How Is Herpes Simplex Diagnosed
Healthcare providers may diagnose herpes simplex based on how the sores look. Your provider may take a sample from the sore. Laboratory analysis of the sample can confirm or rule out the herpes virus.
If you dont have sores, your healthcare provider can use a blood test to check for HSV-1 and HSV-2 antibody, a marker showing youve been exposed to the virus. The blood test doesnt show an active infection . But it informs your provider whether youve been exposed to the herpes virus in the past. If this is your first infection, you may not test positive for herpes if there hasnt been enough time for your body to develop antibodies. The HSV-1and HSV-2 antibody test may be repeated in eight to 12 weeks.
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 Is Herpes Treated
There is no cure for the herpes simplex virus. The blisters usually heal and go by themselves, so you may not always need treatment. If treatment is needed, there are antiviral medicines which can help. These can shorten outbreaks, relieve discomfort and stop symptoms from getting worse.
The antiviral treatment is most effective when you take it within the first five days of symptoms appearing. Avoid touching the blisters as this can spread the infection. If treatment requires you to apply cream to a sore, gently pat the cream on, being careful not to rub around the surrounding area.
You can ease your symptoms by:
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keeping the affected area clean using plain or salt water to prevent blisters or ulcers from becoming infected
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applying petroleum jelly, such as Vaseline, to any blisters or ulcers to reduce pain when passing urine
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asking a healthcare provider to recommend painkilling creams
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avoiding tight clothing because it may irritate the blisters and ulcers.
Donât have sex until you or your partner have finished your treatment, and the blisters or ulcers have gone. Recurrent outbreaks are usually milder than the first episode of genital herpes and over time they tend to occur less often.
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Can Genital Herpes Cause Other Problems
For most women, genital herpes does not usually cause serious health problems.
Women with HIV can have severe herpes outbreaks that are long-lasting. Herpes also may play a role in the spread of HIV. Herpes sores can make it easier for HIV to get into your body. Also, herpes can make people who are HIV-positive more likely to spread the infection to someone else.
What If I Am Pregnant
It is important to tell your obstetrician that you or a partner have had genital herpes, so that they can monitor you for symptoms and manage your pregnancy safely. There is a risk you can pass the virus on to your baby if you have a vaginal delivery during a first attack of genital herpes. If this happens you may be recommended to have a caesarean delivery.
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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.
Myth #: People Cannot Spread Herpes To Others Unless They Have Sores Or Blisters
Fact: People can spread herpes to others at any time, including when they do not have any symptoms.
People with herpes may experience outbreaks and remissions. During an outbreak, a person has active sores or blisters, but in remission, they may have no symptoms at all.
The virus is usually more contagious when a person has an outbreak, but it can also spread when it is in remission.
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When Treatments For Genital Herpes Are Given
- Initial treatment. If you have symptoms such as sores when you’re first diagnosed with genital herpes, your doctor will usually give you a brief course of antiviral therapy to relieve them or prevent them from getting worse. Your doctor may keep you on the drugs longer if the sores don’t heal in that time.
After the first treatment, work with your doctor to come up with the best way to take antiviral therapies. There are two options:
- Intermittent treatment. Your doctor may prescribe an antiviral drug for you to keep on hand in case you have another flare-up this is called intermittent therapy. You can take the pills for two to five days as soon as you notice sores or when you feel an outbreak coming on. Sores will heal and disappear on their own, but taking the drugs can make the symptoms less severe and make them go away faster.
- Suppressive treatment. If you have outbreaks often, you may want to consider taking an antiviral drug every day. Doctors call this suppressive therapy. For someone who has more than six outbreaks a year, suppressive therapy can reduce the number of outbreaks by 70% to 80%. Many people who take the antiviral drugs daily have no outbreaks at all.
There is no set number of outbreaks per year that doctors use to decide when someone should start suppressive therapy. Rather, more important factors are how often the outbreaks happen and if they are severe enough to interfere with your life.
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Contact Your Physician Or Clinic
Because the only sure way to diagnose genital herpes is with lab tests, youll need to contact your primary care physician, gynecologist, or local health department for testing. There are six ways to test for HSV-2:
- Swab culture of the blister
- Polymerase chain reaction test
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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.
Send The Message Before You Have Sex
The conversation needs to happen before having sex and hopefully not in the heat of the moment. Alexandra Harbushka, founder of Life With Herpes and spokesperson for Meet People With Herpes, says a great way to lead with the topic is talking about both parties sexual health, and insisting that you both get tested.
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Do Genital Warts And Herpes Look The Same
Genital warts and herpes can be hard to tell apart since they both appear in the genital area. However, genital warts are small, flesh-colored bumps whereas herpes sores look like blisters or open wounds. Both genital warts and genital herpes can be sexually transmitted through skin-on-skin contact.
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.
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What Effects Does Herpes Have During Pregnancy
Itâs really important to speak to a healthcare worker if you have herpes during pregnancy, especially if it’s your first outbreak. If you have herpes there’s a risk that your baby can develop âneonatal herpesâ. This can be very dangerous or even fatal for your baby. Your healthcare provider will be able to prescribe antiviral treatment to keep your baby safe and help you have a healthy pregnancy.
Speak to a healthcare worker for more information or if you have any concerns.
Which Std Tests Should I Get
If you are sexually active, getting tested for STDs is one of the most important things you can do to protect your health. Make sure you have an open and honest conversation about your sexual history and STD testing with your doctor and ask whether you should be tested for STDs. If you are not comfortable talking with your regular health care provider about STDs, there are many clinics that provide confidential and free or low-cost testing.
Below is a brief overview of STD testing recommendations. STD screening information for healthcare providers can be found here.
You can quickly find a place to be tested for STDs by entering your zip code in the form below.
Find an STD testing site near you.
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How Do You Get Herpes
The virus can be passed on by:
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having any skin-to-skin contact with the infected area
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transferring the infection on fingers from someone else to your genitals
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sharing sex toys that aren’t washed or covered with a new condom each time they are used.
The virus is most infectious when you have blisters, but it can be passed on when someone has no symptoms. This is normally immediately before or after an outbreak.
If you have genital herpes while pregnant you can pass the virus on to your unborn baby. Itâs important to speak to your healthcare provider as soon as possible.
For more details on herpes in pregnancy read our âin detailâ tab.
Do Condoms Help Prevent The Spread Of Genital Herpes
Yes. To prevent transmission of herpes, we recommend that condoms be used 100% of the time. Many patients will shed the virus and be contagious when they dont have symptoms. Studies have shown that asymptomatic shedding occurs between 1% and 3% of the time in patients with HSV II genital infections. Many new herpes infections occur from partners who are shedding the virus asymptomatically, so condoms are highly recommended.
Condoms may not be an attractive option for monogamous couples or for couples who desire to become pregnant. Couples may opt to have serological tests to determine if either partner has an asymptomatic infection. In close monogamous relationships, the risks of transmission can be weighed against other relationship issues, such as intimacy and pregnancy.
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Dont Be Afraid To Get Emotionally Intimate
An open and honest conversation about your diagnosis can require emotional intimacy that may be scary to have in a new relationship. Harbushka says to relax and realize that it can be sexy to communicate with your partner about sex and other important intimate topics.
With the right information and adequate protection, you can still enjoy a healthy sexual relationship. Here are some tips to help you and your partner stay safe during sex.
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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What Are Genital Herpes Infections Like
The first herpes infection is usually the worst one. Genital herpes infections come back over and over again. The first time, you may have one sore or many sores. The sores are painful. Some may be hidden inside the urethra. The urethra is the tube that carries urine from your bladder. The sores make urination painful. Some people also have a fever, a sore throat, deep tiredness and body aches. These problems might last three weeks.
After the first infection, HSV sores can come back any time. They often come back when you are sick with something else and when your immune system isnt strong enough. Genital herpes might come back 4 to 6 times a year at first. After a few years, the herpes sores hurt less. They come back less often.
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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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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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What Happens If You Dont Get Herpes Treatment
The good news about herpes is that its not deadly or even very dangerous. It might be annoying, but herpes doesnt get worse over time or cause serious health problems like other STDs can.
If you dont get treated for herpes, you might keep having regular outbreaks, or they could only happen rarely. Some people naturally stop getting outbreaks after a while.
There are a few reasons people may decide not to get treatment. They might not have that many outbreaks, or their outbreaks dont really bother them. Or maybe theyre not having sex, so theyre not that worried about having herpes right now. Whatever your situation is, getting treatment for herpes is your choice.
Having herpes can make it easier to get HIV, because the sores give HIV an open pathway into your body. So always use condomsto help prevent the spread of both herpes and HIV.
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