in a state of deep anxiety. In fact, related communities commonly show cases of people losing weight or suffering from insomnia due to severe anxiety and worry.

What I want to tell you is that this anxiety and worry can expose you to various health conditions, and these symptoms might make you suspect you have herpes HSV even before your test results come back.

Blood tests are highly reliable after 8-10 weeks, and PCR tests are effective when tested at the time symptoms like blisters are observed.

While it's difficult to present specific statistics, more than half of those who visited hospitals with suspected herpes symptoms and received test results were confirmed not to have herpes. Most of these cases were caused by eczema, allergic dermatitis, fungal infections (candida), or other STIs.

Severe anxiety and worry cause short-term immune system suppression.

In your heightened state of sensitivity, you become more acutely aware of sensations and skin abnormalities you wouldn't normally notice. Many people who ultimately received negative results reported experiencing intense nerve pain in the genital area (heavy pain like electric shocks), strange blisters on the skin, and genital discomfort while waiting for their test results. 

False pain caused by excessive worry is indeed real, and immune suppression can trigger dyshidrotic eczema (mainly on hands and feet), eczema, or other skin conditions, which can reinforce your conviction that you're infected with herpes.

The following are frequently mentioned questions or topics in the community.

I have blisters on my hands, feet, or back. Is this HSV-2?

For hands and feet, it's highly likely to be dyshidrotic eczema, and if blisters appear in a band-like pattern on the back or abdomen, it's likely shingles. Generally, HSV-2 does not appear on hands and feet, but primarily occurs around the anus, genitals, or buttocks, because the virus resides in the nerve ganglia in those areas. While there are occasional cases of HSV-1 appearing on fingers (reportedly dental workers sometimes get it), I'd like to mention that even these cases are uncommon. Cases of HSV-2 appearing on hands and feet are extremely rare, so even if you've found such cases, there's no need to associate them with your situation.

When should I get tested after suspected exposure?

If you have visibly observable blisters or rash symptoms, get a PCR test. Blood tests are generally recommended after 8 weeks, because it takes time for your body to form antibodies, and blood tests are the process of detecting whether these antibodies are present. Urine tests have slightly lower diagnostic accuracy unless your symptoms are in the urethra.

I tested positive on a urine test. Does this confirm I have herpes?

If you received a positive result, I can say the possibility is not low, but if you didn't have clear symptoms in your body, I recommend getting a blood test after some time has passed. Urine tests have somewhat lower diagnostic accuracy compared to blood or PCR tests.

I have rash symptoms on my genitals with stinging and pain. These are typical HSV symptoms.

While there are many asymptomatic herpes carriers, doctors say that generally blisters develop within 1-2 weeks after infection, and these initial symptoms cause severe flu-like symptoms and pain in the affected area. If you have wounds and rash symptoms on your genitals but no transparent clustered blister-like vesicles are observed, it's highly likely to be another condition. Herpes blisters typically occur in clusters, and while rare, one or two blisters can also be observed. However, one or two sporadic blisters can also occur due to friction near the genitals, unrelated to herpes.

Can HSV-1 and HSV-2 infect the lips or genitals simultaneously?

Once a virus establishes itself in one area, generally another virus doesn't infect that same area. In other words, it's not common for both HSV-1 and HSV-2 to occupy the genitals simultaneously, or for both to occupy the lips. However, this case does exist: HSV-1 on the lips and HSV-2 on the genitals.

In actual testing, "simultaneous detection of genital HSV-1 + HSV-2" is reported in approximately 2-3% or less of all genital herpes cases.

Recently, cases of HSV-2 on the lips and HSV-1 on the genitals are also being continuously observed, so you cannot definitively conclude that HSV-2 only infects the genitals and HSV-1 only infects the lips.

Can one virus cause outbreaks on both the genitals and lips?

I'd like to say this is also not common. It's possible at a low probability if your immune system is very compromised. If you're a carrier of genital HSV-1 and your partner carries HSV-1 on their lips, generally the likelihood of transmitting the virus to each other's respective areas is low. For this reason, people with genital HSV-1 can feel somewhat less burdened, because quite many people have HSV-1 on their lips.

The same applies to HSV-2. If you're infected with HSV-2 on your lips, the likelihood of it spreading to your genitals is low.

Can I get infected through simple physical contact with a carrier?

Almost none. While there are cases of transmission through simple contact among family members over decades or infections from using public bath facilities, they are nearly impossible to find. Unless it's a common case of simple contact like kissing (lip mucosa) or kissing the eyes or lips of young children with weak immune systems, transmission of herpes through simple physical contact is very rare. Infection mainly occurs through sexual activity (contact of fragile mucosal skin), and since the herpes virus only breaks out in specific areas, you can feel reassured as long as you don't directly contact these outbreak areas with vulnerable parts.

However, since herpes survives longer than usual in humid environments, it's best not to share towels or utensils immediately after use.

It generally doesn't transmit through sexual acts like handjobs 

I'm not a herpes carrier - can I prevent getting herpes from my partner?

Condom use and immune system management are most important. The mechanism of action of herpes antivirals like acyclovir or famciclovir requires the virus to already be established in the body, so taking these medications will not prevent you from getting herpes. These drugs have a different mechanism of action than HIV antivirals like Truvada. Therefore, you need to use condoms, check if your partner's body shows any herpes symptoms, and if your partner is a carrier, verify that they are properly following suppressive therapy.

Please refer to this post for information about herpes transmission probabilities.

Herpes 2 - Diagnosis and Disease Management of HSV-2

My herpes test result is negative, but the value is slightly high - what should I do?

Generally, these values can vary with each test. 

On the 1.0 index, the 0.1-0.4 range is very common, and occasionally some people consistently maintain the 0.5-0.6 range.

 On the 25 index, values below 1 are also uncommon, and values typically stay around 1-6, with 7-10 also frequently seen. If you got tested very early, 6-8 weeks ago, and your value is close to the borderline, follow-up monitoring seems necessary. However, if you get these values after 8 weeks have passed, you don't need to worry. There are also cases where values approach the borderline but don't convert to positive and gradually decrease instead.

However, if you consistently took multiple antivirals before the test, it could affect the test results. Therefore, when you need to get tested, you should not take herpes antivirals like acyclovir for several days.

Do I have to suffer severe pain and discomfort every time herpes occurs?

During the first year after initial herpes outbreak, pain and frequency are most severe, and transmission rates are also highest. However, as time passes, both frequency and pain gradually decrease. While cases vary among patients, this is generally true. In fact, it's not uncommon for people living asymptomatically despite being infected with herpes to accidentally discover they're carriers through testing. Therefore, even if you're infected with herpes and have experienced painful symptoms, you don't need to worry. Since this virus commonly breaks out whenever immunity weakens, through consistent immune management, exercise, and proper sleep regulation, you can enjoy a quality of life no different from others.

These herpes symptoms are accompanied by prodromal symptoms, and you can prevent herpes outbreaks by getting antivirals prescribed when prodromal symptoms occur, or by consistently taking medication through suppressive therapy. Additionally, since this herpes virus can also break out through friction in the affected area, for genital herpes, wearing clothing made of breathable materials with low friction is one good method.

If you still want to find other information, please also refer to the articles at these links.

Dating with HSV-2: When and How to Disclose to Your Partner

Herpes 2 - Diagnosis and Disease Management of HSV-2

Herpes Care Guide : Self-Care Guide for Herpes Management