What is herpes?
Herpes is the name of a group of viruses that cause painful blisters and sores. The most common viruses are:
- Herpes zoster – causes chickenpox and shingles
- Herpes simplex virus (HSV) type 1 and type 2 – causes cold sores or fever blisters around the mouth and sores on the genitals (sexual organs).
Genital herpes is a sexually transmitted infection (STI). Once you are infected, you have the virus for the rest of your life.
Symptoms of herpes
Many people who get herpes never have symptoms. Sometimes the symptoms are mild and are mistaken for another skin condition. If you experience symptoms, they may include:
- painful sores in the genital area, anus, buttocks, or thighs
- painful urination
- vaginal discharge
- tender lumps in the groin.
During the first outbreak (called primary herpes), you may experience flu-like symptoms. These include body aches, fever, and headache. Many people who have a herpes infection will have outbreaks of sores and symptoms from time to time. Symptoms are usually less severe than the primary outbreak. The frequency of outbreaks also tends to decrease over time.
Stages of infection
Once you have been infected with the virus, you’ll go through different stages of infection.
This stage usually starts 2 to 8 days after you’re infected. Usually, the infection causes groups of small, painful blisters. The fluid in the blisters may be clear or cloudy. The area under the blisters will be red. The blisters break open and become open sores. You may not ever notice the blisters, or they may be painful. It may hurt to urinate during this stage. You may run a fever, feel achy, and have other flu-like symptoms.
While most people have a painful primary stage of infection, some don’t have any symptoms at all. They may not even know they’re infected.
During this stage, there are no blisters, sores, or other symptoms. The virus is traveling from your skin into the nerves near your spine.
In the shedding stage, the virus starts multiplying in the nerve endings. If these nerve endings are in areas of the body that make or are in contact with body fluids, the virus can get into those body fluids. This could include saliva, semen, or vaginal fluids. There are no symptoms during this stage, but the virus can be spread during this time.
Many people have blisters and sores that come back after the first herpes attack goes away. This is called a recurrence. Usually, the symptoms aren’t as bad as they were during the first attack.
Stress, being sick, or being tired may start a recurrence. Being in the sun or having your menstrual period may also cause a recurrence. You may know when a recurrence is about to happen because you may feel itching, tingling, or pain in the places where you were first infected.
What causes herpes?
The virus that causes genital herpes is usually spread from one person to another during vaginal, oral, or anal sex. The virus can enter your body through a break in your skin. It can also enter through the skin of your mouth, penis, vagina, urinary tract opening, or anus. Herpes is most easily spread when blisters or sores can be seen on the infected person. But it can be spread at any time, even when the person who has herpes isn’t experiencing any symptoms.
Herpes can also be spread from one place on your body to another. If you touch sores on your genitals, you can carry the virus on your fingers. Then you can pass it onto other parts of your body, including your mouth or eyes.
A pregnant woman should tell her doctor if she has genital herpes, or if she has ever had sex with someone who had it. If you have an active genital herpes infection at or near the time of delivery, you can pass it to your baby. When the baby passes through the birth canal, it may come in contact with sores and become infected with the virus. This can cause brain damage, blindness, or even death in newborns.
If you have an active herpes outbreak when you go into labor, your doctor may do a cesarean section (C-section). Then the baby won’t have to go through the birth canal and be exposed to the virus.
How is herpes diagnosed?
Your doctor will do a physical exam and look at the sores. He or she can do a culture of the fluid from a sore and test it for herpes. Blood tests or other tests on the fluid from a blister can also be done.
Can herpes be prevented or avoided?
The best way to prevent getting herpes is to not have sex with anyone who has the virus. It can be spread even when the person who has it isn’t showing any symptoms. If your partner has herpes, there is no way of knowing for sure that you won’t get it.
There is no time that is completely safe to have sex and not spread herpes. If you have herpes, you must tell your sex partner. You should avoid having sex if you have any sores. Herpes can spread from one person to another very easily when sores are present.
You should use condoms every time you have sex. They can help reduce the risk of spreading herpes. It is still possible to spread or get herpes if you are using a condom.
If you think you have herpes, see your doctor as soon as possible. It is easier to diagnose when there are sores. You can start treatment sooner and perhaps have less pain with the infection.
There is no cure for herpes. But medicines can help. Medicines such as acyclovir and valacyclovir fight the herpes virus. They can speed up healing and lessen the pain of herpes for many people. They can be used to treat a primary outbreak or a recurrent one.
If the medicines are being used to treat a repeat outbreak, they should be started as soon as you feel any tingling, burning, or itching. They can also be taken every day to prevent recurrences. Acyclovir also comes in a cream to put on sores during the primary stage or during recurrences.
What if I have herpes and become pregnant?
If you have genital herpes and are pregnant, be sure to tell your doctor. He or she will give you an antiviral medicine. This will make it less likely that you will have an outbreak at or near the time you deliver your baby. If you do have an outbreak of genital herpes at the time of delivery, your doctor will most likely deliver your baby by C-section. With a C-section, the risk of giving herpes to your baby is small.
What if I get herpes during pregnancy?
If you have your first genital herpes outbreak during pregnancy, tell your doctor. He or she may want to treat you with an antiviral medicine. The risk of your baby getting herpes is much higher if you have your first genital herpes outbreak near the time of delivery.
It is important to avoid getting herpes during pregnancy. If your partner has herpes and you do not have it, be sure to use condoms during sexual intercourse at all times. Your partner could pass the infection to you even if he is not currently experiencing an outbreak. If there are visible sores, avoid having sex completely until the sores have healed.
Living with herpes
It’s common to feel guilty or ashamed when you are diagnosed with herpes. You may feel that your sex life is ruined or that someone you thought you could trust has hurt you. You may feel sad or upset. Talk to your family doctor about how you’re feeling.
Keep in mind that herpes is very common. About 1 in 6 adults have it. Herpes may get less severe as time goes by. You can help protect your sex partner by not having sex during outbreaks and by using condoms at other times.
Tips on dealing with herpes
- Talk to your doctor if you think you may have herpes.
- Remember that you’re not alone. Millions of people have herpes.
- Keep yourself healthy and limit your stress.
- Don’t touch your sores.
- Tell your sex partner and use condoms.
Tips to soothe the pain
- Take aspirin, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
- Place lukewarm or cool cloths on the sore place.
- Take lukewarm baths. (A woman may urinate in the tub at the end of the bath if she is having pain urinating. This may help dilute the urine so it doesn’t burn the sores so badly.)
- Keep the area dry and clean.
- Wear cotton underwear.
- Wear loose-fitting clothes.
Questions to ask your doctor
- What is the best treatment for me?
- Is it safe to have unprotected sex if I don’t have any sores?
- Can I give myself genital herpes if I also have oral herpes?
- What is the best way to prevent herpes outbreaks?
- If I give my baby herpes, is there any treatment?
- Are there any side effects to my treatment?
- Can I live a normal life with herpes?
- Am I at risk of developing any other diseases?
- Are there any support groups in my area?
- Can I give someone else herpes even if I’m not having an outbreak?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.