When Should You Call Your Doctor About Genital Herpes
With an initial outbreak, if an individual has signs or symptoms of a genital herpes infection, he or she should seek the care of a doctor as soon as possible, particularly if the diagnosis of genital herpes has not been previously established. Although genital herpes infections generally are not medical emergencies, treatment is more effective when it is started within the first few days of the outbreak.
Subsequent outbreaks rarely need immediate medical attention.
- If an individual has had a genital herpes outbreak before, discuss options for preventing further outbreaks with a doctor.
- People with severe underlying medical problems are at higher risk of severe illness if the disease is untreated. These individuals should contact a doctor immediately upon noticing genital herpes sores.
- A pregnant woman with signs or symptoms of genital herpes must inform her doctor as soon as possible. Prompt medical therapy may reduce the risk of transmitting the disease to newborn children by exposure in the birth canal.
In otherwise healthy people, genital herpes outbreaks rarely require hospital visits. If an individual is experiencing an initial episode of genital herpes and cannot be seen by a regular doctor within the first few days of the illness, it is advisable to go to a hospital’s emergency department to have medical treatment started.
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.
Treatment For Genital Herpes
There is no medication to cure your body of the herpes virus. Treatment is aimed at easing symptoms, reducing the frequency of recurrences and reducing transmission.
Symptoms can be improved by:
- ice packs to the affected area
- pain-relieving medication such as paracetamol
- antiviral medication such as acyclovir, famciclovir and valaciclovir. These can reduce the severity of an episode if taken early enough . Topical antivirals usually used for cold sores on the lips or face are not suitable for use on the genitals.
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Genital Herpes: How Can You Prevent The Spread Of Herpes In Sexual Relationships
Herpes viruses are most likely to be transmitted during an outbreak, so it’s better to not have sex during this time. Herpes can also be passed on to others in symptom-free phases, though. This risk can be reduced considerably by using condoms.
If you have genital herpes, there are some things you can do on your own to protect your partner from infection. The main things are
- not having sex during an outbreak,
- using condoms during symptom-free phases, and
- talking openly with your partner about the disease.
Preventive treatment with antiviral medication may be an option for people who have genital herpes very frequently. This medication inhibits the activity of the virus, thereby lowering the risk of infecting partners.
Take Time To Understand Your Diagnosis
For most people, the social and emotional impact of herpes is greater than the physical distress, at least in the beginning. Society tends to have a judgmental attitude about sexually transmitted diseases. Many people feel embarrassed or isolated after they are diagnosed. With time, accurate information, and support, most people put herpes in perspective, says Mitch Herndon, program manager of the Herpes Resource Center and National Herpes Hotline at ASHA.
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If You Have Symptoms Find Out What Youre Dealing With
With genital herpes, the biggest mistake people make is not seeking medical advice, says Gade.
People often find the signs or symptoms of a first herpes outbreak confusing, says Gade. You may mistake herpes symptoms for those of a yeast infection and try curing that condition on your own. But if your healthcare provider diagnoses you with herpes, the first line of treatment will be antiviral medications.
, you can make matters worse by putting things on the herpes sores that you shouldnt put on the sores, she says. People often try using Vaseline, bacitracin, or Aquaphor to soothe the itchy or painful eruptions.
Honestly, not putting anything on the sores is best, says Gade. Do keep the area clean and dry, though.
Warm compresses applied to tender or painful areas can help. So can sitting in a warm bath, using Epsom salt.
Sometimes people have enormous pain with urination, says Gade. For relief, you can urinate in your bathwater or while taking a shower to dilute the urine stream and lessen the sensation. You can also use warm water in a spray bottle to dilute the stream while youre urinating.
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How To Treat Herpes Outbreaks
There are two different types of antiviral regimens when it comes to treating recurrent genital herpes and oral herpes: suppressive treatment and episodic treatment.
Suppressive treatment consists of taking daily antiviral medication to suppress the number of outbreaks and thus is often suggested for people who have multiple outbreaks per year. Episodic treatment is more of a reactive treatment initiated on the first signs of an outbreak, what is known as the prodrome, or first signs of a lesion.
Antiviral medications, like acyclovir and valacyclovir, can be used for both types of treatment, although the dosages and the durations vary.
What is Suppressive Treatment?Suppressive herpes treatment aims to suppress and reduce the frequency of herpes outbreaks by taking antiviral medication on a daily basis.
This preventative approach is often prescribed for individuals suffering from frequent outbreaks of six or more times per year. Medical studies report that a suppressive protocol may reduce the frequency of outbreaks by 75%, while for some individuals, a daily antiviral treatment inhibits outbreaks completely.
The quantity of antiviral medication varies, with individuals typically taking 1-2 pills on a daily basis. Additionally, suppressive treatments may prevent the transmission of genital herpes, since it suppresses viral shedding of HSV 2.
Suppressive treatment is therefore helpful and effective for couples who want to mitigate the risks of transmitting the STD.
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Where Does The Herpes Virus Live In The Body
The herpes simplex viruses are latent, meaning they can live in the body without causing symptoms. After the initial infection, the virus gets into the nerve roots and spreads to the sensory nerve ganglia, the junctions where nerves from different parts of the body come together. For the genital area, the ganglia are adjacent to the spinal cord in the lower back. For orofacial herpes , the ganglia are located behind the cheek bone.
How Can I Reduce My Risk Of Herpes Simplex
You can reduce your risk of contracting HSV-1 by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores arent present, but its less likely.
If someone has an active HSV-1 infection, avoid:
- Sharing utensils, cups, lip balms or other personal care products.
- Touching the skin near their mouth.
If youre sexually active, you can take these steps to protect yourself and others from the herpes virus and other STIs:
- Be monogamous with one sexual partner or limit your number of partners.
- Get tested for STIs and complete any prescribed treatment.
- Tell your sexual partners if you have genital herpes so they can get tested.
- Use condoms during intercourse and dental dams during oral sex.
Wash your hands often if you have an outbreak or are around someone with symptoms.
If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:
- Dont have sex when your partner has active symptoms. Condoms may not cover all sores, so you may still get the virus.
- Make sure your partner takes antiviral medication as prescribed.
- Wait to have sex until scabs fall off active lesions.
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Transmission Of The Virus
The highest risk of transmission is during the blister phase, although some virus may be present just before or after an outbreak. Get as informed as you can about the condition and become aware of symptoms such as tingling that indicate you’re about to have an attack. Abstain from sexual activity during an outbreak and consider using condoms and dental dams at other times for added protection.
“This indicates they are likely to have contracted the virus through receiving oral sex from a partner with a cold sore,” he explains. So it is also important to be aware of facial herpes outbreaks in the context of sexual health.
For most people who have been diagnosed, the risk of passing the virus on to someone else when they don’t have any visible symptoms is incredibly low, says O’Mahony.
“The issue with asymptomatic shedding has been blown out of all proportion. Some people will shed tiny amounts of virus in between outbreaks, but it’s very unlikely there’s enough present to cause an infection in somebody else.”
What Is The Difference Between Genital Herpes And Genital Warts
Both genital herpes and genital warts are STIs, are spread through skin-to-skin contact, and are caused by a virus. But the viruses that cause genital herpes and genital warts are different:
- Herpes simplex virus is the virus that causes genital herpes.
- Human papillomavirus is the virus that causes genital warts.
There is no cure for either genital herpes or genital warts. But, different medicines can help manage the symptoms of herpes and treat the complications of HPV infections that can cause genital warts.
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What Is Life Like For Someone Who Has Genital Herpes
The virus that causes genital herpes stays inside your body forever. While many people carry this virus, some dont know that they have it because they never have an outbreak.
If you have an outbreak, taking an antiviral medicine can shorten the outbreak and relieve symptoms. Some people have several outbreaks. For most people, the outbreaks become less severe and occur less often with time.
Anyone who has been infected with the virus, however, can spread the virus to others during sex. Even if you never have an outbreak, you can still spread the virus.
Related AAD resources
Centers for Disease Control. Genital Herpes – CDC Fact Sheet . Last accessed December 19, 2016.
Fatahzadeh M and Schwartz RA. Human herpes simplex virus infections: Epidemiology, pathogenesis, symptomatology, diagnosis, and management. J Am Acad Dermatol 2007 57:737-63.
Madkan V Sra K, et al. Human herpesviruses. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, Spain, 2008:1075-6.
Marques AR, Straus SE, Herpes simplex. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008: 1199-1204.
US Preventive Task Force. Serologic screening for genital herpes infection: US Preventive Services Task Force recommendation statement. JAMA. 2016 316:2525-30.
Questions To Ask Your Doctor
- What is the best treatment for me?
- Are there any side effects to my treatment?
- Is it safe to have unprotected sex if I dont have any sores?
- Can I give myself genital herpes if I also have oral herpes?
- Can I give someone else herpes even if Im not having an outbreak?
- What is the best way to prevent herpes outbreaks?
- 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?
- If I give my baby herpes, what is the treatment?
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What Are The Complications Of Genital Herpes
Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. 5 Both HSV-1 and HSV-2 can also cause rare but serious complications such as aseptic meningitis . 5 Development of extragenital lesions may occur during the course of infection. 5
Can You Prevent Genital Herpes 100% Of The Time
The best way to prevent the transmission of genital herpes is by utilizing consistent, safe sex practices and abstaining from sex during outbreaks.
While practicing ideal hygiene, such as gently washing genitals and thoroughly cleaning sex toys before/after sex, along with using condoms and dental dams, are effective ways to protect your sexual health and decrease your risk of sexually transmitted infections, they are not 100% effective.
Condoms can sometimes break or slip off during sexual activity. Thats why its essential to get tested regularly and have open conversations with your sexual partners about their sexual health and testing practices. â
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What Are Signs Of Genital Herpes In Women
Women who have the herpes virus may have nooutbreaks or signs of infection. Many do not know theyhave the virus. Once you are infected, the virus staysin your nerve cells for life. When the virus is not active,there is no sign of infection. When the virus becomesactive, a herpes outbreak occurs. Some womenmay not have any outbreaks or may have only oneoutbreak, while others may have multiple outbreaks.
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Herpes Symptoms And Signs
In order to diagnose herpes, a health care provider can swab an area of visibly active herpes infection or, if symptoms arent active, a blood test can be given that measures the number of herpes antibodies present in the body. The antibodies dont indicate herpes itself, but rather show the immune systems response to the presence of the virus in the body. Its important to note that sometimes a swab can give false negative results since herpes lesions need to be large enough to yield enough detectable virus and if the outbreak is already healing it also may not be detected in a swab.
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How Big Is The Risk Of Infection
The likelihood of being infected with genital herpes during sex depends on many factors, including how often you have sex, whether and how frequently you use condoms, and how long your partner has already been infected. Someone who has had the virus for a long time is less contagious than someone who has just been infected. In general, women have a higher risk of becoming infected than men. Having other sexually transmitted diseases such as HIV also increases the risk of transmission.
In studies with couples where one partner had genital herpes, the other partner became infected within one year in 5 to 10% of the couples. The people in these studies only rarely used condoms, though and if they did, it was mostly during an outbreak. One of these studies showed that infection occurred in an estimated 1 out of 1,000 sexual acts.
Facts And Statistics About Herpes
- According to the World Health Organization, an estimated two-thirds of the global population under 50 years old are infected with herpes simplex virus type 1 .
- Estimates for HSV-1 prevalence in the U.S. among people aged 049 years are 178 million women and 142 million men .
- In total, about 75 percent or more of the American adult population has the HSV-1 virus that usually causes oral herpes , and about 20 percent to 30 percent have HSV-2 that usually causes genital herpes.
- Men and women are affected by HSV-1 about equally. Roughly 6 million women in the U.S. become infected with HSV-1 each year, along with 5 million men.
- Slightly more women than men are affected by genital herpes, whether from HSV-1 or HSV-2. Middle-aged women are most likely to acquire genital herpes.
- Transmission of HSV most often occurs without symptoms, so its estimated that 85 percent of people with genital herpes dont know it. Many dont have any symptoms at all after the initial infection, and only about 15 percent ever receive a HSV-2 infection diagnosis in their lifetimes.
- Most primary oral/facial HSV infections are caused by HSV-1 however, facial infection by HSV-2 is increasingly becoming common.
- Less children are becoming infected with HSV-1 than in the past in high-income countries, mostly due to better hygiene and living conditions.
- After someone comes into contact with an active herpes outbreak on another person, the incubation period takes about one week.
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Is There A Cure For Genital Herpes
Treatment of genital herpes does not cure the disease. The virus usually lives in an infected person throughout their lifetime. Most people with genital herpes will have recurring outbreaks, sometimes 6-10 a year. Recurrences are likely to have less severe symptoms and sores usually last a shorter period of time.
How Do Doctors Manage Genital Herpes During Pregnancy
Oral antiviral medications as described above may be used during pregnancy. One serious concern with genital herpes in pregnancy is transmission of the infection to the baby during delivery. In an infant, genital herpes infection can spread through the bloodstream and have serious consequences. Cesarean delivery is performed for women who go into labor while there is an active outbreak of genital herpes in order to prevent infection of the baby during birth.
The American College of Obstetricians and Gynecologists recommends that pregnant women with recurrent genital herpes be offered oral antiviral medication at or beyond 36 weeks until delivery in order to increase the chances of being able to deliver vaginally.
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