If my partner and I both have HSV-1 and HSV-2, will having sex cause more outbreaks?

Dear Reader, 

It’s good that you’re considering how to keep you and your partner safe! Herpes simplex virus (HSV) is a lifelong diagnosis. Because of this, you and your partner are likely to experience occasional flare-ups from your initial infections. However, if either you or your partner have a flare-up, you can’t spread it to the other during sex. Rather, these flare-ups are usually triggered by stress, illness, or friction. That also means that if you both have both kinds of herpes, you can’t trigger an outbreak in another part of your partner’s body. Continue reading to learn more about HSV viruses, transmission, prevention, and treatment.  

What is HSV-1 and HSV-2? 

HSV-1 and HSV-2 can both cause blisters or sores on the skin. HSV-1 spreads orally and mostly causes infections around the mouth and sometimes the genital area. HSV-2 is spread through sexual contact and causes infections in the genital area. Neither can be cured, but they can be treated and managed in most cases. 

Common symptoms for HSV-1 and HSV-2 include:  

• Fever
• Muscle pain
• Itching
• Headache
• Cold sores (blisters) and open sores (ulcers) in the genital or oral area
• Tingling, itching, or burning near areas where sores later appear  

List adapted from World Health Organization 

Symptoms can be mild to more severe, and these infections can recur over time.   

If you’re HSV-positive, can having sex with an HSV-positive partner cause a flare-up?  

The answer is a bit nuanced. Sex can trigger a flare-up because friction in the genital area can cause irritation. That’s why you might notice that you and your partner are having flare-ups after sex with each other. However, flare-ups are due to the sex itself, not because your partner also has herpes. 

That said, merely having sex with a HSV-positive partner won’t guarantee a flare-up if you already have the virus.  

What are factors that can cause a flare-up? 

If you have herpes, the virus stays in your body and can be triggered after your initial outbreak. Some people very rarely, if ever, have flare-ups. Those who do experience flare-ups usually find them to be less severe than their original outbreak. Some factors that cause a flare-up include:  

• Stress
• A weakened immune system from illness
• Menstruating
• Friction in the genital area, from tight clothing or sex
• Surgery in the genital area
• Sun exposure  

List adapted from World Health Organization and UK National Health Services  

Can the virus spread to other areas of your body? 

The sores experienced from HSV are concentrated orally (around the mouth or lips) and on or near the genitals or anus. Though outbreaks mostly affect the same area as the initial infection, the virus can spread on its own to other locations during an active flare-up. In rare cases, the virus can spread to the buttocks, lower back, and back of the legs.   

Severe HSV-1 or HSV-2 can lead to infections in the eye or nervous system. It’s recommended to have routine visits with a health care provider to keep your infection in check. 

If you are HSV-positive, can having sex with a HSV-positive partner spread the virus to another part of your body?   

If you and your sexual partner already have the same type of virus, it’s incredibly rare to contract it from them on another part of your body. Your body already has antibodies that defend against the virus and keep you from catching it again. So, for example, if you and your partner both have HSV-2 and you’re performing oral sex on them, it’s very unlikely that you will spread the virus to your face.  

If you and your partner have different types of the virus, you can still transmit it to each other during an active flare-up. However, you’ll probably have mild symptoms, or none at all. That’s because the antibodies for HSV-1 and HSV-2 are very similar, so you’re partially protected from the other version of the virus if you’re positive for one.  

What are treatment options for HSV-1 and HSV-2?  

There are two main ways to treat HSV-1 and HSV-2: taking medicine only when symptoms appear or taking it every day to reduce how often outbreaks happen. Both approaches use antiviral medication, usually starting with the first infection. 

If you’re experiencing a flare-up, antiviral medication can decrease symptoms and shorten the length of the flare-up. There are also ways to manage a flare-up at home, including:  

• Applying petroleum jelly or painkilling cream to the genital area
• Using an ice pack wrapped in cloth over the infection
• Pouring water over your genitals while peeing, if you’re experiencing painful urination 

List adapted from UK National Health Services  

There are ways to maintain a healthy sexual relationship with your partner if you both have HSV. Keep these safety practices in mind and consult with a health care provider to make sure you only scratch the itch you want!