Genital Herpes

What is genital herpes?

Genital herpes is a common infection caused by a virus. The virus is called the herpes simplex virus, or HSV. It causes painful blisters that break open and form sores.

There are 2 types of HSV, type 1 and type 2. HSV-1 usually infects the lips and mouth. HSV-2 usually infects the genital area. However, you can have infections by either virus in any of these places.

How does it occur?

You can get infected with the virus if you touch broken blisters or sores on the genitals, mouth, or rectal area of someone who is infected. The virus can spread to others by kissing or sharing food or drink, or during sex. You may spread it from one part of your body to another if the virus gets on your hands--for example, after touching a blister.

Once you are infected, the virus stays in your body for the rest of your life. Most of the time the virus is inactive, which means it is staying in certain cells in the body and not causing symptoms. However, the virus may become active and cause sores again. The sores may come back often. Outbreaks of sores may occur with physical stress--for example, if you wear tight clothing, have sex without enough lubrication, or have another illness. Emotional stress or menstruation may also cause an outbreak. Many people with herpes have recurrent infections.

Herpes is very contagious when you have sores. The virus may also spread to others even when you don’t have symptoms.

What are the symptoms?

Some people infected with herpes have no symptoms. If you do have symptoms, they usually occur within 2 weeks after the virus enters your body. The symptoms of a herpes simplex infection in the genital area may include:

• painful sores (blisters) on the genitals (for example, on a man's penis or the area around a woman's vagina), thighs, or buttocks
• vaginal discharge
• pain when you urinate or have sex
• trouble urinating
• itching in the genital or anal area that starts suddenly
• general discomfort, such as tiredness and muscle aches
• fever (usually only with the first outbreak of blisters)
• tender, swollen lymph nodes in the groin

The sores appear first as tiny clear blisters. Usually they occur in groups of several blisters, but sometimes there may be just one blister. The blisters usually lose their thin tops quickly. Then they look like small (1/8 inch to 1/4 inch wide), pink or red shallow sores. The blisters may be painful and oozing. They may become covered with a yellowish dried crust.

The symptoms of herpes are worst during the first outbreak.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. Infection can be confirmed with lab tests. Cells or liquid from a sore will be tested in the lab for the virus. You may have blood tests to see if you have had a herpes infection before.

How is it treated?

Genital herpes cannot be completely cured. The virus will stay in your body. It will tend to become active in times of stress, but outbreaks can be unpredictable. Your healthcare provider may prescribe antiviral medicine such as acyclovir, famciclovir, or valacyclovir to relieve your symptoms more quickly. The infection will still be very contagious as long as you have sores, but the medicine will shorten the amount of time you are contagious. If you are pregnant, discuss the use of these medicines with your provider.

Pain medicine such as acetaminophen or ibuprofen can help relieve pain and fever. Sitting in a bathtub of warm water 2 or 3 times a day may also help soothe the pain.

A herpes infection for the first time during the first 3 months of pregnancy might cause a miscarriage or problems with the baby. If you get a herpes infection for the first time later in the pregnancy, it may cause premature labor and delivery. If you have an active herpes infection when your baby is born, you could pass the infection to the baby. It could cause serious problems for the baby.

If you are pregnant and have had herpes, tell your provider so steps can be taken to avoid infecting the baby. Antiviral medicine, such as acyclovir, famciclovir, or valacyclovir, is a safe medical treatment for infected pregnant women. It can help prevent an active infection that could be passed to your child during birth. However, if you have sores at the time of delivery, antiviral medicine does not keep the infection from being passed to the baby. If you have an active herpes infection when you go into labor, your provider may suggest a cesarean delivery (C-section) to avoid infecting the baby.

Breast-feeding is safe as long as there are no sores on or around the breast.

How long will the effects last?

The sores usually start to heal after about 5 to 7 days. They generally go away in 1 to 3 weeks. Sometimes they may last for as long as 6 weeks. The sores rarely leave scars.

The virus stays in your body and you may get more sores. Repeat outbreaks of sores tend to be milder than the first outbreak and the sores heal more quickly.

How can I take care of myself while I have an active infection?

• Follow the full treatment prescribed by your healthcare provider. Be sure to take all of your medicine as prescribed by your healthcare provider.
• Use a disposable glove to put medicine on the sores. This helps prevent spread of the infection to other parts of your body.
• Wipe yourself from front to back after you use the toilet.
• Wear loose clothing, preferably cotton, to allow circulation of air. It also helps avoid pressure on the skin. (Pressure can cause more blisters.)
• Take aspirin, acetaminophen, or ibuprofen to reduce pain or fever.
  • Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.
• Don’t use douches, perfumed soaps, sprays, feminine hygiene deodorants, or other chemicals in the genital area.
• Avoid a lot of sunlight and heat. They may cause more blisters.
• Avoid sexual contact with others.

There are many herpes counseling groups that give support to people who have herpes. You can get more information by calling the National Sexually Transmitted Disease Hotline at 1-800-227-8922.

What can I do to help prevent recurrences of herpes infection?

You may have fewer recurrences if:

• You take antiviral medicine as prescribed by your healthcare provider. Daily doses of acyclovir or another antiviral medicine may lessen the frequency of outbreaks of herpes sores. In some cases it may prevent recurrences completely.
• You follow your healthcare provider's instructions for follow-up visits and tests.
• You tell your sexual partner or partners about the infection so they can be checked and treated, if necessary.
• You avoid conditions that might cause the infection to come back, such as vaginal infections or a lot of stress.

How can I help prevent infection with genital herpes?

• Practice safe sex. You cannot know or predict when the virus will be shed or passed to someone else. Always use latex or polyurethane condoms during any sexual contact. This includes oral-genital and anal-genital sex. Also, you are less likely to get a sexually transmitted disease if you have just one sexual partner who has no other partners.
• Ask your partner(s) if they have had herpes because herpes may be spread from areas not protected by a condom, such as the groin, thigh, and rectum. Avoid sexual contact if your partner has any sores.
• Avoid oral-genital and oral-anal sex with someone who has fever blisters (cold sores) in the mouth. Cold sores are caused by a related virus that can infect the genitals.