Symptoms Of Genital Herpes
Many people who have genital herpes may not be aware they have the infection, because they may not have any symptoms.
The first episode of herpes can cause considerable pain and distress. Symptoms of the first episode may include:
- flu-like symptoms such as feeling unwell, headaches and pains in the back and legs, with or without enlarged glands in the groin
- small blisters around the genitals these break open to form shallow, painful ulcers, which scab over and heal after one to two weeks
- small cracks in the skin with or without an itch or tingling
- redness or a distinct rash
- some people also have considerable pain and swelling in the genital area, and hence may have additional pain and difficulty passing urine.
Pain And/or Itching In Or Around The Blisters
Lesions are usually very painful to touchespecially during the first herpes outbreak, which tends to be more severe. The main thing that brings women into the office with herpes is pain, says Dr. Shirazian. Bumps that you find just by chance when sudsing up in the shower or toweling off probably arent herpes. Herpes lesions will make themselves known and felt, she says. They can also itch, especially as they begin to scab over and heal.
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What Happens If I Dont Get Treated
Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.
If you touch your sores or the fluids from the sores, you may transfer herpes to another part of your body, such as your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, immediately wash your hands thoroughly to help avoid spreading your infection.
If you are pregnant, there can be problems for you and your developing fetus, or newborn baby. See Im pregnant. How could genital herpes affect my baby? above for information about this.
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What Is Neonatal Herpes
Neonatal herpes can be a very serious infection. Babies generally contract the virus from their birthing parent during childbirth even if the parent doesnt have active lesions. They may also get HSV-1 if an adult with an active cold sore kisses them. Breastfeeding babies can also get HSV-1 from the breast if there are lesions present. But babies cant get herpes from breast milk, so its safe to pump and feed.
Herpes simplex can be more dangerous for young babies because they dont have a fully developed immune system. But most babies with neonatal herpes can recover fully with treatment.
The dangers of neonatal herpes are much higher if the infection spreads to the babys organs. If youre pregnant and have herpes, speak with your healthcare provider about how to lower the risk of passing the infection to your baby.
How Is Genital Herpes Treated
Herpes has no cure. But antiviral medicines can prevent or shorten outbreaks during the time you take the medicine. Also, daily suppressive therapy for herpes can lower your chance of spreading the infection to your partner.
Your doctor will either give you antiviral medicine to take right after getting outbreak symptoms or to take regularly to try to stop outbreaks from happening. Talk to your doctor about treatment options.
During outbreaks, you can take the following steps to speed healing and prevent spreading herpes to other parts of your body or to other people:
- Keep sores clean and dry.
- Try not to touch the sores.
- Wash your hands after any contact with the sores.
- Avoid all sexual contact from the time you first notice symptoms until the sores have healed.
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How Is Genital Herpes Diagnosed
HSV nucleic acid amplification tests are the most sensitive and highly specific tests available for diagnosing herpes. However, in some settings viral culture is the only test available. The sensitivity of viral culture can be low, especially among people who have recurrent or healing lesions. Because viral shedding is intermittent, it is possible for someone to have a genital herpes infection even though it was not detected by NAAT or culture. 11
Type-specific virologic tests can be used for diagnosing genital herpes when a person has recurrent symptoms or lesion without a confirmatory NAAT, culture result, or has a partner with genital herpes. Both virologic tests and type-specific serologic tests should be available in clinical settings serving patients with, or at risk for, sexually transmitted infections. 11
Given performance limitations with commercially available type-specific serologic tests , a confirmatory test with a second method should be performed before test interpretation. If confirmatory tests are unavailable, patients should be counseled about the limitations of available testing before serologic testing. Healthcare providers should also be aware that false-positive results occur. In instances of suspected recent acquisition, serologic testing within 12 weeks after acquisition may be associated with false negative test results. 11
Providers are strongly encouraged to look at CDCs STI Treatment Guidelines for further diagnostic considerations.
What Happens If I Dont Receive Treatment
Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.
If you touch your sores or fluids from the sores, you may transfer herpes to another body part like your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, quickly wash your hands thoroughly to help avoid spreading the infection.
If you are pregnant, there can be problems for you and your unborn fetus, or newborn baby. See Im pregnant. How could genital herpes affect my baby? for information about this.
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If I Don’t Have Herpes Now How Can I Avoid It In The Future
The only sure-fire way to avoid getting genital herpes is to abstain from sex or have sex only with someone who is also herpes-free. Short of that, a latex condom offers some protection if it covers the infected area. Remember, you can get genital herpes by receiving oral sex from someone with a cold sore on the mouth. Likewise, you can get oral herpes from someone’s genitals by way of oral sex.
If you know that a sex partner has genital herpes, you can reduce your risk by having sex only when they have no symptoms. Nevertheless, genital herpes can be contagious even when there are no visible symptoms, so you should always use a latex barrier, such as a condom or a dental dam.
If your partner has a known history of herpes, the rate of transmission can be decreased by having your partner on a daily prophylactic dose of antiviral herpes medication like acyclovir. Your partners doctor can prescribe this.
Studies are under way to investigate medicated gel products that can be placed in the to reduce the transmission of herpes and HIV. These may be available in the near future.
What Are The Symptoms Of Herpes Simplex
Many people with the infection never experience any herpes symptoms. If you do notice symptoms, youll experience them differently depending on whether youre having your first herpes outbreak or a repeat outbreak. Recurring symptoms are usually milder than the first outbreak. Symptoms dont last as long with later outbreaks. Some people may only have one or two outbreaks during their lifetime. Others may have as many as four or five outbreaks a year.
People who do have herpes symptoms may experience:
- Cold sores around their lips, mouth or tongue. They may look crusty or like fluid-filled blisters.
- Tingling, itching or burning.
- Pain while urinating.
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Can I Treat Herpes Simplex At Home
Avoiding known triggers, such as illness or stress, can help reduce how often you have herpes outbreaks.
How can I ease my symptoms during an outbreak of HSV-1 ?
- Over-the-counter creams such as L-lysine, benzocaine or docosanol .
- Applying ice to blisters or sores.
How can I ease my symptoms during an outbreak of HSV-2 ?
- Apply an ice pack to your genitals. Wrap the ice pack in a washcloth or apply it over your underwear.
- Keep your genitals dry. Wear cotton or other nonsynthetic underpants and avoid tight-fitting clothes. Moist sores take longer to heal.
- Soak in a warm bath.
- Take nonsteroidal anti-inflammatory drugs to relieve pain.
- Topical 1% or 2% lidocaine may be used as a topical analgesic.
What Should I Do If I Have Genital Herpes
If you have genital herpes:
- See a doctor or nurse as soon as possible for testing and treatment.
- Take all of the medicine. Even if symptoms go away, you need to finish all of the antiviral medicine.
- Tell your sex partner so they can be tested and treated if necessary.
- Avoid any sexual contact while you are being treated for genital herpes or while you have an outbreak.
- Remember that genital herpes is a lifelong disease. Even though you may not have a genital herpes outbreak for long periods of time, you can still pass the virus to another person at any time. Talk with your doctor or nurse about how to prevent passing the virus to another person.
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More Questions From Patients:
Many people with genital herpes have no symptoms, or have very mild symptoms that go unnoticed.
The first time genital herpes symptoms appear is called the “first episode” or “initial herpes.” Initial herpes symptoms are usually more noticeable than later outbreaks.
Symptoms of genital herpes in men may include
burning when you pee if you have sores
trouble peeing if you have sores covering your urethra
itching or pain around your genitals
During initial herpes, symptoms may also include
swollen, tender glands in the pelvic area, throat, or under the arms
So Cold Sores Are Only Caused By Hsv
Both HSV-1 and HSV-2 can cause cold sores on the mouth and face.
Although its more common for HSV-1 to cause cold sores, it isnt impossible for HSV-2 to cause them, too.
- are caused by the herpes simplex virus
- usually develop near the outside of the mouth, such as below your nostrils or on your lips
- cause redness and fluid-filled blisters
- usually appear in groups
- eventually break and ooze, forming a crust-like scab
- may take 2 to 4 weeks to completely heal
- may be caused by food or chemical sensitivities, dietary deficiencies, minor injury, or stress
- may develop anywhere inside your mouth, such as at the base of your gum line, inside your lip, or under your tongue
- are shaped like a circle or oval
- are typically yellow or white with a red border
- may appear solo or in groups
- usually take 1 to 2 weeks to completely heal
HSV-1 is spread through direct contact with the virus, which can be present in or around cold sores, in oral secretions , and in genital secretions .
Some of the ways it can be transmitted include:
- kissing someone on the mouth
- sharing eating utensils or cups
- sharing lip balm
- performing oral sex
The herpes virus usually affects the area where it first made contact with the body.
Some of the ways HSV-2 can be transmitted include:
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How Does Someone Know They Have Herpes
The symptoms of the HSV are not the same for all people. So whilst many people have HSV, there are lots of people that will not even know they have it.
People wont know theyve been exposed to HSV until they have their first episode, this is where physical symptoms show up. This can include a cold sore, blisters, ulcers or split skin. An episode is when the virus is most contagious and likely to be spread.
What are the symptoms?
The most noticeable symptoms are:
- Blisters, split skin or sores around the mouth and/or genitals/anus area
- Red skin on the genitals
- Irritation of the urethra
- Experiencing difficulty when urinating
What Are The Symptoms Of Genital Herpes
Most individuals infected with HSV are asymptomatic or have very mild symptoms that go unnoticed or are mistaken for another skin condition. 9 When symptoms do occur, herpes lesions typically appear as one or more vesicles, or small blisters, on or around the genitals, rectum or mouth. The average incubation period for an initial herpes infection is 4 days after exposure. 10 The vesicles break and leave painful ulcers that may take two to four weeks to heal after the initial herpes infection. 5,10 Experiencing these symptoms is referred to as having a first herpes outbreak or episode.
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How Do People Get Genital Herpes
Infections are transmitted through contact with HSV in herpes lesions, mucosal surfaces, genital secretions, or oral secretions. 5 HSV-1 and HSV-2 can be shed from normal-appearing oral or genital mucosa or skin. 7,8 Generally, a person can only get HSV-2 infection during genital contact with someone who has a genital HSV-2 infection. However, receiving oral sex from a person with an oral HSV-1 infection can result in getting a genital HSV-1 infection. 4 Transmission commonly occurs from contact with an infected partner who does not have visible lesions and who may not know that he or she is infected. 7 In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on 10.2% of days, compared to 20.1% of days among those with symptomatic infections. 8
How Can I Tell If It’s Scabies Or Herpes
Scabies is caused by tiny eight-legged mites that burrow into the skin to live, feed, and lay their eggs. There are millions of cases of scabies worldwide each year.
Herpes may be confused with scabies because both conditions can cause a skin rash of small, itchy bumps and blisters that spread through person-to-person contact. As with herpes, the scabies skin rash is sometimes seen in the genital area. It can be transmitted through close physical or sexual contact because the mites can move from one body to another. If you’ve never had scabies before, it can take two to six weeks to develop symptoms after the mites move in.
Unlike herpes, you can also get scabies from bedding, clothes, or furniture that’s infested with mites, since the mites can live for about three to four days without being on a human.
Also unlike herpes, scabies is most commonly found on the hands, arms, and legs, and the most common symptom is severe itching that occurs mainly at night.
Your dermatologist can tell if you have scabies by examining your skin or looking at a small piece of skin under a microscope, notes the American Academy of Dermatology.
Scabies is easily treated with a medicated cream or lotion that kills the mites.
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Is Herpes Simplex Related To Herpes Zoster
Like HSV-1 and HSV-2, shingles can cause a painful, blistering rash. The shingles rash usually shows up on the back, side, abdomen , neck and face. It is often only on half of your body, following the pattern of your nerves. See your healthcare provider if you have a new rash and suspect you may have shingles.
A note from Cleveland Clinic
Herpes simplex is a virus. Once you have herpes, its a lifelong condition. A herpes infection can lead to outbreaks , but youll also have times when you have no symptoms. The main sign of herpes is sores that appear on the infected skin. Some people choose not to treat herpes, especially if symptoms are mild. Others take antiviral medications to reduce the severity and frequency of outbreaks.
Last reviewed by a Cleveland Clinic medical professional on 05/17/2022.
How Herpes Is Treated
There is no cure for herpes.
- The health care provider may prescribe antiviral medicine to help speed up the healing process. It also shortens the time when the virus can spread from the herpes sores.
- Pain may be treated with medicine such as Tylenol or Motrin or by applying an ice pack wrapped in a towel to the affected area.
- If sores are in the mouth, avoid foods high in acid, like citrus fruits and juices.
- The infected area should be kept clean and dry.
- Wash hands often and avoid touching the sores to prevent spreading the virus.
- It is important to stay healthy by getting enough rest, having proper nutrition and exercise and managing stress well.
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What Are The Differential Diagnoses
Other medical conditions could be confused with genital herpes or cold sores. The conditions are severe, and it is wise to consult with a medical expert. Herpes could be distinguished from these conditions with a lab test or medical exam.
- Medical reactions: Medication might lead to sensitive reactions and allergies that could appear as rashes. Although medication-induced rashes do not appear in the genital area, they are common around the patient’s mouth and lips.
- Concurrent HSV-2 or HSV-1: If the patient has either type of herpes, they could also be infected with the other. The viruses are different, and having one does not prevent or cause the other.
- Pre-cancer or Cancer: Lesions around and in your genital area could be symptoms of cancer. The appearance of precancerous or cancerous shouldn’t have blisters that come with HSV lesions. However, your doctor should be able to tell the difference.
- Syphilis: Syphilis is an STD that manifests in genital sores that could be confused with herpes. Your OBGYN should be capable of telling the difference through visual lesions inspection.
- Canker sores: Usually, canker sores are red, raw, painful, and whitish in the middle. They are due to oral trauma and can appear in the mouth. While the painful sensation of cold sores and canker sores is alike, a lesion looks different.