Treatment The First Time You Have Genital Herpes
You may be prescribed:
- antiviral medicine to stop the symptoms getting worse you need to start taking this within 5 days of the symptoms appearing
- cream for the pain
If you have had symptoms for more than 5 days before you go to a sexual health clinic, you can still get tested to find out the cause.
Medical Treatment For Oral Herpes
Oral herpes symptoms may resolve without treatment within one to two weeks.
If needed, your healthcare provider will prescribe certain antiviral medications to treat your condition. These medications help with any pain you may be experiencing as well as alleviate symptoms more quickly.
Medications that are used to treat HSV-1 include acyclovir, famciclovir, and valacyclovir, which are most effective if taken when initial warning signs of an incoming flare-up appear and before blisters develop.
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.
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Testing For Genital Herpes
If you think you may have genital herpes you should make an appointment with your GP or local sexual health services.
If there are symptoms present such as blisters, sores and ulcers, your doctor or nurse may be able to make a diagnosis straight away.
If you have visible blisters, your doctor or nurse may take a swab for testing, to check if this is herpes and what type. This swab can also test for another STI which causes blisters called syphilis.
The genital herpes swab tests are very reliable, though if the ulcer is too dry then it may be less likely to find a positive result.
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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Is Herpes Simplex Related To Herpes Zoster
Herpes simplex and the varicella-zoster virus are related, but they arent the same. VZV causes chickenpox and shingles.
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.
References
How Common Is Herpes Simplex 1
HSV-1 is extremely common. In 2012 the World Health Organization estimated that a staggering 67% of the population was infected with the virus, and 140 million of those infected were estimated to have genital HSV-1. Oral HSV-1 is most commonly contracted during childhood after receiving kisses from family members who carry the virus. Cases of oral HSV-1 and genital HSV-1 are on the rise.
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What Are The Symptoms Of Genital Herpes
Most people infected with genital herpes have no symptoms, but some people can experience:
- stinging or tingling in the genital area
- small blisters on the genital area that develop into small painful red sores
- sores that look like a rash or cracked skin on the genitals
- difficulty passing urine
The first episode of infection can also have flu-like symptoms such as:
After the first episode, the virus remains dormant in your body for the rest of your life, which means you can experience recurrent episodes of sores and blisters.
Recurrent episodes are usually milder, shorter and less frequent over time. They are more likely to occur when your immune system is weak, due to illness, tiredness or stress.
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Stages Of Oral Herpes
There are three main stages of oral herpes:
- Primary infection: This stage consists of the initial contraction of the virus.
- Latency: When the infection enters the latency phase, it is dormant and symptoms are absent.
- Recurrence: Following the primary infection and periods of latency, outbreaks can recur.
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Is There Anything I Can Do To Relieve The Symptoms Myself
In some women, genital herpes blisters cause pain when urinating . Many of them find it soothing to pee while sitting in warm, shallow water . You can do this using special tubs that fit into toilet bowls. They are available at a reasonable price, for instance from pharmacies or on the internet. Itâs best not to use soaps or bath additives because they can irritate the affected area even more. Other things you can do to avoid irritating it further include wearing loose-fitting clothes and underwear made out of fabrics that have a smooth surface.
Painkillers such as ibuprofen are an option if the blisters become very painful.
Topical antiviral treatments such as creams or ointments donât provide any relief, but they can increase the risk of viral resistance. Experts advise against using topical treatments for genital herpes.
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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Genital Herpes: Frequently Asked Questions
What is genital herpes?
How common is genital herpes?
World Health Organization estimates that in 2012, 19.2 million new cases of HSV-2 infection happened among adults and youth aged 1549 years worldwide, with around 417 million cases already existing. The highest number of cases are found in WHO African Region and the WHO Region of the Americas. The reason the number of existing cases is so high is because there is no cure for herpes. In the region of the Americas there were around 2.2 million new cases of HSV-2 infections among females and 1.3 million among men in 2012, adding to the already around 45.2 million existing cases for females and 25.1 million existing cases for males.
How is genital herpes spread?
How is genital herpes prevented?
Currently there is no cure or vaccines for herpes. Condoms help reduce the chances of infection but do not eliminate it completely, because outbreaks of genital herpes can occur in areas not covered by a condom. Condom use is still advisable as they can prevent other sexually transmitted infections and unplanned pregnancies.
What are the symptoms of genital herpes?
What are the problems of genital herpes?
Repeated symptoms of genital herpes may be painful, and the infection can lead to social stigma and emotional distress. These factors can have an important impact on quality of life and sexual relationships. However, with time, most people with herpes adjust to living with the infection.
How is genital herpes diagnosed?
How Do I Know If I Have Genital Herpes
Most people with genital herpes have no symptoms or have very mild symptoms. Mild symptoms may go unnoticed or be mistaken for other skin conditions like a pimple or ingrown hair. Because of this, most people do not know they have a herpes infection.
Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. This is known as having an outbreak. The blisters break and leave painful sores that may take a week or more to heal. Flu-like symptoms also may occur during the first outbreak.
People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they have HSV-2. However, repeat outbreaks are usually shorter and less severe than the first outbreak. Although genital herpes is a lifelong infection, the number of outbreaks may decrease over time.
Ask a healthcare provider to examine you if:
- You notice any symptoms or
- Your partner has an STD or symptoms of an STD.
STD symptoms can include an unusual sore, a smelly genital discharge, burning when peeing, or bleeding between periods .
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How Can I Reduce My Risk Of Herpes Simplex
Preventing HSV-1
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.
Preventing HSV-2
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.
What Are The Possible Side Effects Of Valacyclovir Tablets
Kidney failure and nervous system problems are not common, but can be serious in some patients taking valacyclovir tablets. Nervous system problems include aggressive behavior, unsteady movement, shaky movements, confusion, speech problems, hallucinations , seizures and coma.
Kidney failure and nervous system problems have happened in patients who already have kidney disease and in elderly patients whose kidneys do not work well due to age. Always tell your healthcare provider if you have kidney problems before taking valacyclovir tablets.
Common side effects of valacyclovir tablets in adults include headache, nausea, stomach pain, vomiting and dizziness. Side effects in HIV-infected adults include headache, tiredness and rash. These side effects usually are mild and do not cause patients to stop taking valacyclovir tablets.
Other less common side effects in adults include painful periods in women, joint pain, depression, low blood cell counts and changes in tests that measure how well the liver and kidneys work. The most common side effect seen in children < 18 years of age was headache.
Talk to your healthcare provider if you develop any side effects that concern you. These are not all the side effects of valacyclovir tablets. For more information ask your healthcare provider or pharmacist.
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Herpes And Newborn Infants
Herpes infection in a newborn can cause a range of symptoms, including skin rash, fevers, mouth sores, and eye infections. If left untreated, neonatal herpes is a very serious and even life-threatening condition. Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis. It also can lead to intellectual disability, cerebral palsy, and death. Herpes can also spread to internal organs, such as the liver and lungs.
Infants infected with herpes are treated with acyclovir, an antiviral drug. They usually receive several weeks of intravenous acyclovir treatment, often followed by several months of oral acyclovir. It is important to treat babies quickly, before the infection spreads to the brain and other organs.
Can You Get Oral Herpes From Genital Herpes
Yes! The same goes for vice versa. We can not stress how easy it actually is to get either strain of herpes in either location, even if youre using protection.
- If your partner has HSV-2 and it is located genitally, and you give them oral pleasure, you can recieve HSV-2 that is located orally.
- If your partner has HSV-1 and it is located genitally, and you give them oral pleasure, you can recieve HSV-1 that is located orally.
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Symptoms Of Type 1 Genital Herpes
There are two types of herpes virusesherpes simplex virus type 1 and herpes simplex virus type 2 1. While HSV-1 primarily causes sores to develop on the mouth or face, it is estimated that 30 percent of all genital herpes infections are caused by HSV-1 12. These cases are sometimes transmitted through genital-to-genital contact, but more often through oral to genital contact. Like those with HSV-2 infections, approximately two-thirds experience no symptoms and are not aware they have herpes 1.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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Herpes Simplex Virus 1
Herpes Simplex Virus 1 is a strain of the herpes simplex virus. People may believe that HSV-1 is the same thing as oral herpes, and that it always causes cold sores to appear on the mouth or facial region, but thats not always true. HSV-1 can be acquired in the genital region, creating genital HSV-1.
Similarly, HSV-2 is popularly known as genital herpes, but HSV-2 can be acquired in the facial region creating oral HSV-2. Both HSV-1 and HSV-2 are nearly identical they share 50% of their DNA and produce almost indistinguishable symptoms. This is why its important to get tested for both strains of the disease.
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What If You And Your Partner Already Have Oral Herpes
We hope you get the idea by now: Yes, you can still get genital herpes.
Even if you already have either strain in either location, you can still receive either strain in the other location.
- If you have HSV-1 on your mouth, your partner can still give you HSV-2 on your genitals.
- If you have HSV-1 on your genitals, your partner can still give you HSV-2 on your mouth.
- If you have HSV-1 on your mouth, your partner can still give you HSV-1 on your genitals.
- If you have HSV-1 on your genitals, your partner can still give you HSV-1 on your mouth.
Again, were sorry if you didnt need this all spelled out for you, but a lot of people have a lot of questions about herpes, and we just want to give the people what they want. When that means a more informed approach to sexual health, who can be mad?
Should You Even Be That Worried?
With all of the information weve shared today, lets create a fake scenario:
John Does aunt kisses him on the mouth when he is a tiny baby, but she has a cold sore. Her cold sore was caused by HSV-1. John Doe lives his life and grows into a man, unaware that the herpes simplex virus type-1 is living asymptomatically within his DNA. John Doe meets a lovely lady named Jane Doe and he goes down on her. The HSV-1 is spread to Jane Does genitals, and she accuses John Doe of being a cheater and she leaves him. John Doe is confused, Jane Doe is confused, and this whole situation could have been solved if they had just both read this blog post!
Is It Safe To Breastfeed If I Have Genital Herpes
Yes as long as there isnt an open lesion on your chest or breast. If you have an active outbreak while breastfeeding, its possible to spread the infection to your nipples through touch. Careful hand-washing can prevent this spread. You shouldnt nurse from a breast that has herpes sores. You can pump breast milk until the sores heal. Dont give your baby expressed breast milk if the pump comes into contact with an open sore.
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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.
Is There A Cure Or Treatment For Herpes
There is no treatment that can cure herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication. In addition, daily suppressive therapy for herpes can reduce the likelihood of transmission to partners.
Oral acyclovir markedly shortens the course of a first episode and limits the severity of recurrences if taken within 24 hours of onset of symptoms. People who have very frequent episodes of the disease can take oral acyclovir daily for up to one year to suppress the virusâ activity and prevent most recurrences. Acyclovir does not cure herpes, but it interferes with the virusâ ability to reproduce itself. Other new drugs â famciclovir and valacyclovir â now work in a similar manner.
Does genital herpes cause any complications?
Genital herpes can cause painful genital sores in many adults and can be severe in people with suppressed immune systems. If a person with genital herpes touches their sores or the fluids from the sores, they may transfer herpes to another part of the body. This is particularly problematic if it is a sensitive location such as the eyes. This can be avoided by not touching the sores or fluids. If they are touched, immediate and thorough hand-washing make the transfer less likely.
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