How are herpes outbreaks triggered?

Recurrent genital herpes outbreaks will occur after a period of herpes dormancy. The amount of time that herpes lies dormant varies by person (each person’s health, immune system and overall biology is different). Genital herpes stays at the base of the spine (in the sacral ganglia), invisible until something triggers the herpes symptoms. At that point, it wakes up and makes its way to the surface of the skin via the nerve pathways to generally end up at or around the original site of herpes infection.

None of these herpes triggers are absolute since it’s very difficult to prove causality at all times between these factors always leading to herpes outbreaks. Also, even if you find that one trigger does actually cause herpes symptoms for you, it isn’t guaranteed to do so every time. Each person has a different experience of what triggers their outbreaks. The bottom line is the more you stay healthy (both your body and mind), the less chance of triggering a herpes outbreak.

Potential herpes triggers include:

• Sex factors: Friction (due to lack of lubrication), irritation (from nonoxynol-9, for example)
• Weak immune system, Colds/Fevers/Surgery: Any time your body’s immune system is compromised, the herpes virus can overpower the body’s weakened defenses and lead to an outbreak.
• Hormonal changes: Hormonal changes that happen during menstrual cycles could trigger herpes outbreaks.
• Stress: Either physical stress (different workout schedule, not getting enough sleep) or mental stress can trigger an outbreak. Destress and re-happify yourself!
• Heat and humidity: Traveling to hot climates, excessive sweating, and prolonged moisture in skin folds can irritate the skin and potentially trigger an outbreak. That said, heat rash and friction from sweating are super common on their own, so a red bumpy rash after a tropical trip isn't automatically herpes. If it doesn't follow your usual prodrome pattern, it's more likely just your skin reacting to the heat.
• Illness or surgery: Any time your body is fighting something else (a cold, the flu, recovering from a procedure), it has fewer resources to keep herpes dormant.