Last updated: May 14, 2008
Herpes treatment can reduce outbreaks—and also help prevent transmission.
Genital herpes—a disease that can manifest in painful, itchy sores on the genitals—is caused by a virus and is one of the sexually transmitted diseases (STDs) that frightens people most. But in most cases, having herpes just means having an unpleasant skin condition—a surprisingly common one: About one in five American adults has the virus that typically causes genital herpes, though most of them don't realize it.

It's true that herpes is incurable, however, and that there's no foolproof way to prevent the possibility that you'll spread it to your partners.

The pain of herpes can be more emotional than physical
"I don't know why genital herpes has this pariah, fearful component to it," says H. Hunter Handsfield, MD, a clinical professor of medicine at the University of Washington in Seattle and a nationally recognized STD expert. "Herpes is, in fact, the same disease as our cold sores and fever blisters around the mouth, but we don't react emotionally the same way."

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He points out that "people are more afraid of herpes than they are of chlamydia, and in the long run chlamydia is more likely to cause serious damage to their reproductive and general health than herpes ever is."

Another sneaky STD
Like chlamydia, herpes usually doesn't announce itself. Experts advise looking at a new partner's genitals to make sure there are no signs of infection. But "most herpes transmission comes from people who are not having symptomatic outbreaks," says Jeanne Marrazzo, MD, an STD specialist at the University of Washington medical school.

The good news? "Most people who have the virus won't have recurrent outbreaks. In fact, most people won't have outbreaks at all. For some people, though, it's a really awful, symptomatic, recurrent thing," Dr. Marrazzo says.

New treatment options
There didn't used to be very much you could do about a herpes outbreak, other than to wait it out and take sitz baths. But now there are several antiviral drugs available that reduce the intensity and duration of symptoms, and, if taken daily, can also reduce the frequency of outbreaks. And in July 2006, the FDA approved Famvir as the first one-day treatment of symptomatic herpes.

Good news about transmission
If you're taking one of the antiherpes drugs now available, you're less likely to transmit the virus to someone else. (Condoms can help prevent transmission of the herpes virus, but they aren't 100% effective since the virus can be on parts of the genital area that are not covered.)

Dr. Marrazzo cites a study involving monogamous heterosexual couples in which one partner had herpes and the other didn't. They were followed for eight months. All were offered condoms. In the couples where the infected partner was given the antiviral drug, the rate of herpes transmission was 1.9%, compared to 3.6% in the couples that got the placebo.