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.
The most common herpes symptoms include:
- Developing either a single cold sore or cluster of multiple cold sores that form on the lips, inside the mouth, or on the genitals, buttocks and upper thighs.
- Sores can sometimes be severe, painful and rupture and cause fluid to be secreted out.
- Some herpes canker sores develop a thin, white coating and burn when touched while they healing.
- Around herpes cold sores, its common to feel pain, tenderness and other symptoms of a rash, such as redness or signs of swelling.
- Some people are able to tell before an outbreak if one is going to occur because they feel tingling, itchy sensations near the affected area.
- Some people develop other symptoms during herpes outbreaks that are similar to those caused by a cold or the flu. This may include fatigue, irritability, aches or a slight fever.
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.
What Is The Prevalence Of Genital Herpes In The Uk And Worldwide
In the UK, there was a 15% increase in the number of diagnoses of first attack of genital herpes from 16479 cases in 1995 to 19180 cases in 2004.1 In the United States, an estimated 40-60 million people are infected with HSV-2, with an incidence of 1-2 million infections and 600000-800000 clinical cases a year.2 The prevalence of genital herpes in developing countries varies from 2-74% according to the country. In some African countries that are experiencing HIV epidemics, HSV-2 is highly prevalent , and there is evidence that genital HSV increases the risk of HIV infection and that people with both are more likely to transmit HIV infection.3
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Treatment For Oral Herpes
The antiviral medications available in pill form have been specifically developed for the treatment of genital herpes. However, it is not uncommon for healthcare providers to prescribe the antiviral drugs to those who have frequent or severe outbreaks of oral herpes.
A recent study found valacyclovir to be effective for treating oral herpes in a one-day treatment of 2 grams taken at the first sign of a cold sore, and then again about 12 hours later.
There are two topical antiviral medications prescribed for the treatment of oral HSV symptoms: acyclovir ointment and penciclovir cream. Both work to speed up the healing process and reduce the viral activity. These topical drugs are put directly on the lesions themselves, but can also be used at the onset of prodrome.
Other topical treatments for oral herpes are available over-the-counter , but are not antiviral compounds like acyclovir and penciclovir. Some also contain ingredients that numb the area and induce temporary relief from the discomfort of an outbreak. Unfortunately, some OTC treatments may actually delay the healing time of symptoms because they can further irritate the area with repeated applications. There is only one OTC FDA-approved cream, called Abreva®, which has been clinically proven to help speed the healing process.
Does A Cold Sore On My Mouth Mean I Have Genital Herpes
No, a cold sore on your mouth usually means you have herpes simplex virus type 1 . You can get HSV-1 by kissing someone or sharing utensils, towels, razors, or lipstick with someone who has HSV-1.
HSV-1 cannot turn into HSV-2 , but you can get a cold sore on your mouth from HSV-2 if you give oral sex to someone with HSV-2. Cold sores caused by HSV-1 or HSV-2 are contagious. You can spread it to other people or other parts of your body if you touch an open sore and then touch another part of your body. That means if you have a cold sore and give oral sex to someone, that person will get the herpes virus on his or her genitals.
Avoid touching your cold sore as much as possible. If you touch your cold sore, wash your hands right away to avoid spreading the infection to other parts of your body or other people.
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If You Have Genital Herpes Already Can It Be Spread To Other Parts Of The Body Such As The Arms Or Legs
No. Genital herpes cannot be transmitted to another part of your body such as your arm, leg or hand after the first infection occurs. If you have genital HSV II, you will not get HSV II at another site in your body. The immune system produces antibodies that protect other parts of your body from infection. However, there are cases where a person has multiple site infections from the same virus. This is usually acquired at the time of the first infection. For example, if someone has never had herpes but then has oral and genital sex with an infected partner, they can acquire the infection at both sites.
Im Pregnant How Could Genital Herpes Affect My Baby
If you are pregnant and have genital herpes, prenatal care visits are very important. Some research suggest that a genital herpes infection may lead to miscarriage or make it more likely to deliver your baby too early. You can pass herpes to your unborn child before birth, but it more commonly passes during delivery. This can lead to a deadly infection in your baby . It is important that you avoid getting genital herpes during pregnancy. Tell your healthcare provider if you have ever had a genital herpes diagnosis or symptoms. Also tell them about any possible exposure to genital herpes.
If you have genital herpes, you may need to take anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes when you deliver. At the time of delivery, your healthcare provider should carefully examine you for herpes sores. If you have signs or symptoms of genital herpes at delivery, a C-section is likely to occur.
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Treatment If The Blisters Come Back
Go to a GP or sexual health clinic if you have been diagnosed with genital herpes and need treatment for an outbreak.
Antiviral medicine may help shorten an outbreak by 1 or 2 days if you start taking it as soon as symptoms appear.
But outbreaks usually settle by themselves, so you may not need treatment.
Recurrent outbreaks are usually milder than the first episode of genital herpes.
Over time, outbreaks tend to happen less often and be less severe. Some people never have outbreaks.
Some people who have more than 6 outbreaks in a year may benefit from taking antiviral medicine for 6 to 12 months.
If you still have outbreaks of genital herpes during this time, you may be referred to a specialist.
How Has My Partner Caught Genital Herpes
If your partner has only just been diagnosed with genital herpes, this does not necessarily mean that they have been unfaithful to you or sexually promiscuous in the past.
- Your partner may have caught genital herpes from you. You can carry the virus without knowing you have it as some people have no symptoms.
- It is also possible that your partner caught the virus from a cold sore on your mouth or face during oral sex. You can pass the virus on even if you don’t have a cold sore at the time of contact.
- Your partner may have contracted the virus from a previous sexual partner, even several years ago. The virus can remain inactive in your body for long periods.
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Myth: If You Get A Cold Sore You Have Genital Herpes
Cold sores and genital herpes are two distinct strains of the herpes simplex virus. Many people get cold sores, but that doesn’t mean they have an Sexually transmitted diseases .
Herpes simplex virus type 2 is the form of herpes categorized as a sexually transmitted infection , and is the main cause of genital herpes. It doesn’t usually cause cold sores, which are caused by HSV-1. There is no cure for HSV-2, so it’s a lifelong disease.
How Far Away Is A Cure For Herpes
Theres currently no cure for herpes, but that might change in the future.
According to 2020 research published in Nature, scientists from the Fred Hutchinson Cancer Research Center removed 90 percent of the HSV-1 virus from cells in mice using gene editing.
However, it takes time to transition potential treatments from animals to humans. In a 2020 news article, one of the researchers that authored the Nature paper estimated that it would be at least 3 years before human trials.
Scientists are also researching the possibility of creating a vaccine to prevent herpes. A 2022 study outlined a new approach to developing an mRNA vaccine for herpes. The vaccine mentioned in the study worked well in mice and guinea pigs.
The researchers say that theyre aiming to conduct human trials before the end of 2022, and the vaccine could be available within the next 10 years.
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Myth: You Always Get A Herpes Outbreak Soon After Becoming Infected
Herpes is a sneaky infection. It can exist in the body for months or even years without showing symptoms, but it’s still contagious nonetheless.
If you do develop an outbreak, it will most likely happen two to twelve days after initial exposure to the virus. After the blisters break, they can take up to four weeks to heal.
Fortunately, subsequent outbreaks tend to be less intense. Recurring outbreaks are common but don’t last nearly as long. These sores tend to heal within three to seven days, and the number of outbreak periods may even decrease over time.
What Happens At A Sexual Health Clinic
The doctor or nurse at the sexual health clinic will:
- ask about your symptoms and your sexual partners
- use a small cotton bud to take some fluid from 1 of your blisters or sores for testing
The test cannot:
- be done if you do not have visible blisters or sores
- tell you how long you have had herpes or who you got it from
Symptoms might not appear for weeks or even years after you’re infected with the herpes virus.
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Treating Genital Herpes And Prevention
Once you get Genital Herpes, there isnt an immediate way to treat it. It can remain dormant in the human and then reappear one day in the form of sores. There are prescription medicines to prevent transmission and also to reduce the likelihood of recurrence. A person with this can promote healing and reduce the risk of transmission by:
- Keeping sores dry and clean
- Avoid sexual contact with a different person unless fully healed
- Not touching sores
- Using a barrier as protection during sex
- Washing hands after touching the sores
When sores are present, then sexual contact must be avoided. Use of condoms does reduce the risk of infection, but as the skin around the genital sis infectious as well, this isnt a foolproof method. Doctors usually recommend checks after having intercourse with a new partner.
First Episode Of Genital Herpes
The initial episode is the first episode of genital infection with either HSV-1 or HSV-2 . Primary genital herpes is the first episode in an individual with no pre-existing antibodies to either HSV type. A non-primary first episode is the first infection in an individual with pre-existing antibodies to the other HSV type.45
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Myth: A Condom Protects 100% Against Genital Herpes
The herpes virus is always active in your body, even when no sores are present.
Wearing a condom is an important preventative measure if you or your partner has herpes, but it doesn’t guarantee complete protection. The herpes virus lives both inside and outside the area a condom covers, so it can still spread from one person to another.
If you’re concerned about contracting or transmitting herpes, don’t have sex if you or your partner has an active herpes outbreak. The virus is more likely to spread when active sores and ulcers exist. It’s also important that the infected person regularly take antiviral medicine to keep their infection under control.
Prevention And Management Of Genital Herpes
Cortney M. Mospan, PharmD, BCACPAssistant Professor of Pharmacy PracticeEast Tennessee State University
David Cluck, PharmD, BCPS, AAHIVPAssistant Professor of Pharmacy PracticeEast Tennessee State University
US Pharm. 2016 41:30-33.
ABSTRACT: Genital herpes continues to be a relevant public-health concern because of its prevalence and its association with an increased risk of acquiring other sexually transmitted diseases. Genital herpes may present as vesicular lesions that can rupture and become painful however, more than 80% of individuals are asymptomatic, which makes it difficult to contain the spread of disease. The treatment of genital herpes serves to shorten symptom duration and improve quality of life, but it does not cure the disease. Strategies to prevent transmission include chronic suppressive therapy in serodiscordant couples, safe-sex practices, and avoidance of sexual intercourse during outbreaks. Currently available therapies are well tolerated and highly effective, and some newer therapeutic options are being investigated.
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Don’t Have Sex During An Active Outbreak
You can also limit the risk of transmission by refraining from intimate contact until a herpes outbreak clears and heals completely. The virus is highly contagious for your partner from the time you begin to feel the sensation of developing sores until your outbreak has completely scabbed and healed.
Can I Be Treated To Prevent Genital Herpes Transmission To My Partner
Yes. A large study showed that if one partner has herpes and the other partner is uninfected, treating the infected partner with suppressive therapy can prevent transmission of symptomatic herpes in over 90% of cases. This is an option for couples who are interested in having unprotected sex or who are planning to become pregnant.
If you are entering into a new relationship and are aware that you have herpes simplex infection, you owe it to your partner to notify them before having sex.
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What Happens During An Outbreak
Genital herpes is an infection caused by the herpes simplex virus. You catch it by having intimate contact with someone who has the virus.
In between episodes, most people don’t know they have been infected by it. The virus remains in your nervous system and can be reactivated from time to time to give you symptoms. Outbreaks can occur in the genital area if the first infection was in the genitals. They cause crops of small painful blisters in the genital area and back passage . Herpes can also cause recurrent cold sores if the primary infection was around the mouth.
No one knows why outbreaks occur, although sunlight, physical illness, excess alcohol, and stress are all thought to be trigger factors. They often do become less frequent over time.
Recurrent episodes of genital herpes generally don’t last as long as the first outbreak. They are sometimes preceded by itching or tingling in the genital area. Recurrent outbreaks usually last about 7-10 days, shorter than the primary infection which can last up to two weeks. They are also often milder than a primary infection but as R35506 found, the shallow ulcers left when the blisters break can still be quite painful.
Prevention Of Genital Herpes
The best protection against STIs is to always use barrier protection such as condoms, female condoms and dams . Because herpes is spread by skin-to-skin contact, condoms will reduce the risk of transmission, but it will not protect sexual partners completely as condoms do not cover the entire genitals.
Using lubricant with a condom during sex will also reduce the risk of trauma to the genital skin. This has been shown to reduce HSV transmission, especially in the first six months of a sexual relationship. Silicone-based lubricants are recommended.
Remember that herpes transmission can occur when symptoms are present , but may also occur even if there are no genital symptoms through asymptomatic viral shedding.
For people who have frequent episodes of genital herpes, antiviral medication, taken daily, helps to reduce transmission of herpes to a sexual partner.
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Box 1 Presentation Of First Episode Of Genital Herpes
- Multiple grouped vesicles that rupture easily leaving painful erosions and ulcers
- There may be associated systemic symptoms such as fever and myalgia
- Healing of uncomplicated lesions takes two to four weeks
- Severe complications are rare but can include autonomic neuropathy with urinary retention and aseptic meningitis
I Diagnosis Of Genital Herpes
Key Question 1: What are the optimal tests for HSV-1 or HSV-2 detection from a genital ulcer/lesion/suspected HSV outbreak?
As of 5 April 2019, 17 HSV nucleic acid amplification test /polymerase chain reaction diagnostic assays were US Food and Drug Administration approved for detection of HSV from clinical specimens . Although these tests vary in sensitivity and specificity, most available tests with published data have > 90% sensitivity and specificity . In addition, some laboratories use in-housedeveloped HSV PCR assays, for which test performance characteristics may be difficult to assess. Providers should be aware of the test characteristics of HSV NAATs that are performed in their clinical setting. Assays that differentiate between HSV-1 and HSV-2 infection should be utilized, to provide patients with information regarding expected natural history of genital herpes.
While HSV molecular assays are highly sensitive and specific, there may be situations in which false-negative results occur. For instance, the yield of HSV viral culture decreases as genital ulcers heal it is likely that healing lesions may become negative for HSV DNA as well. HSV molecular assays should not be obtained in the absence of a genital ulcer to diagnose genital herpes infection due to the intermittent nature of genital HSV shedding, swabs obtained in the absence of genital ulcers would not be sensitive. In these situations, HSV serologic assays should be performed.
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