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Live healthy: Living with Herpes simplex

There are two types of herpes simplex virus, type 1(HSV1) and type 2 (HSV2). Cold sores or fever blisters are usually caused by type 1 while type 2 is more often associated with genital herpes.

Herpes simplex 1 & 2 present as blisters on the skin and genitals.
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How herpes simplex is spread

The virus is spread by skin or mucous membrane (the thin moist lining of many parts of the body such as the nose, mouth, throat and genitals) contact with infected saliva. People with a history of cold sores may shed the virus in their saliva even without a blister being present. Sometimes these viruses can cause infections of the eyes, hands or brain and may cause severe illness in pregnant women or people whose immune systems are weakened.

Signs and symptoms

The most common symptoms of infection by herpes simplex virus type 1 (HSV1) are cold sores. These are ulcers of the skin or mucous membranes.

Although HSV1 infection can occur at any age, most people get their first infection in early childhood; frequently symptoms are mild or non-existent. After the first infection, the virus remains latent (resting) in nerve cells in the brain or spinal cord and is present for life.

If the virus becomes active again, it results in cold sores which are painful, clear blisters with a red base usually visible on the face or lips. Symptoms of a breakout include tingling, itching and pain at the site. The blisters crust and heal within a few days. Physical or emotional stress, sunlight, a viral infection or hormonal changes can all trigger the virus to become active again.


Herpes simplex virus infection can be diagnosed by scraping the base of the cold sore and examining cells under the microscope, by growing the virus, or by a PCR (polymerase chain reaction) test in a pathology laboratory. Blood tests are not usually helpful in diagnosis. Incubation period, the time between becoming infected and developing symptoms is two to 12 days. The infectious period when an infected person can infect others with HSV1 or HSV2 is most likely when a blister or cold sore is present.


Topical therapy (cream or ointment) is available through pharmacies without a prescription. Oral (by mouth) antiviral therapy is restricted to severe cases and requires a doctor's prescription. The cost of prescriptions may be covered by various types of insurance benefits.


  • Young children unable to follow good hygiene practices should be excluded from childcare, preschool or school while the cold sore is weeping
  • Cold sores should be covered with a dressing where possible
  • Follow good hand washing techniques
  • Do not kiss on or near the cold sore
  • Do not perform oral sex if cold sores are present
  • Do not share food or drink containers
  • Dispose of used tissues correctly.

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