Herpes

Herpes spreads by skin to skin contact, through touching or rubbing. This can happen during any kind of sex: vaginal, anal and oral. If a person has skin sores there is a high risk of them passing on the virus. In almost all cases herpes is only found on one area of a person’s body. If your partner’s herpes is in the skin of his penis, you can only catch the virus by contact with this part of his penis.

Similarly, if your partner’s herpes is in the vulval skin, you can only catch the virus by touching that part of her vulva. Many cases of genital herpes occur when a person has infection around the mouth and kisses their partner’s genitals. Herpes cannot be caught from towels, swimming pools, saunas or from toilet seats

The virus will not pass through a condom, but as condoms do not cover all of the genital area, it is possible to infect genital skin that is not covered by the condom.

If you already have one type of HSV it is still possible for you to get the other type (although you may not notice any symptoms).

Not everyone who has the virus will get symptoms. As such, only 1 in 5 people with herpes, know that they have it.

Some people will get symptoms within four or five days of coming into contact with the virus. In other people, the virus may be in the body for several weeks, months, or possibly years before any symptoms appear. Only one third of people will get symptoms at the time of infection. This means that when you get symptoms it doesn’t necessarily mean you have recently come into contact with the virus.

Symptoms may be mild or quite severe. If you do get symptoms they may include:

• Flu-like symptoms such as fever, tiredness, headache, swollen glands, aches and pains in the lower back and down the legs or in the groin
• Stinging, tingling or itching in the genital or anal area
• Small, fluid-filled blisters anywhere in the genital or anal area, on the buttocks and the tops of the thighs. These burst within a day or two leaving small, red sores which can be very painful
• Pain when passing urine caused by the urine flowing over the sores.

Recurrent outbreaks are usually milder than with the first outbreak and clear up more quickly (in about a week). You may experience, on average, four outbreaks per year and the frequency is likely to reduce over time.

You can only be certain you have genital herpes if you have a test while the sores are present.

You can visit an axess sexual health clinic or speak to your GP.

A clinician can take a swab sample if you have ulcers or blisters present. Once you have had a diagnosis confirmed the clinician will be able to offer you advice for managing future outbreaks.

It’s not always necessary to treat herpes. If this is the first time you have had herpes, a course of genital herpes treatment (antiviral tablets) may be helpful. However, if you’ve had the sores for more than six days, the treatment probably won’t help as your immune system will have started to kill the virus in the skin. The aim of treatment is to relieve the symptoms only. It does not clear the virus from the body.

Some people choose not to take antiviral tablets and instead take over-the-counter painkillers, such as paracetamol, whilst their ulcers heal.

You can also use local anaesthetic ointment, such as lidocaine. This will numb the skin where the sores are in order to ease the pain.

Some people use longer ‘suppressive’ treatment courses if:

• They are experiencing repeated outbreaks (usually more than six in a year) and their symptoms are particularly severe and/or causing distress
• If the individual is pregnant we advise taking suppression from 32 weeks to avoid passing the infection on during childbirth.

The treatment you can buy for facial cold sores is not recommended for genital herpes, as topical treatments (such as creams or gels) are less effective than oral treatments.

Using condoms reduces the risk of contracting all sexually transmitted infections, including genital herpes.

Genital herpes can be passed on, even when there are no blisters present. This is called ‘asymptomatic shedding’ (when small amounts of virus are on the skin). The risk is much greater in the first few months after you catch herpes. Asymptomatic shedding happens less over time and is rare after two years.

Blisters and sores are highly infectious. 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
• Avoid any genital or anal contact when you, or a partner, have genital sores or blisters, or if you feel an outbreak starting.

It is rare for genital herpes to cause any long term health problems.

However, the virus remains in the body and you can have repeat outbreaks. It is common to get outbreaks at times when your immune system is less able to keep the virus under control, for example, when you feel run down, or if you are pregnant.

If you experience symptoms of genital herpes during pregnancy then it is important to tell your midwife and/or obstetrician immediately and contact your local sexual health clinic.