Oral and genital herpes are recurring viral infections caused by herpes simplex virus (HSV). Oral outbreaks are commonly known as cold sores; genital infections can present with different findings. Below is general information about disease course, transmission, diagnosis and specialist referral pathways.
Herpes is most often due to HSV‑1 or HSV‑2. After first exposure the virus can remain latent in nerve cells and reactivate later, causing recurrent lesions. The initial episode is often more pronounced; repeat episodes tend to be milder. Frequency of recurrences varies with immune status and individual triggers.
Oral lesions usually appear as small blisters or crusted sores around the lips; genital infection can cause painful vesicles or ulcers. Many people experience prodromal symptoms such as tingling, itching or local sensitivity before lesions appear. Systemic signs—fever, swollen glands or fatigue—may occur, especially with a first episode. Newborns and immunocompromised individuals can have more severe courses and need prompt evaluation.
HSV spreads by direct skin or mucosal contact—kissing, oral sex, vaginal or anal intercourse are common routes. Asymptomatic viral shedding means transmission can occur without visible sores. Barrier methods like condoms or dental dams lower but do not eliminate risk. Avoid contact with active lesions, do not share personal items like lip balm or utensils during outbreaks, and maintain hand hygiene to reduce spread.
Diagnosis often begins with clinical examination; confirmation can use PCR or culture from a lesion and serologic (antibody) tests when appropriate. Primary care providers can assess most cases and refer to Dermatology, Infectious Diseases or Gynecology/Urology for complex situations. If a newborn shows signs of infection, or if someone develops high fever, neurological symptoms, or rapidly worsening illness, seek urgent medical evaluation.
Herpes during pregnancy requires coordination with prenatal care. Active genital lesions at delivery raise the risk of neonatal infection; individuals planning pregnancy or who are pregnant should inform their maternity team. Immunocompromised people and newborns need specialized assessment and close follow‑up.
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