Herpes simplex virus (HSV) is one of the most common viral infections worldwide, yet it remains surrounded by misinformation and misunderstanding. Two main types exist — HSV-1 and HSV-2 — and both can cause oral or genital infection, though they differ in their most typical presentation patterns.
Misconceptions about herpes contribute to unnecessary stigma and may discourage individuals from seeking testing. In reality, symptoms vary considerably between individuals, and many people who carry the virus experience mild or no symptoms at all.
This article addresses the most common herpes myths vs facts, explains the differences between HSV-1 and HSV-2, and clarifies how laboratory testing provides accurate confirmation of infection status.
Quick Answer: What Are the Most Common Myths About Herpes?
Common myths suggest herpes only affects certain groups, always causes visible sores, or can be diagnosed by appearance alone. In reality, herpes simplex virus (HSV) is common, may cause mild or no symptoms, and requires laboratory testing for confirmation. Understanding accurate medical information helps reduce stigma and misinformation.
Herpes Myths vs Facts at a Glance:
- •Myth: Herpes always causes visible sores — Fact: Many people have mild or no symptoms
- •Myth: HSV-1 is “oral only” — Fact: Both HSV-1 and HSV-2 can affect oral or genital areas
- •Myth: You can diagnose herpes by appearance — Fact: Laboratory testing confirms infection
Many individuals with HSV are unaware they carry the virus.
What Is Herpes Simplex Virus (HSV)?
Herpes simplex virus (HSV) is a viral infection that exists in two main types. HSV-1 is traditionally associated with oral infections, commonly presenting as cold sores around the mouth and lips. HSV-2 is more commonly associated with genital infection. However, both types can infect either the oral or genital region.
Once acquired, the virus remains in the body. It resides in nerve cells and may become periodically active, sometimes producing symptoms and sometimes remaining dormant. Many individuals who carry HSV experience mild symptoms or none at all, and may be unaware of their infection status without laboratory testing.
HSV is transmitted through direct skin-to-skin contact with an infected area. The virus is common across all demographics and age groups, and its presence does not indicate anything about an individual’s lifestyle or behaviour.
HSV-1 vs HSV-2: What’s the Difference?
While HSV-1 and HSV-2 are closely related viruses, they have traditionally been associated with different sites of infection. Understanding the distinction between HSV-1 vs HSV-2 helps clarify common misconceptions about how each type presents.
- •HSV-1: Most commonly associated with oral cold sores. It is typically acquired during childhood or adolescence through non-sexual contact. However, HSV-1 can also cause genital infection, usually through oral-genital contact
- •HSV-2: More commonly associated with genital herpes. It is typically transmitted through sexual contact. HSV-2 can, in rarer cases, cause oral infection, though this is less common
Both types can infect either location, and transmission patterns are not as fixed as commonly believed. The distinction between HSV-1 and HSV-2 relates to the virus type rather than the body site it affects. Laboratory testing can identify which type is present, providing clearer information about the infection.
Cold Sores vs Genital Herpes: Are They the Same Virus?
In many cases, yes. Cold sores are most commonly caused by HSV-1, and genital herpes can be caused by either HSV-1 or HSV-2. The distinction between cold sores vs genital herpes is primarily about the location of the infection rather than a fundamentally different virus.
Cold sores typically appear as small blisters around the mouth and lips. Genital herpes presents as similar sores in the genital or anal area. The symptoms can overlap, and the appearance of sores at either site may be similar regardless of which HSV type is responsible.
Because HSV-1 can cause genital infection through oral-genital contact, the traditional separation between “oral herpes” and “genital herpes” is less clear-cut than often assumed. Laboratory testing is required to confirm which virus type is causing the infection, as visual assessment alone cannot reliably distinguish between them.
Myth: Herpes Always Causes Visible Symptoms
One of the most persistent misconceptions about herpes is that it always produces obvious, visible sores. In reality, a significant proportion of individuals who carry HSV experience no recognisable symptoms or have symptoms so mild they go entirely unnoticed.
Mild irritation, slight tingling, or minor skin changes may occur but are often attributed to other causes such as skin sensitivity or friction. Without recognisable sores, many people do not associate these signs with herpes infection.
Additionally, asymptomatic viral shedding means the virus can be present on the skin surface and potentially transmissible even when no visible lesions exist. This is why relying on the presence of sores as an indicator of infection is unreliable. Routine laboratory testing may detect infection even when no symptoms are present.
Myth: Herpes Is Rare
HSV is not a rare infection. HSV-1 is one of the most common viral infections globally, with a large proportion of the adult population estimated to carry the virus. HSV-2 is also widely prevalent, particularly among sexually active adults.
Many HSV infections remain undiagnosed because they produce no symptoms or only mild signs that are not recognised as herpes. This means that the actual number of people carrying the virus is likely to be higher than the number of confirmed diagnoses.
Stigma surrounding herpes can contribute to reluctance around testing and open discussion. However, the widespread nature of the virus means that infection is a common occurrence rather than an exceptional one. Accurate medical information helps contextualise HSV as a manageable viral infection rather than a condition defined by stigma.
Herpes Transmission Facts
Understanding how herpes is transmitted helps address common misconceptions and supports informed decision-making about sexual health. The following herpes transmission facts clarify the primary routes and correct frequently repeated inaccuracies:
- •Skin-to-skin contact: HSV is transmitted through direct contact with an infected area. This includes kissing (for oral herpes) and sexual contact (for genital herpes)
- •Oral, vaginal, or anal contact: The virus can be transmitted during any form of sexual contact involving skin-to-skin or mucous membrane exposure
- •Transmission without visible sores: Asymptomatic viral shedding means the virus can be present on the skin surface and potentially transmissible even when no active outbreak is occurring
- •Not spread through casual contact: HSV is not transmitted through toilet seats, swimming pools, shared towels, or casual non-intimate contact. The virus requires direct skin-to-skin contact with an infected area
A herpes test can confirm whether HSV-1 or HSV-2 is present, using swab testing of active lesions or blood tests for antibodies.
Can You Diagnose Herpes Without Testing?
No. Visual assessment alone cannot reliably confirm a herpes diagnosis. Sores, blisters, and skin irritation in the oral or genital area may resemble herpes but can also be caused by other conditions, including contact dermatitis, bacterial infections, or other viral infections.
Laboratory testing provides the confirmation needed for an accurate diagnosis:
- •Swab testing: During an active outbreak, a swab of the affected area can detect HSV DNA and identify the virus type. This is most effective when sores are fresh and active
- •Blood tests: Blood tests detect antibodies to HSV-1 or HSV-2, indicating whether the body has been exposed to the virus. These tests can be used when no active lesions are present
Laboratory confirmation removes uncertainty and provides clear, type-specific information. This is particularly important because management approaches may differ depending on the virus type and location of infection.
Herpes Management: What Medical Guidance Focuses On
For individuals diagnosed with HSV, medical guidance typically focuses on understanding the infection, monitoring symptoms, and reducing the risk of transmission. The following areas are commonly addressed:
- •Symptom monitoring: Understanding what constitutes an active outbreak and recognising early signs can help individuals manage their condition. Outbreaks may become less frequent over time
- •Reducing transmission risk: Awareness of asymptomatic shedding and understanding transmission routes supports informed decision-making about sexual health and partner communication
- •Antiviral medication: Antiviral medications may be prescribed by an appropriate clinician to manage outbreaks. Prescribing decisions are made separately from the testing service
- •Testing and counselling support: Accurate diagnosis through laboratory testing, combined with clear medical information, supports individuals in understanding and managing their infection
HSV is a manageable condition. While the virus remains in the body, many people experience infrequent or mild symptoms, and accurate information helps reduce the psychological impact often associated with diagnosis.
Should You Get Tested for Herpes?
There are several circumstances in which herpes testing may be a relevant consideration:
- •Presence of sores: Blisters, sores, or unusual skin changes in the oral, genital, or anal area may warrant laboratory investigation to determine whether HSV is responsible
- •Exposure concerns: If there has been sexual contact with an individual known to carry HSV, testing can clarify infection status
- •Partner diagnosis: If a partner has been diagnosed with herpes, testing provides clarity about one’s own status and supports informed discussion about risk
- •Routine sexual health screening: Herpes testing can be included as part of a broader sexual health screen for individuals who wish to have a comprehensive understanding of their infection status
A comprehensive STI screening panel can include herpes testing alongside other common infections, providing a thorough assessment from a single visit.
We provide laboratory-based STI screening. Treatment arrangements are managed separately if required.
People Also Ask
Is HSV-1 the same as genital herpes?
HSV-1 can cause genital herpes, though it is most commonly associated with oral cold sores. The virus can be transmitted to the genital area through oral-genital contact. Both HSV-1 and HSV-2 can infect either the oral or genital region, and laboratory testing is required to identify which type is present.
Can you have herpes without symptoms?
Yes. Many people who carry herpes simplex virus experience no noticeable symptoms or have symptoms so mild they go unrecognised. Asymptomatic viral shedding means the virus can be present on the skin without visible sores. Laboratory testing is the only reliable way to confirm infection status.
Is herpes only spread during an outbreak?
No. Herpes simplex virus can be transmitted even when no visible sores or symptoms are present. This is known as asymptomatic viral shedding, where the virus is active on the skin surface without causing recognisable signs. Transmission risk may be higher during active outbreaks, but it is not limited to those periods.
Can cold sores be considered herpes?
Yes. Cold sores are typically caused by herpes simplex virus type 1 (HSV-1). They are a clinical manifestation of herpes infection, usually appearing around the mouth and lips. The term “cold sore” is a common name for oral herpes, and laboratory testing can confirm the specific virus type responsible.
Should you test if you think you have herpes?
Yes. Visual symptoms alone cannot reliably confirm herpes infection, as sores and irritation may resemble other conditions. Laboratory testing — including swab tests of active lesions or blood tests for antibodies — provides accurate confirmation and identifies the specific virus type.
This article is for general information. Laboratory testing is required to confirm any infection.
Ready to Book an Appointment?
Our team is here to help you with all your dental and medical needs.
For general information only — not a substitute for professional advice. In an emergency call 999, visit A&E, or call NHS 111.