How Soon Do Symptoms Appear
Symptoms tend to come on suddenly anywhere from two days to two weeks after youve been exposed to the virus.
The appearance of symptoms is called an outbreak. After your initial outbreak is treated, you may have subsequent outbreaks during the next year and occasionally throughout the rest of your life.
Frequently Asked Questionsexpand All
People with HSV-2 infection have an increased risk of getting human immunodeficiency virus if they have sex with an HIV-infected partner. Taking suppressive therapy does not decrease this risk.
If a woman is pregnant and infected with HSV, it can be passed to the fetus during birth while passing through the womans infected birth canal. This is most likely to occur if a woman first becomes infected with HSV during pregnancy and in a woman who has her first outbreak late in pregnancy. But it also can occur during a recurrent outbreak in a woman who was infected before pregnancy, although the risk is much lower.
If you have sores or warning signs of an outbreak at the time of delivery, you may need to have a cesarean delivery to reduce chance of infection. The decision depends on many factors, including where the sores are on your body and whether the fetus would come into contact with them during delivery.
Yes, in most cases. The herpes virus cannot be passed to a baby through breast milk. However, the baby could get infected by touching a sore on your body. Make sure any sores that the baby could come into contact with are covered when you hold your baby or while breastfeeding. Wash your hands with soap and water before and after feeding your baby. If you have sores on your breast, you should not breastfeed your baby from that breast.
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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.
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How Can You Avoid Genital Herpes
Most women get genital herpes through sexual contactwith a person who has herpes sores. You can get thevirus without having sex. To avoid infection:
- Avoid skin-to-skin and sexual contact.
- Have safer sex:
- Reduce the number of sexual partners.
- Condoms, when used correctly, can reduce therisk of getting genital herpes. Each time you have sexuse a condom :
- Before vaginal sex
- Before oral sex
For more information, see Safer Sex.
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
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Genital Herpes Is Spread By Skin
The virus can be spread when someone with HSV has an episode or an outbreak characterised by having a sore, blister, ulcer or skin split . It can also be spread between episodes, when there is no sore, blister, ulcer or skin split present called asymptomatic viral shedding.
During viral shedding the virus is on the skin surface and can be spread through genital skin-to-skin contact, or from the mouth or face to genital skin during contact.
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Fever Blisters And Cold Sores Are Oral Herpes Too
Fever blisters and cold sores are just different names for oral herpes, and theyve been around for a very long time. Legend has it that in ancient Rome, the emperor Tiberius banned kissing at public events because of an outbreak of fever blisters. In other words, they even knew back then how contagious fever blisters are.
The best way to protect yourself is to avoid contact with a person who has a cold sore and refrain from sharing eating utensils, lip balm, and the like. Note that someone with oral herpes can give you genital herpes if they perform oral sex on you. Avoid kissing and oral sex when outbreaks are present.
There is no cure for fever blisters and no vaccine to prevent them, although research into preventing and treating them is ongoing. If you do get oral herpes, your doctor may recommend over-the-counter pain medication and topical anesthetics to relieve symptoms. Some people also choose to take antiviral medication to make cold sores go away faster.
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What Are The Causes Of Genital Herpes
Genital herpes is spread by skin-to-skin contact with someone who has the HSV virus, usually during genital or oral sex. It can also be spread through kissing, foreplay or non-penetrative sex.
- HSV1 commonly causes cold sores on the lips or face.
- HSV2 causes most genital herpes.
The HSV virus is most easily spread when there are blisters or sores, but it can still be passed even if a person has no current blisters or sores or other symptoms.
You cannot get genital herpes from things like hugging, swimming pools or toilet seats.
Could I Have Genital Herpes And Not Know
Unless no one has ever kissed you, and unless youve never had sex, it is possible that youve picked up a herpes virus.
Oral herpes, usually caused by the herpes simplex virus type 1 , shows up as cold sores or fever blisters on the mouth. Even a casual peck on the lips from someone with a cold sore can give you the virus. Thats why its so common: As many as 50% to 80% of adults in the U.S. have oral herpes.
Genital herpes, most often caused by the second type of herpes virus , is less common, but plenty of people still have it. Roughly one in five U.S. adults has genital herpes. But up to 90% of those who have it dont know they are infected. You could be one of them.
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What Causes Symptoms To Come Back
When symptoms recur, they usually come on during times of emotional stress or illness. That’s because, during these times, your body’s immune system may be less able to suppress the virus and keep it from becoming active.
Symptom triggers can include:
- Interfere with a person’s sense of security and intimacy
In some cases, though, complications from genital herpes can be serious, even life-threatening.
Although it’s rare, pregnant women can pass on the herpes infection to their child. This can result in a serious and sometimes deadly infection in the baby. That’s why taking steps to prevent an outbreak at time of delivery is recommended starting at 34 weeks into the pregnancy. If you have signs of an active viral infection when it’s time to deliver, your doctor will likely recommend a cesarean section for delivery.
If you have any reason to believe you may have an HSV infection as the result of a sexual encounter — either genital or oral — contact your health care provider.
What About Chlamydia The Most Common Std
Chlamydia is caused by bacteria, whereas herpes is caused by a virus. This is why chlamydia is easily treated and cured with antibiotics. However, many people have chlamydia and dont know it because they don’t have any symptoms. That’s why people who are at higher risk of chlamydia, including sexually active young women and men who have sex with other men, are advised to get a test for chlamydia every year.
If you don’t treat chlamydia, it can increase the chances of both men and women getting or giving HIV and AIDS, according to Medline Plus. Untreated chlamydia can also cause serious pelvic inflammatory disease in women, which can lead to infertility, and in men it can spread to the testicles and the tube that carries sperm, causing inflammation.
Screening for chlamydia is usually done by taking a urine sample or a swab from your genitals. Results of these tests are usually found quickly. Different testing methods are used for infections of the rectum and throat, and these take more time.
While the only way to completely avoid getting chlamydia or herpes is to not have sex, you can reduce your chances of getting both by being in a long-term, mutually monogamous relationship with a partner who is not infected with an STD and by using latex condoms every time you have sex.
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How To Avoid Genital Herpes
Using condoms reduces the risk of contracting all sexually transmitted infections including genital herpes.
Genital herpes can be passed on even when there are not blisters present.
However, the blisters and sores are highly infectious, so if you or a partner have cold sores or genital herpes:
- avoid kissing when you, or a partner, have cold sores around the mouth
- avoid oral sex when you, or a partner, have mouth or genital sores
Can Genital Herpes Be Treated
Your physician can prescribe different medications to help reduce your symptoms and speed up the healing of an outbreak. These medicines work best when you start them soon after an outbreak occurs.
To reduce pain during an outbreak:
- Sit in warm water in a portable bath or bathtub for about 20 minutes. Avoid bubble baths.
- Keep your genital area clean and dry, and avoid tight clothes.
- Take over-the-counter medications, such as acetaminophen or ibuprofen. Avoid aspirin.
Let your physician know if you are worried about your genital herpes. He or she can recommend a support group to help you cope with the virus.
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Sexuality In Midlife And Beyond
The physical transformations the body undergoes with age have a major influence on sexuality. This Special Health Report, Sexuality in Midlife and Beyond, will take you through the stages of sexual response and explain how aging affects each. Youll also learn how chronic illnesses, common medications, and emotional issues can influence your sexual capabilities. Finally, youll find a detailed discussion of various medical treatments, counseling, and self-help techniques to address the most common types of sexual problems.
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What Are Genital Warts
Genital warts are one of the most common sexually transmitted infections, says Michael Cackovic, MD, a maternal fetal medicine physician at The Ohio State University Wexner Medical Center in Columbus.
The warts are caused by an infection from the human papillomavirus . Many HPV strains can be spread through sexual contact. If you have HPV, it’s possible to spread the infection even if you don’t have active warts, Jeffy says.
Here are a few symptoms of genital warts:
- Flesh-colored bumps that may or may not be visible. Warts usually appear in the genital area but can also be in the mouth or throat from oral sex with an infected person, the American Academy of Dermatology reports.
- Mild pain or no pain at all
- Itchiness in the genital area
- Bleeding of warts during sex
- Warts may feel sore if they rub against skin or clothing.
Left untreated, an outbreak of genital warts can last months or even years. Sometimes they will go away on their own, but usually they require treatment, says Cackovic. Treatments for genital warts include prescription topical medications such as imiquimod, freezing them with liquid nitrogen, or excision, i.e. surgical removal.
Although topical treatments may take a few weeks to work, they are the easiest to prescribe because you can use them at home every day, Cackovic says. The US National Library of Medicine advises avoiding sexual contact while using treatments such as imiquimod because it can weaken condoms and vaginal diaphragms.
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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.
How Can I Confirm Whether I Have Genital Herpes
Herpes doesnt always cause symptoms, so your best bet is to make an appointment with a healthcare provider. They might be able to diagnose you just by looking at your symptoms.
They may also take a fluid sample from a blister and test it or have you do a blood test.
Youll likely be asked some questions about your sexual history. Its very important that youre honest in your answers. This will help to determine whether you should be tested for any other STIs while youre there.
Remember, theres no cure for herpes. But antiviral medication can help to prevent the virus from reproducing and reduce the number of outbreaks you have. This can also reduce your risk of passing the virus to others.
Common antiviral medications used for herpes include:
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How Can I Best Learn To Cope With Herpes Simplex
Some people feel distressed or embarrassed about their herpes simplex infection. Its important to understand that the herpes virus is common. For most people, herpes doesnt significantly interfere with daily life.
To cope with negative feelings, you may consider:
- Connecting with others through support groups or online forums.
- Sharing your feelings with a trusted friend or loved one.
- Speaking with a therapist.
Ingrown Hair And Pseudofolliculitis
When the hair is not properly shaved on fragile skin, it can curl inside it, forming a bump, and can progress to pseudofolliculitis or even folliculitis.
The skin in the genital area is particularly fragile, and ingrown hair can easily occur there as a result of a nonoptimal shaving technique. The bump of ingrown hair is usually small and firm, but it can look like a blister, which makes it look like a herpes lesion. It can also be painful, but its pain does not resemble the distinctive burning pain of herpes. It also does not ulcerate, and if it pops open it usually heals very quickly, unlike herpes.
When there is recurrence of ingrown hair, inflammation can occur in that area and present as redness of the surface of the skin and a chronic recurrence of itchy buttons. The condition is commonly seen in the beard area, especially on the neck and under the chin where the skin is more fragile, but it can also be seen in the pubis and other areas.
The skin lesions of pseudofolliculitis are, like ingrown hair and contrary to herpes, unlikely to ulcerate. They follow the pattern of hair growth, and they have particularly more pruritis or pain a day or two after shaving.22
Image 7. Ingrown hair and pseudofolliculitis .
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What Is Herpes Simplex
Herpes simplex is a virus that causes skin infections. The infection lasts your lifetime, and it causes painful or itchy sores and blisters that come and go. Herpes simplex virus typically doesnt cause severe problems. But it can be dangerous in infants and people with weakened immune systems. There are two types of herpes simplex:
- Herpes simplex 1 tends to affect your mouth or face. It causes cold sores. HSV-1 spreads through contact with saliva .
- Herpes simplex 2 is a sexually transmitted disease . It causes sores on skin that comes in contact with the genitals of an infected person.
Sometimes a herpes infection can affect other parts of your body, such as your eyes or other parts of your skin.
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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