Herpes

HSV enters the body through small cracks in the skin, or through the mouth, vagina, rectum, urethra (the tube where urine comes out), and under the foreskin.

It can be passed on through skin to skin contact during oral, vaginal, or anal sex, or by sharing sex toys with someone who is infected.

You cannot get genital herpes from sharing baths or towels, from swimming pools, toilet seats, or from sharing cups, plates or cutlery.

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, which is why many people do not know they are infected. Only 10-20% of people who carry the infection will have been previously diagnosed.

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.

Many people will not need treatment and will have very few outbreaks. The aim of genital herpes treatment (antiviral tablets) 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 causing distress
• they are with a new partner and want to reduce the chances of passing the infection on
• if they are in later stages of pregnancy, 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 not blisters present.

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.