Sore subject: Herpes isn't a Greek god


When I was a freshman in college, my fellow pre-med friend, George, pointed at my face and laughed. I asked him what was so funny. He chanted, "You've got a herpes, you've got a herpes..." and did a funny bunny-like dance.

The classroom erupted in laughter as I defended myself, "It's a zit!" (This preceded Seinfeld's famous rejoinder, "It was a scratch, not a pick," when his girlfriend caught him touching his nose in the car.)

So why was I so embarrassed over this cold sore? For starters, my parents never let me share glasses or silverware, or greet other people with a kiss on the lips because they didn't want me to get a cold sore. So to me, herpes was something to be embarrassed about.

It goes beyond embarrassment. Herpes can weaken the immune system and can allow HIV to enter the body more easily. Pregnant women with herpes can give their newborns potentially blinding and fatal conditions. But let's backtrack a minute.

There are two types of Herpes Simplex Viruses: HSV-I (cold sore) and HSV-II (genital herpes). They sound like car models: "I drive the 4-wheel HSV– I and can't say enough about it. It's a mouthful." However, about 10-20 percent of the time, each type of herpes can show up on the "wrong part of the body": HSV-I on the genitals, HSV-II on the face.

Shockingly, studies have shown that depending on the population sample, 45 to 98 percent of adults have HSV-1 antibodies. This means it's likely that even those who have never had a cold sore have been exposed to HSV-I. Not everyone who has herpes will have an outbreak of blisters. Whether a cold sore will pop up is as good a guess as Dionne Warwick's predictions.

Forty to sixty million North Americans have HSV-II antibodies, meaning they have been exposed to HSV-II. "Genital herpes" is the most widespread STD in the world: 25-35 percent of sexually active adults are affected.

Here's the scary fact: about 40-60 percent of people with herpes don't know they have it. You might ask how anyone could not know they have painful blisters that take at least two weeks to heal. "Was he in a coma? Was she at Mardi Gras?"

It is believed that not everyone has a breakout of blisters when contaminated with herpes, and only about one-third of people who do have an initial breakout will have future outbreaks. So some lucky people never have a breakout. Others didn't know what the blisters were and did the ostrich maneuver: head in sand.

You can close your mouth now. It's shocking to know that herpes is so prevalent and you might actually be a carrier. People with HSV can break out with blisters years, even decades, after exposure– a fact which has unfortunately ruined many relationships.

I have had married or partnered patients who broke out with herpes blisters and were subsequently accused of infidelity. I have treated people who for genital herpes from oral sex, touching the mouth lesion and then the genitals, etc. The emotional and psychological stress that occurs in these situations is horrible.

Can you prove someone has been unfaithful? Not really, but in general the first outbreak after initial exposure is huge: fever, blisters that light up the Eastern Seaboard fever, and the person feels really ill. Down-the-road outbreaks tend to be more mild.

Herpes is not a popular dinner-table topic. It ranks up there with politics, religion, and Gigli. So next time you're having dinner and say, "Pass the peas," see if they're his peas, your peas, or herpes.

In all seriousness, check my webpage under and look for herpes if you want more information.

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