Herpes viral shedding means that the herpes virus — both HSV1 and HSV2 — can be present on the surface of the skin even when no visible signs or symptoms of a herpes outbreak are present. (Genital HSV-1 sheds less than genital HSV-2; download the “Disclosure cheat sheet” from the herpes resources page for specifics on the percent of days that virus is shedding depending on the strain and location.) Studies have shown that within the first few months of initial herpes exposure, the rate of viral shedding is much higher than after the body has a chance to build up a tolerance to the herpes virus through antibodies in the bloodstream. An average of six months after the first herpes outbreak, viral shedding is said to occur around 5-20% of the time, depending on what study you read. Shedding virus doesn’t necessarily mean that there is enough virus to be passed to a partner. Mayo Clinic experts have determined that around 70 percent of all cases of genital herpes were acquired when an infected partner showed no physical signs or symptoms, but when HSV was actively shedding. Visible herpes outbreaks are the result of herpes virus shedding to the point that adds up to the outbreak.
Where does viral shedding happen? If you’ve had a herpes outbreak, then it’s safe to assume that herpes viral shedding happens right around that general location. That’s because how the virus comes to the surface of your skin from the base of your spine is through your nerves. Once there is a pathway that has been paved for the virus after a few outbreaks, the virus tends to take that path of least resistance (but not always) whether it’s for viral shedding purposes or full-fledged herpes outbreaks. If you haven’t had an active herpes outbreak and you found out that you have HSV-1 or HSV-2 through a herpes blood test, then there’s no telling where the virus might be shedding from. Best thing to do when disclosing to a potential partner is tell them you are a carrier of HSV, but haven’t had an actual herpes outbreak.
How can genital herpes be spread?
Herpes can only be passed when the contagious area comes into direct skin-to-skin contact with a mucous membrane or a break in the skin. In many instances, the location of the occurrences will stay in the same area time after time, so if that location is covered by a condom, the chances of spreading the virus are much less. However, some people’s herpes locations are in areas that a condom cannot cover. More >
Michelle Landry talks about living with herpes in this interview on the Tyra Banks show. Her confidence in herself and not allowing the herpes virus to overshadow her value is beautiful to see. What if the whole herpes community could treat herpes for really what it is? A simple, manageable virus? Thank you, Michelle, for your bravery in being so public about it and spreading the positive message instead of the virus. More >
Genital herpes is caused by HSV (Herpes Simplex Virus). There are two types of herpes simplex viruses: HSV-1 and HSV-2. HSV-1 generally prefers the area around the mouth (also referred to as “cold sores” or “fever blisters”) and HSV-2 generally prefers the genitals (also referred to as genital herpes). These two virus types belong to the much larger herpes virus family, which includes other viruses such as chicken pox and Mononucleosis. More >
Sometimes it’s hard to find herpes facts from reputable, trusted sources. When first diagnosed with the news, it’s a mad scramble all across the internet to find any sort of useful information that tells you that you’re okay or that normalizes herpes for you. More >
When people hear “What is herpes?” most immediately think of genital herpes specifically. But herpes is a large family of viruses including cold sores, genital herpes, mononucleosis and even chicken pox! The two strains of viruses that can manifest as genital herpes are HSV1 (the strain that causes oral cold sores) and HSV2. For the most part, HSV2 is the strain that manifests as genital herpes, but HSV1 can show up on the genitals, too. You can get genital herpes from oral sex. These herpes viruses are transmitted only via skin-to-skin contact. There are many herpes myths that abound. Genital herpes is a sexually transmitted virus. The herpes virus doesn’t have to be visible on the skin as an outbreak in order to pass it on due to viral shedding. The good news is that herpes isn’t really that big of a deal as far as physical symptoms are concerned. “Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection.” (CDC) A lot of people experience shame (especially when disclosing “I have herpes“) with a herpes diagnosis thanks to the strong herpes stigma that’s pervasive in our culture. That’s why the herpes opportunity was created. (How can herpes possibly be an opportunity?)
I’m not really sure if I have herpes. How can I know for sure?
Before you consider getting a blood test for herpes, if you are having an active expression of something resembling a herpes outbreak (bumps, lesions, sores, etc.), the absolute best way to know for sure if you have herpes or not is to get it cultured (swabbed with a Q-tip and tested) by your doctor. This is the best way because it comes straight from the source. A blood test (aside from it taking around 3 months for herpes antibodies to build to detectable levels) will simply tell you if you have HSV-1 or HSV-2 (or both). It won’t tell you in which location the virus might express itself (orally or genitally or neither — 15-20% of people never have an active herpes outbreak, but herpes viral shedding does still occur).
The IgG Blood Test for Herpes
The most well-known blood test called the IgG test. This herpes test looks for antibodies in the blood that would be present to specifically combat the herpes virus. This test can tell you which type of herpes you have, whether HSV1 or HSV2 (either can show up on either the lips or genitalia, but 1 prefers oral and 2 prefers the genitals).
But the tests need time from herpes exposure to test in order for the antibodies to build up in the blood to be detectable. Here’s a quote from the ASHA message boards: “The challenge here is that the time it takes for IgG antibodies to reach detectable levels after initial infection can vary from person to person. For one person, it could take just a few weeks, while it could take a few months for another. So even with the accurate tests, a person could receive a false negative if the test is taken too soon after contracting the virus. For the most accurate test result, it is recommended to wait 12 – 16 weeks from the last possible date of exposure before getting an accurate, type-specific blood test in order to allow enough time for antibodies to reach detectable levels. False positives are rare with type-specific blood tests when used in this manner.”
The Western Blot Blood Test for Herpes
There is also another blood test called the Western Blot that is even more definitive than the IgG, but less accessible. Here’s what the University of Washington has to say (they lead in administering the Western Blot):
“The HSV Western blot uses HSV-1 and HSV-2 proteins which have been separated by size so that type-specific antibody profiles can be recognized with a specificity of >99% . This method may be used to distinguish maternal from infant antibody profiles and to distinguish serum and cerebrospinal fluid profiles of HSV antibodies. This test has been exhaustively validated in studies of well-characterized patient populations. It is the current gold standard HSV serology and provides a highly accurate confirmatory test for positive results by ELISA.”
From the University of Washington FAQ page:
How is HSV diagnosed?
There are three common ways HSV infections can be diagnosed. One way is by a visual examination conducted by a health care provider. This diagnosis should always be confirmed by a lab test. The “gold standard” to diagnose herpes is through a herpes culture, but the result can be negative even though someone has HSV. A positive culture should identify whether the infection is HSV-1 or HSV-2. Finally, blood tests can detect antibodies to HSV. The antibodies may not develop until two months after someone has become infected. The Western Blot, the most accurate of these blood tests, is done at the University of Washington.
Where can I get tested?
You can have your blood tested with a Western Blot at the University of Washington Virology Lab. To do this, have your health care provider call #206-598-6066 to request the HSV Type-Specific Serology information packet. Other accurate tests for HSV-2 may also be available through your local healthcare provider.
Get the herpes facts. All you see here comes from reliable herpes sources.
- Over 25 million Americans (and counting) have genital herpes
- If you do the math at 16.2% of Americans ages 14 to 49 having herpes (CDC) and multiply that by how many people are in the US (around 311 million according to the latest US census, of which 49.2% are ages 14-49), the number of Americans with genital herpes is around 25 million. There are 776,000+ new herpes cases yearly (that’s 2,000+ new herpes cases daily). More >
What is a genital herpes sore?
If you’ve ever had or seen a cold sore/fever blister (which 80% of Americans age 14-49 have), that’s what it looks like “down there,” too (which 16% of Americans age 14-49 have). Herpes sores show up as small pustules, usually as a small cluster. Most of the time they show up in the same general area for each herpes outbreak. The pustules eventually scab over as the healing process continues.
Common questions about genital herpes:
- What are the symptoms of genital herpes?
- For some, a cluster of blisters forms on the genitals; others may never get any physical symptoms but could still put their sexual partners at risk of getting herpes. Some people claim to feel a “tingling” on the genitals before a herpes outbreak that signals that the virus is preparing to surface. Some feel a tingling in their calf, thigh, buttocks or lower back regions because the virus uses the nerve ganglia as its method of travel from the base of the spine (where it hibernates) to the skin (see herpes prodrome symptoms).
- How can I spread herpes?
- Herpes can only be spread when the contagious area comes into direct skin-to-skin contact with a mucous membrane or a break in the skin. In many instances, the location of the herpes outbreaks will stay in the same area time after time, so if that location is covered by a condom, the chances of spreading the virus are much less. However, some people’s herpes locations are in areas that a condom cannot cover.
- Can I spread herpes even when I’m not having a herpes outbreak?
- Physical signs of herpes don’t have to be present in order for to pass the virus to your partner. This is known as “viral shedding,” when the virus is silently active, which occurs 5-10% of the time. You can never know for sure when shedding is occurring, although some claim they get the same tingling sensations as though an outbreak were about to happen but never does.
- I’m not really sure if I have herpes. How can I know for sure?
- There is a definitive test called the IgG test that looks for antibodies in the blood that would be present to specifically combat the herpes virus. This test can tell you which type of herpes you have, whether HSV1 or HSV2 (either can show up on either the lips or genitals, but 1 prefers oral and 2 prefers genitals).
- I’m feeling really alone. What can I do?