Genital herpes

Genital herpes is spread by skin-to-skin contact with someone who already has the virus, including contact with infected skin during sex. Cold sores on the mouth can spread the virus to the genitals during oral sex.

There is no cure for herpes. Once you have the virus, it stays in the nerves of the infected area of skin. It can appear to go away for some time and then flare up.

Herpes is most infectious from the first signs of sores developing (tingling of the skin, numbness or shooting pains) until the scabs have gone.

You can pass on herpes to someone even when you have no visible blisters or sores. This is most likely in the first 2 years of infection.

You can’t catch herpes or pass it on to another person unless you have skin-to-skin contact with the infected area.

Pregnancy and herpes

An infected mother can pass herpes on to her baby during pregnancy or at birth, causing serious illness. This is most serious in women who have their first symptoms of herpes just before giving birth. Women who already have the virus when they get pregnant have protective antibodies which protect the baby too, so it’s very unlikely to be infected. If you become pregnant, tell your doctor if you or your partner have ever had herpes. Your doctor can then work out the risk at birth and any possible risk to the baby.

When you are first infected, you may not get sores. Many people with genital herpes don’t know they have it because they have no symptoms.

The first time you get sores or blisters (called a herpes ‘episode’) is usually the worst. You may feel generally unwell as if you are getting the flu, then small blisters appear. They burst and become sores. Later, scabs form, and finally the skin heals after 1 or 2 weeks.

In girls and women, blisters may appear around the vagina, the urethra, the cervix, or between the vagina and the anus, or around the anus.

In boys and men, blisters may appear on the penis and foreskin, and sometimes inside the urethra, on the scrotum or in the area between the penis and the anus, or around the anus. It can be very painful to urinate if the urine runs over the sores.

Rarely, herpes can appear on the buttocks, lower back and other areas below the waist, as well as the hands, breasts, back, fingers – anywhere that has touched an infected area.

Many cases of genital herpes don’t show up as blisters. They can appear as a small area of rash, cracked skin, or some other skin condition on the genitals.

Although herpes sores heal, the virus stays in the body, and you can have more outbreaks. These are called ‘recurrent episodes’.

Have any unusual condition of the genital skin checked out by your doctor and tested for herpes.

The doctor will take a sample from an infected area with a swab and send it to a laboratory. It’s best if the sore or blister is less than 4 days old. You may need a blood test as well to see which type of HSV you have.

Your doctor may prescribe anti-viral drugs. These ease the pain and severity of the sores or blisters, especially if you take them within 2 days of any sign of blisters. If you have lots of outbreaks you need to take medicine all the time. Anti-viral drugs can’t cure you or stop you passing herpes on to another person. However, they can reduce the symptoms, and lower the risk of infecting another person when you don’t have any symptoms.

During an episode of genital herpes

These treatment tips may help ease the symptoms:

• Paracetamol or aspirin can reduce pain and soreness.
• Bathing sores with salt water (2 teaspoons of salt per litre, or 1 cup of salt in a bath) can help them heal.
• Applying an anaesthetic jelly or cream can reduce the pain, particularly when urinating.
• If it hurts to urinate, you can also try urinating while sitting in a warm bath.

You can reduce the risks of getting genital herpes by following this advice:

• To protect yourself and your partner, avoid sex when there are any signs of sores on the genitals. Don’t have oral sex when there is any sign of a cold sore on the mouth.
• Condoms with water-based lubricant and dental dams reduce the risk, but they only protect the area of skin covered by the condom or dam. They do protect you against other sexually transmitted infections (STIs).

Talking about STIs can be difficult, but any person you have sex with has a right to know if you have an infection. Discuss it when you are feeling relaxed and confident, not just before you have sex. Your partner will appreciate your honesty and that you don’t want to infect him/her. You have the right to know if they are infected, too.

Is there a vaccine for genital herpes?

There is no vaccination for genital herpes.

Recurrent episodes

Recurrent episodes usually occur on the same part of the body as the first attack, but are often shorter and milder. Recurrent episodes are less likely with HSV Type I infection. Usually they happen less often and are milder over time, and can just stop.

Some infected people only get symptoms once. Some people can have herpes but never have symptoms at all. Herpes episodes are more likely to happen when your immune system is weak. Illness, tiredness, stress, periods or sexual activity can trigger them, but they can occur for no obvious reason.

Coping with herpes

Herpes only affects a small area of skin. It doesn’t usually make you ill, and it has no obvious long-term side effects in healthy adults. If you have herpes, don’t feel ashamed or guilty, or think you can’t have sex.