HSV 1 vs 2: Differentiating Between the Herpes Types

Amoha Jha
Medically reviewed by
Dr. Kaushal

Review medical content on WOW Rx Pharmacy, so that accurate drug use information is easily accessible to everybody.
Dr. Akansha is a licensed Clinical Pharmacologist. She possesses remarkable knowledge in Pharmacovigilance, prescription analysis, drug information, and drug safety services. Additionally, she is a keen learner and an educator.

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hsv 1 vs 2

Herpes Simplex Virus (HSV) is recognized as the causative agent of a common STD, Herpes.

There are two types of HSV, i.e., HSV-1 and HSV-2. They can be understood depending on their distinct affected areas, symptoms, and complications.

HSV-1 is commonly called Oral Herpes, which generally infects the mouth and throat, whereas HSV-2 is recognized as Genital Herpes, as it infects the genital region.

However, in some cases, these HSV types can infect either the oral or genital region, resulting in difficulty in the diagnosis of Herpes.

Therefore, understanding the differences between HSV-1 and HSV-2 is necessary for reducing its transmission and proper diagnosis.

This comprehensive article will elaborate on a clear overview of HSV 1 vs 2 with their risk factors and treatment options.

Overview

The table below differentiates between HSV-1 and HSV-2 depending on their distinct characteristics. 

CharacteristicsHSV-1HSV-2
Other namesOral HerpesGenital Herpes
LocationMouth and throat, and sometimes genital areaSkin and mucous membrane of the genital region (vagina, penis, vulva, anus, cervix), and sometimes oral region
AppearanceCold sores form blisters on the lips, outside and inside the mouth. Blisters turn into sores filled with fluidSores in the genital region
Common signs and  symptomsSwelling and redness of gums, swollen neck glands, burning, tingling, and feverItching, tingling and burning sensation in the genitals, swollen glands, fever, difficulty and pain in urination
TransmissionKissing or oral sexOften from sores or blisters, sexual intercourse (vaginal, anal, and oral) and Intrauterine Insemination (IUI)
ComplicationsHerpes Simplex Encephalitis, Herpetic Gingivostomatitis, Herpes Simplex Keratitis, etc.Meningitis, other Sexually Transmitted Diseases (STDs), and Internal Inflammatory Diseases
Risk of occurrence and severityLess frequent and severe than Genital HerpesOutbreaks can frequently re-occur

About HSV 1 vs 2

HSV-1 is a double-stranded DNA virus that is responsible for primary and recurrent infections in the oral region, i.e., mouth and throat.

As per the World Health Organization, approximately 3.7 billion people under 50 worldwide, i.e., 67% of the world population, have HSV-1.

On the other hand, HSV-2, also a double-stranded DNA virus known to affect the genital region, can manifest as a primary or recurrent Herpes infection.

Almost 491.5 million people between ages 15 and 49, i.e., 13.2% of the world’s population, have HSV-2 infection.

While HSV-1 is more involved in affecting the oral region, HSV-2 is recognized to affect the genital area.

However, HSV-1 is less severe than HSV-2 in terms of risk of reoccurrence and shedding.

The virus-shedding phase is when the body produces infectious virus particles that can be transmitted to other people.

Did you know?
The prevalence of Genital Herpes is much higher in females than males.

Appearance

HSV-1 and HSV-2 may appear as sores in the mouth and genitals.

The sores usually appear as one or more blisters and are called outbreaks.

The blisters may break and cause painful sores that may take one or more weeks to heal.

Transmission

Sexual contactSource: Signature_images
Sexual contact

Generally, HSV-1 is recognized to be transmitted through kissing or oral sex, whereas HSV-2 through vaginal, anal, or oral sex.

However, in some cases, a person can acquire HSV-2 in the mouth by giving oral sex to another person infected with Genital Herpes.

Similarly, individuals can get HSV-1 in their genital area if a person with a cold sore gives oral sex to them.

Fact:
An infected mother can transmit Herpes to her child during childbirth if the virus is active during that time.

HSV 1 vs 2 symptoms

Checking her body temperatureSource: Kzenon
High fever(Symptom)

Generally, HSV-1 and HSV-2 do not cause any prominent symptoms after infections.

However, some common signs and symptoms of HSV-1 are:

  • Cold sores form blisters on the lips outside and inside the mouth
  • Blisters turn into sores filled with fluid
  • Swelling and redness of gums
  • Burning, itching, and tingling sensations
  • Flu-like symptoms, such as fever
  • Swollen neck glands

Further, common signs and symptoms of HSV-2 are the following:

  • Macular skin and mucous membrane lesions that progress to vesicles, pustules, and ulcers
  • Itching, tingling, and burning sensation in the genitals 
  • Swollen lymph nodes
  • Fever
  • Difficulty and pain in urination

As per a report, the frequency of recurrent Genital Herpes has been seen among 80% of individuals infected with primary HSV-2 Genital Herpes. However, this statistic is less than 50% in the case of primary HSV-1 Genital Herpes.

Risk factors

The HSV-1 virus has a wide variety of clinical presentations and risk factors associated with it, as in the following cases:

  • Orolabial Herpes: The major risk factor includes any activity that exposes one person to the infected saliva of another person, such as mouth-to-mouth contact
  • Herpetic Sycosis: It is also called HSV Folliculitis. It is a rare Herpes virus infection of the skin and hair follicles. The major risk factor of this condition is shaving closely with a razor blade in the presence of Orolabial infection
  • Herpes Gladiatorum: This is a skin infection, also called Mat Herpes, as it is especially found in high-contact sports players, such as wrestlers
  • Herpetic Whitlow: This condition is a kind of finger infection. Its main risk factor is common in children with the habits of finger-sucking and nail-biting
  • Herpes Encephalitis: It is a rare neurological disorder characterized by brain inflammation. The major risk for this condition involves mutations in certain genes and receptors
  • Kaposi Vricelliform eruption: It is a life-threatening skin barrier dysfunction. The major risk factors are mutations in genes and the use of topical calcineurin inhibitors

The risk factors for acquiring HSV-2 revolve around direct exposure to infected fluid during sexual intercourse.

Treatment options

There is no cure for Herpes. 

However, some antiviral medications treat symptoms of Herpes, such as sores and bristles.

The prescribed antiviral medications for this STD may include the following drugs:

  • Famciclovir
  • Acyclovir
  • Valacyclovir

These medications effectively heal the sores during primary outbreaks and lower the risk of recurrent outbreaks.

Warning:
HSV-1 and HSV-2 never leave or are cleared from the body. Rather, they embed themselves in the nerve cell and remain in the dormant stage until they get reactivated to cause a new outbreak. Thus, it is necessary to consult a doctor and seek medical treatment to prevent further outbreaks.

Further, they can lessen the severity of symptoms and reduce its transmission to a sexual partner.

Conclusion

There are two types of Herpes virus, i.e., HSV-1 and HSV-2.

HSV-1 is a double-stranded DNA virus that is recognized to affect the perioral region, whereas HSV-2 is known to infect the genital region.

HSV-1 can be transmitted through oral contact, while HSV-2 by genital contact. However, a person can acquire HSV-2 in the mouth by giving oral sex to an infected individual.

The common symptoms of HSV-1 include cold sores on the lips or inside the mouth, swollen gums, and lymph nodes, accompanied by a burning, tingling sensation.

On the other hand, HSV-2 can cause macular or papular skin that progresses into blisters and ulcers, fever, and painful urination.

Currently, there is no cure for Herpes. However, certain antiviral drugs, such as Famciclovir and Acyclovir, can be used to treat the symptoms of Herpes.

Recommended Article
Read Understanding the Genital Herpes Stages to get a comprehensive insight into distinct phases of the Herpes cycle.

Frequently Asked Questions

Is it better to have HSV-1 or HSV-2?

HSV-1 is less severe than HSV-2 in terms of recurrence and shedding. However, it is not safe to delay treatment based on the type of HSV causing Herpes. Therefore, consult a healthcare practitioner and seek prompt medical attention.

What are the differences in symptoms of HSV-1 and HSV-2?

Generally, HSV-1 causes cold sores in the mouth and lips, having symptoms like burning, tingling sensation, and flu-like symptoms. On the other hand, HSV-2 can cause burning, itchy, and tingling sensations in the genitals and painful urination. However, either HSV type can infect the oral or genital region.

Is HSV-1 more serious than HSV-2?

HSV-1 and HSV-2 are the causes of Oral and Genital Herpes. These conditions need equal medical attention for faster recovery and preventing transmission to other persons. Thus, seeking a proper diagnosis to detect the HSV type and seek medical treatment is necessary.

How do you treat HSV-1 and HSV-2?

There is no cure for HSV-1 or HSV-2. However, they can be treated with antiviral medications, which include Famiciclovir, Acyclovir, and Valacyclovir. These medications can heal the sores and lower the risk of recurrent outbreaks.

Citations:
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