What is genital herpes?

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

There are 2 types of HSV. 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.

What is the cause?

You can get infected with the herpes virus if you touch blisters or sores on the genitals, mouth, or rectal area of someone who is infected. The virus can spread to others by kissing, 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 then rubbing your eye.

Once you are infected, the herpes virus stays in your body, even after the sores are gone. Most of the time the virus is inactive, but the virus can become active again and cause an outbreak of sores. Repeat outbreaks of genital herpes are particularly common during the first year of infection.

What are the symptoms?

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

• Painful sores on the genitals (for example, on a man’s penis or the area around a woman’s vagina) or on your thighs or buttocks
• Vaginal discharge
• Pain when you urinate or have sex
• Trouble urinating
• Itching in the genital or anal area that starts suddenly
• Muscle aches and feeling tired (usually only with the first outbreak of blisters)
• Fever (usually only with the first outbreak)
• Tender, swollen lumps (lymph nodes) in your groin

The sores appear first as tiny clear blisters. Usually there are small groups of several blisters, but sometimes there may be just 1 blister. The blisters usually lose their 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 usually worst during the first outbreak.

Herpes is very contagious when you have sores. However, you can spread the virus to others even when you don’t have sores or other symptoms.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history 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.

How is it treated?

Genital herpes cannot be cured. The virus will stay in your body. It will tend to become active during times of stress or if the genital area is injured–for example, from tight or irritating clothing or from sex without enough lubrication. Outbreaks can be unpredictable. Your healthcare provider may prescribe antiviral medicine to help the symptoms go away more quickly. The infection is still contagious while you are taking this medicine. Your healthcare provider may recommend or prescribe another medicine to lessen pain and itching.

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.

Repeat outbreaks of sores tend to be milder than the first outbreak and the sores heal more quickly.

If you get a herpes infection for the first time during the first 3 months of pregnancy, it might cause a miscarriage or problems with the baby. If you get infected for the first time later in the pregnancy, it may cause premature labor and delivery. If you have an active herpes infection during labor and delivery, you could pass the infection to the baby. Your baby could get a serious infection of the liver, brain, or other organs.

If you are pregnant and have had herpes, tell your healthcare provider so that steps can be taken to avoid infecting the baby. Antiviral medicine 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 your baby. If you have an active herpes infection when you go into labor, your provider may suggest a C-section to avoid infecting the baby during a vaginal delivery. If you don’t have any sores at the time of labor, you may have a vaginal birth.

Breast-feeding is safe as long as you don’t have sores on or around your breast.

How can I take care of myself?

Follow the full treatment prescribed by your healthcare provider. Be sure to take all of your medicine as prescribed by your provider.

When you have an outbreak of sores:

• Wear loose clothing, preferably cotton, to keep pressure off your skin. Pressure from rubbing by your clothing can cause more blisters.
• Sit in a bathtub of warm water 2 or 3 times a day to help soothe the pain.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
  • 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.
• Don’t use douches, perfumed soaps, sprays, feminine hygiene deodorants, or other chemicals in the genital area.
• Do not share towels or clothing.
• Ask your healthcare provider:
  • How and when you will hear your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

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

To have fewer repeat outbreaks:

• Take antiviral medicine as prescribed by your healthcare provider. Daily doses antiviral medicine may lessen the frequency of outbreaks of herpes sores. In some cases it may prevent repeat outbreaks completely.
• Follow your healthcare provider’s instructions for follow-up visits and tests.
• Tell your sexual partner or partners about the infection so they can be checked and treated.
• Avoid things that might cause new outbreaks, like tight clothing or sex without enough lubrication.

How can I help prevent genital herpes?

• Practice safe sex:
  • Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex.
  • Have just 1 sexual partner who is not having sex with anyone else.
  • If you have had sex and are worried that you may have been infected, see your healthcare provider even if you don’t have any symptoms.
  • If you have been sexually assaulted, you may need to be treated to prevent sexually transmitted infections. You should have an exam within a few hours of the assault (and before showering or bathing) even if you don’t want to press charges.
• Ask your partner (or partners) if they have herpes because herpes may be spread from areas not protected by a condom, such as the groin, thigh, and rectum. Avoid sexual contact if you or your partner has any sores.
• Avoid oral sex with someone who has fever blisters (cold sores) in the mouth.