Herpes (HSV)

Herpes (HSV) is a common viral infection caused by HSV-1 and HSV-2. Many people have no symptoms, while others notice tingling, burning, or clusters of blisters that ulcerate and heal. The best way to know is with the right test for the right situation.

If you have a new or recurring sore, the most accurate test is a swab of the lesion for HSV PCR/NAAT (detects viral DNA at that site). If you don’t have a sore but want to know your exposure or type, a type-specific HSV-1/HSV-2 IgG blood test can help. Early blood tests can miss new infections, so repeat testing is sometimes needed. These labs support screening (when appropriate)diagnostic triage, and monitoring, but they do not replace a clinician’s care, partner counseling, or emergency services.

Signs, Symptoms & Related Situations

  • Skin/genital/oral: tingling or burning, painful blisters/ulcers on lips, mouth, genitals, perineum, or anus; itching; fissures; crusting

  • Systemic: fever, swollen glands, body aches (often with first episode)

  • Neurologic (rare): severe headache, neck stiffness, confusion (medical emergency)

  • When to consider testing: new or recurrent sores, partner with HSV, uncertain diagnosis after “yeast/BV/UTI” treatments, pregnancy planning, or frequent “cold sores” with concern about type/location

  • Seek urgent care now: severe headache/neck stiffness, eye pain/redness with vision changes, severe dehydration, or rapidly worsening symptoms

Symptoms require evaluation by a qualified clinician.

Why These Tests Matter

What testing can do

  • Confirm active infection at a specific site (lesion PCR/NAAT)

  • Identify prior exposure and HSV type (type-specific IgG to HSV-1 and HSV-2)

  • Guide counseling on recurrence patterns, transmission risk, and pregnancy planning

What testing cannot do

  • IgG cannot date an infection or tell where it is (oral vs genital)

  • IgM testing is not recommended (poor accuracy and cross-reactivity)

  • negative early blood test does not rule out very recent infection—repeat may be needed

What These Tests Measure (at a glance)

  • HSV PCR/NAAT (lesion swab): detects HSV-1 or HSV-2 DNA from a fresh vesicle/ulcer; highest yield early in a new sore.

  • HSV culture (less sensitive): older method; may be used in select settings; sensitivity drops as lesions heal.

  • Type-specific HSV-1/HSV-2 IgG (blood): detects antibodies to glycoprotein G antigens; indicates past exposureand type.

    • Window period: antibodies often appear 6–12 weeks after infection; if exposure was recent, repeat at 12–16 weeks if the first test is negative.

    • Low-positive index values may need confirmatory testing/algorithmic review—discuss with your clinician.

  • Context tests (as directed): HIV and syphilis screening (coinfections and counseling), pregnancy testing (hCG) when relevant.

Quick Build Guide

Goal / Scenario Start with Add if needed
Active sore now Lesion HSV-1/2 PCR/NAAT(clinician-collected) Type-specific IgG later for typing history
No sore, want to know status Type-specific HSV-1/HSV-2 IgG (blood) Repeat IgG at 12–16 weeks if recent exposure
Unclear past diagnosis Type-specific IgG If low-positive, ask about confirmatoryapproach
Frequent “cold sores,” new genital symptoms Lesion PCR if a sore appears Type-specific IgG to clarify HSV-1 vs HSV-2 exposure
Pregnancy planning/partner has HSV Type-specific IgG Repeat later if exposure was recent; add STI screen per clinician
Severe/refractory symptoms Lesion PCR Broader STI panel; clinician evaluation for complications

How the Testing Process Works

  1. Match the test to your situation: sore present → lesion PCR; no sore → type-specific IgG blood test.

  2. Prepare correctly: no fasting required. For swabs, testing early in a fresh lesion improves accuracy.

  3. Provide samples: clinician-collected swab for lesion PCR; standard blood draw for IgG.

  4. Get secure results: most results post within a few days.

  5. Plan next steps: review with your clinician for counseling, pregnancy considerations, and partner discussion.

Interpreting Results (General Guidance)

  • Lesion PCR positive (HSV-1 or HSV-2): confirms active infection at that site and type.

  • Lesion PCR negative: may be too late in healing or a different cause; re-test early in a new sore if symptoms recur.

  • HSV-2 IgG positive: usually indicates anogenital HSV at some point; does not localize site.

  • HSV-1 IgG positive: common from childhood oral exposure; may be oral or genital—blood test alone cannot tell.

  • Negative early IgG with recent exposure: repeat at 12–16 weeks to rule out a new infection.
    All results should be interpreted with a qualified healthcare professional.

Choosing Panels vs. Individual Tests

  • Core choices:

    • Lesion PCR/NAAT when sores are present (preferred for diagnosis)

    • Type-specific HSV-1/HSV-2 IgG when no lesions are present or for exposure/type clarification

  • Add-ons (as indicated): HIV 4th-generationsyphilis tests, and other STI screens for comprehensive care

  • Not recommended: HSV IgM (low specificity and clinical value)

FAQs

What’s the best test if I have a sore right now?
lesion swab for HSV PCR/NAAT—it detects viral DNA and identifies type.

Can a blood test tell if my herpes is oral or genital?
No. IgG shows exposure and type (HSV-1 or HSV-2) but not the location.

How soon after exposure can a blood test detect herpes?
Antibodies often appear by 6–12 weeks; if you test earlier and it’s negative, repeat at 12–16 weeks.

Is HSV IgM useful?
No. IgM is not recommended due to false positives and cross-reactivity.

Can antivirals affect test results?
They can reduce shedding, which might lower swab/PCR yield if the lesion is old, but IgG results are not suppressedby short-term treatment.

Should people without symptoms get screened?
Routine population screening is not generally recommended. Targeted testing can help if you have a partner with HSV, recurrent/atypical symptoms, or you’re planning pregnancy—discuss with your clinician.

I’m pregnant—should I test?
Discuss with your obstetric clinician. Knowing type and history can help with counseling and delivery planning.

Related Categories & Key Tests

  • STD Tests Hub

  • All STD Tests • Chlamydia Tests • Gonorrhea Tests • Syphilis Tests • HIV Tests • Reproductive Health Tests

  • Key Tests: HSV-1/HSV-2 PCR/NAAT (lesion swab) • HSV-1/HSV-2 Type-Specific IgG (blood) • HSV Culture (select use) • HIV-1/2 4th-Generation Ag/Ab • Syphilis (RPR with confirmatory treponemal test)

References

  • Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines: Genital Herpes.
  • World Health Organization. Herpes Simplex Virus (HSV) fact sheet.
  • American College of Obstetricians and Gynecologists. Management of Genital Herpes in Pregnancy.
  • Infectious Diseases Society of America. Diagnostic testing guidance for STIs.
  • Clinical reviews on type-specific HSV serology (glycoprotein G) and limitations of IgM testing.
  • Laboratory best-practice summaries on lesion PCR vs culture sensitivity across lesion stages.

Available Tests & Panels

Your Herpes (HSV) Tests menu is pre-populated in the Ulta Lab Tests system. If you currently have a sore, plan for a lesion PCR/NAAT (often clinician-collected). If you do not have a lesion, choose type-specific HSV-1/HSV-2 IgG to clarify exposure and type, and repeat at 12–16 weeks if exposure was recent and results are negative. Use filters to add HIV and syphilis screening when appropriate. Review results with your clinician to plan counseling, partner discussions, and follow-up.

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The Herpes Simplex Virus 1 IgG Type-Specific Antibody HerpeSelect® Test detects IgG antibodies to HSV-1, the virus commonly associated with oral herpes. A positive result indicates past exposure, as IgG develops weeks after infection and remains for life. Doctors use this test to confirm HSV-1 infection, evaluate unexplained sores, or guide sexual health management. Results provide essential insight into infection history, immune response, and long-term HSV-1 status.

Blood
Blood Draw
Also Known As: Herpes 1 Test, Herpes 1 IgG Test, Oral Herpes Test

The Herpes Simplex Virus 1 and 2 IgG Type-Specific Antibody HerpeSelect® Test detects IgG antibodies to HSV-1 and HSV-2, distinguishing between the two types. A positive result indicates past exposure, as IgG develops weeks after infection and remains long-term. Doctors use this test to confirm herpes diagnosis, guide treatment, or support sexual health decisions. Results provide vital insight into HSV status, infection history, and long-term immune response.

Blood
Blood Draw
Also Known As: Herpes 1 and 2 Test, Herpes IgG Test

The Herpes Simplex Virus 2 (HSV-2) IgG HerpeSelect® Test with Reflex to HSV-2 Inhibition detects IgG antibodies specific to HSV-2, the virus causing genital herpes. The reflex inhibition assay confirms positive results, improving accuracy and reducing false positives. Doctors order this test to diagnose genital herpes, even in asymptomatic patients. Results help confirm infection status, guide counseling, and support treatment or management of HSV-2 and related complications.

Blood
Blood Draw
Also Known As: Herpes 2 Test, Genital Herpes Test

The Herpes Virus 6 DNA Test detects HHV-6 DNA in blood or tissue to evaluate active infection or viral reactivation. Human herpesvirus 6 is associated with roseola in children and has been linked to encephalitis, seizures, myocarditis, chronic fatigue, and transplant complications. This molecular test helps assess viral load, monitor disease progression, and guide evaluation of neurological and immunological conditions.


The Herpes Virus 6 IgG IgM Antibodies Test detects immune response to HHV-6, a virus linked to roseola and other illnesses. IgM antibodies suggest recent or acute infection, while IgG indicates past exposure or reactivation. This test supports evaluation of fever, rash, or neurologic symptoms and may help identify complications in immunocompromised patients, providing valuable insight into HHV-6 infection status and immune activity.

Blood
Blood Draw


The Varicella Titer Test is a blood test that measures antibodies to the varicella-zoster virus (VZV), which causes chickenpox and shingles. A positive result indicates past infection, while a negative suggests no exposure. This test is not considered reliable for confirming immunity from vaccination. Doctors use it to evaluate history of natural infection, meet school or work requirements, and provide documentation of varicella exposure status.

Blood
Blood Draw
Also Known As: Varicella Zoster Virus IgG Antibody Test, Chicken Pox Titer Test, Shingles Titer Test

The Varicella IgM Antibody Test measures IgM antibodies produced in response to varicella-zoster virus, helping identify current or recent chickenpox infection. It aids in differentiating acute illness from prior exposure or immunity. This test supports evaluation of symptoms such as rash, fever, or fatigue, and provides valuable information about immune activity and viral health risks.

Blood
Blood Draw
Also Known As: Varicella Zoster Virus IgM Antibody Test, Chick Pox IgM Antibody Test

Blood
Blood Draw, Phlebotomist

Varied
Phlebotomist

Did you know that the Centers for Disease Control (CDC) estimated that there were 572,000 new cases of genital herpes in the United States in a single year?

That's right. It's an incredibly common disease. But did you also know that most Americans who are infected aren't even aware of it? The CDC estimated that 87.4% of people in the 14–49 age range with the disease haven't been diagnosed!

Herpes is highly contagious and potentially dangerous, so don't stay in the dark about it. Keep reading to learn more about the symptoms of herpes and the different herpes tests that can be used to diagnose it.

About Herpes

Herpes simplex virus (HSV) produces a lifelong viral infection in humans. Both of its subtypes are highly infectious and transmissible. 

The first subtype, HSV-1, can cause infections of both the mouth and the genitalia. However, it is the primary cause of cold sores around the mouth (known in medical terminology as "herpes labialis"). These painful lesions can also affect the nasal passages and eyes.

HSV-2 is the main culprit behind genital herpes, outbreaks of which also cause blisters to erupt on or around the genitals, rectum, or mouth. During the first outbreak, which can occur from 2–12 days after exposure to the virus, these symptoms tend to be severe. The vesicles that appear break and leave behind painful ulcers that can take from two to four weeks to heal.

After this "first outbreak" episode, HSV remains in the body by invading the nerve cells, allowing it to hide from the immune system. There, it lies dormant until it reactivates, which happens sporadically. Once active, the virus uses the nerve's axon like a highway to travel to the skin, where it can begin replicating and shedding all over again.

HSV's ability to lie dormant and hidden from the immune system is one of the reasons it so often evades clinical diagnosis. Its resemblance to other skin conditions upon subsequent outbreaks, which are much milder than the initial one, are some more reasons why diagnosing genital herpes can be so difficult.

On rare occasions, both HSV subtypes can lead to aseptic meningitis.

Prevalence and Risk Factors

In the United States, the infection rate of HSV-1 is estimated at 47.8%, while that of HSV-2 is estimated at 11.9%. And although genital herpes is mainly caused by HSV-2, its infection rate is actually higher than that of HSV-2 itself. That's because HSV-1 can also cause genital herpes.

Age is not a significant risk factor. HSV can infect anyone at any age. Even a newborn can contract the disease from their infected mother during pregnancy, delivery, or the postpartum period. The primary risk factor, in any case, is coming into contact with a herpes infection.

HSV-2 was found to have been more prevalent among women (15.9%) than men (8.2%) during studies carried out from 2015–2016. This may be due to the fact that genital infections are transmitted more easily from men to women than vice versa during sexual intercourse.

Thus, an abbreviated list of risk factors for contracting genital herpes would include:

  • Having unprotected sex
  • Having multiple sexual partners
  • Having another sexually transmitted infection
  • Being female
  • Being immunocompromised at all

HSV-2 is also found more often among non-Hispanic blacks than non-Hispanic whites (34.6% versus 8.1%, respectively), and this disparity is present even among individuals with similar average numbers of sexual partners. 

Signs or Symptoms

The following are some warning signs of herpes infection.

  • Watery, blistering sores around the mouth or genitals
  • Painful urination
  • Itchy skin
  • Flu-like symptoms 
    • Headache 
    • Fever
    • Swollen lymph nodes
    • Fatigue
    • Decreased appetite
  • Herpes keratitis
    • Eye pain
    • Discharge
    • Redness
    • The feeling of a foreign substance in the eye

Bear in mind that an infected person is only more contagious when their infection is active. They can still spread the virus during periods of remission!

Laboratory Tests for Herpes

Anyone displaying the signs and symptoms outlined above (or with a sexual partner infected with HSV) should consider herpes testing so that it can be detected, officially diagnosed, and treated.

There are a variety of herpes tests available, and the best one depends on the patient's circumstances. Herpes testing does involve having blood drawn, though, so it cannot be done at home with a kit. Blood needs to be drawn by a qualified phlebotomist.

Serologic testing can be performed to identify past or recent exposure to HSV. However, it cannot tell precisely when exposure occurred, nor can it determine the infection site. The most common type of serologic test is the immunoglobulin G test, which can be targeted to either one or both subtypes.

Frequently Asked Questions

Is there a cure for herpes?

Antiviral therapy has been developed that can suppress the virus's activity, but no outright cure for either HSV-1 or HSV-2 has been found.

What kind of medication will I need to take to manage my herpes?

Antiviral drugs like acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex) can be taken to prevent or shorten herpes outbreaks, making it less likely to infect others.

Are there only two subtypes of herpes?

No. In fact, there are six others, and they form the taxonomic family known as Herpesviridae.

Order Your Herpes Test With Ulta Lab Tests

Blood work needs to be done for herpes tests, and that can be expensive and difficult. But at Ulta Lab Tests, we've done all we can to make the process affordable and convenient.

We offer tests that are accurate and reliable, so you can make informed decisions about your health. The confidential results of your herpes simplex antibody IgM or IgG test will be with you within 24–48 hours.

You won't need insurance or a referral, and the doctor's order will be included in the price. And your satisfaction is 100% guaranteed!

Take control of your health with Ulta Lab Tests today!