Overview

Genital herpes – the basics: Genital herpes is caused by two viruses called Herpes simplex, types 1 and 2. The viruses are very similar and both can cause blisters or ulcers. When these occur on the face they are known as ‘cold sores’ and when they occur on the genitals they are called ‘genital herpes.’ However, both viruses can be caught on other parts of the body. This means that genital herpes and cold sores on the face can be caused by either Herpes simplex 1 or 2.

How common is genital herpes?

Herpes infection is very common. In the UK, most people (about 70%) will have been infected with either type 1 and/or 2 by their 25th birthday.

How do you catch genital herpes?

Herpes spreads by skin to skin contact, through touching or rubbing. This can happen during any kind of sex: vaginal, anal and oral. If a person has skin sores there is a high risk of them passing on the virus. In almost all cases herpes is only found on one area of a person’s body. Many cases of genital herpes occur when a person has infection around the mouth and kisses their partner’s genitals. Herpes cannot be caught from towels, swimming pools, saunas or from toilet seats.

Treatment from a sexual health clinic can help. Symptoms clear up on their own but can come back.

Go to a sexual health clinic as soon as possible if you have:
  • small blisters that burst to leave red, open sores around your genitals, anus, thighs or bottom
  • tingling, burning or itching around your genitals
  • pain when you pee
  • in women, vaginal discharge that's not usual for you

These can be symptoms of genital herpes.

Go even if you haven't had sex for a long time, as blisters can take months or years to appear.

Why you should go to a sexual health clinic

You can see a GP, but they'll probably refer you to a sexual health clinic if they think you might have genital herpes.

Sexual health clinics treat problems with the genitals and urine system.

Many sexual health clinics offer a walk-in service, where you do not need an appointment.

They'll often get test results quicker than GP practices.

Find a sexual health clinic

What happens at a sexual health clinic

The doctor or nurse at the sexual health clinic will:

  • ask about your symptoms and your sexual partners
  • use a small cotton bud (swab) to take some fluid from 1 of your blisters or sores for testing

The test cannot:

  • be done if you do not have visible blisters or sores
  • tell you how long you have had herpes or who you got it from

Symptoms might not appear for weeks or even years after you're infected with the herpes virus.

If you have genital herpes, your previous sexual partners should get tested.

The doctor or nurse at the clinic can discuss this with you and help you tell your partners without letting them know it's you who has the virus.

There is a blood test for herpes simplex but it is not usual for clinics to do it for people who have no symptoms. This is because people who have no symptoms do not need treatment. However, the herpes blood test can be helpful in certain situations. You can discuss this with your doctor.

Treatment for genital herpes

There's no cure. Symptoms clear up by themselves but the blisters can come back (an outbreak or recurrence).

In some, but not all, people the herpes sores come back (recur). However, such recurrences are usually much less painful and smaller in size than the first episode. Recurrent genital symptoms occur more often with type 2 infections than with type 1.

Treatment from a sexual health clinic can help.

Treatment the first time you have genital herpes

You may be prescribed:

  • antiviral medicine to stop the symptoms getting worse – you need to start taking this within 5 days of the symptoms appearing
  • cream for the pain

If you've had symptoms for more than 5 days before you go to a sexual health clinic, you can still get tested to find out the cause. However, the treatment probably won’t help as your immune system will have started to kill the virus in the skin. The doctor will advise you about this. Painkillers such as paracetamol and anti-inflammatory tablets can be used to ease any pain.

You should keep the sores clean by bathing them with salt water every day.

If the sores are near your urethra (from where you pass urine or pee) it may be painful to pass urine. Sitting in a warm bath when you pass urine may help to reduce the pain. Your doctor may give you lidocaine anaesthetic gel to numb the skin and make peeing more comfortable. You can buy lidocaine gel from the chemist without a doctor’s prescription

Treatment if the blisters come back

Go to a GP or a sexual health clinic if you've been diagnosed with genital herpes and need treatment for an outbreak.

Antiviral medicine may help shorten an outbreak by 1 or 2 days, if you start taking it as soon as symptoms appear.

But outbreaks usually settle by themselves, so you may not need treatment.

Recurrent outbreaks are usually milder than the first episode of genital herpes.

Over time, outbreaks tend to happen less often and be less severe. Some people never have outbreaks.

Some people who have more than 6 outbreaks in a year may benefit from taking antiviral medicine for 6 to 12 months.

If you still have outbreaks of genital herpes during this time, you may be referred to a specialist.

How to deal with outbreaks yourself

If you've been diagnosed with genital herpes and you're having an outbreak:

Do

  • keep the area clean using plain or salt water to prevent blisters becoming infected
  • apply an ice pack wrapped in a flannel to soothe pain
  • apply petroleum jelly (such as Vaseline) or painkilling cream (such as 5% lidocaine) to reduce pain when you pee
  • wash your hands before and after applying cream or jelly
  • pee while pouring water over your genitals to ease the pain

Don't

  • do not wear tight clothing that may irritate blisters or sores
  • do not put ice directly on the skin
  • do not touch your blisters or sores unless you're applying cream
  • do not have vaginal, anal or oral sex until the sores have gone away

When can I have sex again?

Same sexual partner If you and your partner have the same virus you cannot pass it back to each other. You can start having sex again when you feel comfortable about it.

New sexual partner If you are planning to have sex with a new partner and have just had your first episode of herpes you should wait until your skin has fully healed. Delaying sex in this way makes it much less likely you might pass on the virus to your partner. However, it is still sometimes possible to infect your partner even when you have no sores on the skin. Using condoms every time you have sex makes it less likely you can pass the virus on. It has been found that people who tell their partners that they have genital herpes are less likely to pass on the infection. The clinic doctor or sexual health adviser can give you advice about the best way to tell a partner.

How genital herpes is passed on

Genital herpes is very easy to pass on (contagious) from the first tingling or itching of a new outbreak (before any blisters appear) to when sores have fully healed. You may also be able to pass on the virus even if you do not have any symptoms. This is because of ‘asymptomatic shedding’ (when small amounts of virus are on the skin). The risk is much greater in the first few months after you catch herpes. Asymptomatic shedding happens less over time and is rare after two years. However, after this time it is more common in people who have frequent recurrences. Using condoms offers some protection to your partner.

You can get genital herpes:

  • from skin-to-skin contact with the infected area (including vaginal, anal and oral sex)
  • when there are no visible sores or blisters
  • if a cold sore touches your genitals
  • by transferring the infection on fingers from someone else to your genitals
  • by sharing sex toys with someone who has herpes

You can't get genital herpes:

  • from objects such as cutlery or cups – the virus dies very quickly when away from your skin

Protecting against genital herpes

You can reduce the chances of passing herpes on by:

  • using a condom every time you have vaginal, anal or oral sex – but herpes can still be passed on if the condom does not cover the infected area
  • avoiding vaginal, anal or oral sex if you or your partner has blisters or sores, or a tingle or itch that means an outbreak is coming
  • not sharing sex toys – if you do, wash them and put a condom on them

Why genital herpes comes back

Genital herpes is caused by a virus called herpes simplex. Once you have the virus, it stays in your body.

It will not spread in your body to cause blisters elsewhere. It stays in a nearby nerve and causes blisters in the same area.

If you can, avoid things that trigger your symptoms.

Triggers can include:

  • ultraviolet light – for example, from sunbathing or sunbeds
  • friction in your genital area – for example, from sex (lubricant may help) or tight clothing
  • smoking
  • drinking alcohol

Some triggers are unavoidable, including:

  • being unwell
  • stress
  • during the menstrual cycle
  • surgery on your genital area
  • a weakened immune system – for example, from having chemotherapy for cancer

Genital herpes and HIV

Genital herpes can be a more serious condition for people with HIV.

If you have HIV and herpes, you'll be referred to a genitourinary medicine (GUM) specialist.

Genital herpes and pregnancy

First episode genital herpes before 28 weeks of pregnancy Women are recommended to re-start antiviral medication from week 36 until the baby is born. The woman should expect to have a normal vaginal delivery if that is what she and her midwife/obstetrician had planned. If a woman then goes into labour before 32 weeks (six weeks premature) the baby may need to be delivered by caesarean section because there is a risk of the baby catching herpes during a normal vaginal delivery. Your obstetrician will discuss this with you.

First episode genital herpes after 28 weeks of pregnancy Women are advised to continue antiviral medication until the baby is born. The baby may need to be delivered by caesarean section. This is because there is a risk of the baby catching the virus during a normal vaginal delivery. Aciclovir, one of the treatments for herpes, is safe to use in pregnancy.

Recurrent genital herpes in pregnancy Having recurrent genital herpes during pregnancy does not harm the baby in any way. Antibodies produced by the woman’s immune system against the virus offer some protection for the baby. Doctors may advise the woman to take antiviral medication from 36 weeks of pregnancy until the baby is born, to prevent a recurrence at the time of delivery. A woman who has a genital herpes recurrence (even if she is in labour at the time) will usually have a normal vaginal delivery.

Important

See your midwife or GP if you think you have genital herpes in pregnancy.

The Herpes Viruses Association (HVA) The HVA is a patient support group which for many years has helped and advised people with herpes infection. HVA Helpline 0845 123 2305 (weekdays only) HVA e-mail info@herpes.org.uk HVA Website www.herpes.org.uk



The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 24/03/2022 14:16:22