What Happens If Herpes Is Not Treated
Herpes can be painful, but it generally does not cause serious health problems like other STDs can.
Without treatment, you might continue to have regular outbreaks, or they could only happen rarely. Some people naturally stop getting outbreaks after a while. Herpes typically does not get worse over time.
The information on this page is adapted from the CDC and Planned Parenthood.
When To Seek Help For Herpes Symptoms
If your herpes symptoms are bothersome or youre worried about giving someone else the virus, see your doctor or another healthcare provider.
Antiviral medications can help make genital herpes sores go away faster, reduce the number of outbreaks, and lower the risk of transmission.
Consistent use of condoms and dental dams during sex also lowers but doesnt eliminate the risk of transmitting the virus.
If you dont have a primary care doctor or gynecologist, you can find expert advice at a Planned Parenthood clinic or a community health center.
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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:
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When To See A Doctor
Because a person might not have symptoms even if they have herpes, it can be difficult to know when to see a doctor for diagnosis and treatment.
Planned Parenthood recommends that a person see a healthcare professional as soon as they notice sores on or around their genitals. Other STIs, such as syphilis, can have similar symptoms but require different treatment. The American Sexual Health Association also recommends seeing a doctor to get a culture of any lesion or cold sore a person notices.
People may wish to take an at-home STI test before seeing a doctor. However, at-home tests should not replace professional diagnosis and treatment.
- applying aloe vera gel to sores
- applying petroleum jelly to the affected areas
- wearing loose clothing to avoid irritation
- refraining from sexual activity, even with protection, until symptoms have gone
- applying a cream or lotion to the urethra before urinating, such as one that contains lidocaine
Some people find that using ice packs help. However, never apply ice directly to the skin wrap it in a cloth first.
What Is The Herpes Virus
Herpes is a virus that causes skin sores. The medical term for it is the Herpes Simplex Virus . It most commonly produces sores on the mouth or genitals.
Herpes is very common and doesnt usually cause severe health problems. However, it is very contagious and there is no cure.
There are two types of herpes: oral and genital. Oral herpes is called HSV-1, and genital herpes is called HSV-2.
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How Can Herpes Be Prevented
Correct and consistent use of latex condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.25,26
The surest way to avoid transmission of STDs, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested for STDs and is known to be uninfected.
Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV.
Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. 27 Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences.
How Does Genital Herpes Affect Pregnant Women
While genital herpes rarely causes serious health problems in healthy men and women, HSV-2 can be dangerous for pregnant women and the neonate, particularly during the last trimester of pregnancy. The virus may cause premature labor and babies can contract the virus in the womb or when passing through the birth canal.
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How Does Genital Herpes Affect Pregnancy
Herpes simplex virus doesnt affect fertility or your ability to conceive. Pregnant women diagnosed with HSV-2 should start a daily antiviral at 36 weeks of pregnancy as prescribed, to prevent outbreaks during delivery. If you have an active infection at the time of childbirth, you can pass the herpes virus to your baby. Neonatal herpes puts a baby at risk for blindness, brain damage, skin infections and death. Your healthcare provider will perform a cesarean section to lower this risk.
Preventing The Spread Of Herpes
The following tips may help prevent the condition from reactivating or spreading:
- Wash any items that may have had contact with the contagious sores, like towels, in boiling water after use.
- Dont share food utensils or other personal items with people who have oral herpes.
- Dont share cold sore creams with anyone.
- Dont kiss or participate in oral sex with someone who has a cold sore.
- To keep the virus from spreading to other parts of the body, dont touch the blisters or sores. If you do, wash your hands with soap and water immediately.
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Support And Advice For Genital Herpes
If you have just found out you have genital herpes, you may feel shocked and may have a lot of questions. It may help you to gather as much information as you can about herpes. This can help you to make fully informed decisions about your treatment, safe sex and preventing further recurrences. Talking to a counsellor about your concerns may also help.
What Happens During A Herpes Antibody Test
There are different tests for HSV. Doctors will choose a test based on a persons health history and symptoms. Options include the following:
- Swab test: A healthcare professional uses a swab to take a sample of fluid and cells from a herpes sore. They then order a PCR test or viral culture to determine whether HSV is present. This is the most reliable way to test for HSV. Doctors normally do this as standard procedure before ordering any other sort of test.
- Blood test: A healthcare professional uses a needle to take a small amount of blood from a vein in a persons arm.
- Lumbar puncture: Doctors may use this method if they suspect a person has an infection in the brain or spinal cord. It involves numbing the skin of the lower spine and inserting a thin, hollow needle between two vertebrae to collect cerebrospinal fluid.
A doctor will send samples to a laboratory for testing and a person should get their results within a few days.
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What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- What is the best treatment for me?
- What happens if I dont treat a cold sore?
- What are the side effects of antiviral medications?
- How can I reduce the risk of future outbreaks?
- Whats the best way to prevent getting another STI?
- How can I protect my partner from getting genital herpes?
- Should I lookout for signs of complications?
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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What Is Oral Herpes
More than half of American adults have oral herpes. Some estimates say up to 80% of American adults have oral herpes.
Oral herpes is primarily caused by HSV-1, although it is also possible to have an HSV-2 infection around the mouth.
A person with an oral herpes outbreak may first feel itching, burning, or tingling around the mouth, lips, or tongue. Later, cold sores or small blisters may develop in these areas or anywhere on the skin.
Roughly four to six days after these cold sores start leaking, they start healing by forming a crust. Outbreaks of oral herpes can last for two to three weeks, which can be shorter than the two to six weeks of a genital herpes outbreak.
People who develop symptoms of herpes may first experience tingling, itching, or burning, then notice sores or blisters forming around the mouth or genitals.
Symptoms tend to develop 220 days after exposure to the virus.
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.
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What Can I Do If I Have Herpes
Many people who find out they have herpes feel depressed knowing they will always have the virus and can give it to others. But you arent alone. Herpes is one of the most common STIs, both in the U.S. and worldwide. If you have herpes, you should:
- Learn all you can about it. Information will help you to manage your disease and feel better about yourself.
- Talk about your illness with your doctor.
If you have herpes, you can still:
- Have sex if you use a condom , and you tell your partner about your illness. Some couples, who have sexual relations only with each other, may choose not to use condoms even though one partner has herpes. Because each situation is different, you should ask your doctor if this is the right choice for you in your relationship.
- Have children. People with herpes can still give birth to healthy babies. If you have herpes and plan to have children, discuss your illness with your healthcare provider.
If you have herpes, you should also get checked for HIV and other STIs .
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What Does Genital Herpes Look Like
While some people with genital herpes will never have any symptoms, other people can develop symptoms within a few weeks of being infected.
Often, before the lesions appear, patients describe a prodrome, characterized by a tingling or burning sensation in the area where the lesions will develop that can be noticed during urination, along with itching or discomfort in the genital area.
You can also have the following symptoms:
- Blisters on the mouth or lips
- Fever, headache or pain in the joints
- Trouble urinating
The symptoms of genital herpes often go away and come back as recurring outbreaks. For most people, the first outbreak is the worst, and can last from two to three weeks. Future flare-ups are often less severe and do not last as long. Still, some people shed the virus regularly. The following triggers can make outbreaks more likely to occur:
- Viral or bacterial infections
- Menstrual periods
Recurrent genital herpes is most common in the first year after the initial infection and decreases as time goes on.
In many cases, anti-herpes medicine can help patients. When a person experiences a prodrome and suspects a recurrence is going to happen, they begin taking anti-herpes medications that lessen symptoms and shorten the time of the outbreak.
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When To Call The Doctor
Even though HSV sores can hurt and be unsightly, most cases of herpes do not cause serious illness. The sores go away in a few days. Contact the health provider if:
- Sores are present and you think it might be a first herpes infection. The diagnosis is usually made by examining the sores. If the sores have not healed, sometimes a laboratory test is done.
- Sores do not heal by themselves or show signs of infection such as pus, spreading redness or fever.
- Sores are near the eyes.
- You have another health condition with a weakened immune system.
Is There Any Resistance To Genital Herpes Medication
Resistance to drugs that treat genital herpes even after 20 years of use is very rare. Herpes medications may not work as well in patients who are very immunosuppressed and have been treated with these drugs for a long time. Each individuals response to treatment may vary. In some cases, patients may need more drugs to suppress their viral outbreaks than others.
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What Are The Different Types Of Herpes
There are two types of herpes simplex virus: HSV I and HSV II. HSV I commonly causes oral herpes, or cold sores. This virus can show up as an upper respiratory tract infection during early childhood. HSV II is the cause of most cases of genital herpes. However, it is possible for HSV I to cause genital herpes and HSV II to cause oral herpes.
Clinicians cannot tell the difference between the two types by physical examination alone, but there are differences between the two viruses. For example, genital herpes caused by HSV II is much more likely to recur. This diagnosis can be helpful in establishing a health care plan.
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.
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Can I Still Have Sex If I Have Herpes
If you have herpes, you should talk to your sex partner about their risk. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners.
You may have concerns about how genital herpes will impact your health, sex life, and relationships. While herpes is not curable, it is important to know that it is manageable with medicine. Daily suppressive therapy can lower your risk of spreading the virus to others. Talk to a healthcare provider about your concerns and treatment options.
A genital herpes diagnosis may affect how you will feel about current or future sexual relationships. Knowing how to talk to sexual partners about STDs is important.
Herpes Myths To Stop Freaking Out About
A surprising number of people you know probably have herpes.
Shocked? You shouldnt be, since the virus is very common. According to the World Health Organization, 3.7 billion people under age 50 have herpes simplex virus type 1 thats 67 percent of the global population in that age bracket. Another 417 million people between ages 15 and 49 worldwide have herpes simplex virus type 2 .
Many people consider HSV-1 more benign, but it turns out theres not much difference between the two types of virus. While its true that HSV-2 is a sexually transmitted disease and can cause genital sores or blisters, type 1 can do the same thing.
One big misconception is that cold sores are caused by HSV-1 and genital herpes are always type 2, but thats not always the case, says Sarah Vensel, a physician assistant in San Francisco. Cold sores are so common theyve been normalized at this point. But genital herpes is sometimes the exact same virus just in a different location.
Not only is herpes incredibly common its also totally manageable. Allow us to set your mind at ease and debunk three widespread herpes myths:
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