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Genital herpes

Genital herpes is caused by the virus Herpes Simplex (HSV). There are two types, HSV 1 and HSV 2. Both HSV 1 and HSV 2 can infect the genital and anal area and also the mouth and nose (cold sores).

Here are some key facts:

  • It is highly contagious (it easily spreads from person to person)
  • It causes very sore, painful blisters on the genitals
  • It can affect anyone who is sexually active
  • Even after treatment, the virus remains in your body and can cause outbreaks at a later date
  • Tests usually involve taking a swab of fluid from a blister
  • It can be passed on through any kind of sexual contact 
  • Even if someone with genital herpes has no symptoms, they can pass it on
  • The only way to protect yourself is to use condoms every time you have sex and avoiding having any sexual contact before during or after an outbreak
  • It is treated with antiviral medicines but there is no cure
  • There are a number of self-help treatments to ease symptoms

You can read about genital herpes in more detail below.

Signs and symptoms of genital herpes

Many people with the herpes simplex virus may not even realise because they may not get any visible signs or symptoms. If you do get symptoms they may include the following: 

  • Flu like symptoms such as fever, headache, aches and pains
  • Stinging, tingling or itching in the genital or anal area
  • Small fluid-filled blisters appear anywhere in the genital or anal area, as well as the buttocks or tops of the thighs – these burst leaving small, red sores which can be very painful
  • Pain when passing urine – due to the urine passing over the sores
  • May have vaginal or urethral discharge

Altogether, the first outbreak can last up to two to four weeks with the sores generally healing within 5 to 10 days. The sores will eventually scab and heal without scarring. 

The outbreaks that follow the first one are usually less severe and heal more quickly because your body will have had an opportunity to produce antibodies that fight infection. You will often start by feeling some tingling and possibly some flu-like symptoms. Some people find that certain things can trigger an outbreak, such as:

  • Being unwell or  run down
  • Stress
  • Certain times in your menstrual cycle
  • Friction from sex or masturbation
  • Sunbeds or sunbathing
  • Tight non-cotton underwear
  • Drinking and smoking too much

But remember, even if you don’t have any of these symptoms, it’s really important you go to be tested for STIs if you’ve had unprotected sex.

You also need to consider emergency contraception if you’ve had unprotected sex. 

The causes and how it is passed on

The virus enters the bodies through small cracks in the skin or through the soft, moist lining of the mouth, vagina, rectum, urethra (where urine comes out) and under the foreskin. After being in contact with the virus some people may experience an outbreak of genital herpes.

Herpes is passed on during sexual contact and is most likely to be passed on before, during or immediately after an outbreak. It is easiest to pass on when someone has blisters or sores. In some people the virus can be present without any symptoms of genital herpes and can be passed on. This is called asymptomatic shedding. Your doctor or nurse will advise you. 

It is passed from one person to another through:

  • Unprotected vaginal sex
  • Unprotected anal sex 
  • Unprotected oral sex
  • If you receive oral sex from someone who has a cold sore or is about to get one
  • Your genitals coming into contact with your partners genitals
  • Skin-to-skin contact during sex if the virus is active on the skin outside the area protected by a condom
  • Sharing sex toys without washing them or covering them with a condom with each use
  • If a person with whitlows (herpes on the hand) touches a partner’s vagina, genitals or anal area

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

You don’t need to have had lots of partners and you or your partner may not have experienced symptoms to pass it on.

Genital herpes can be safely treated during pregnancy. It is important to discuss with your midwife if you have, or have had, herpes infections. The treatment you receive may depend on whether it is your first herpes infection and also where in the pregnancy you are but your midwife will advise you.

Testing for genital herpes

You can only have a check-up for herpes when you have signs or symptoms and if you start to develop signs and symptoms, have a check-up as soon as possible.

The doctor or nurse may be able to diagnose genital herpes by looking at the affected area however they will want to confirm this by taking a swab of fluid from the blisters in the affected area. This involves brushing a swab (similar to a cotton bud) over the blisters. It may sting a little but shouldn’t be painful.

The swab will be sent to a lab for testing and you will normally get your result within one to two weeks.

If you have no symptoms, there is no routine test for genital herpes but remember, if you’ve had unprotected sex, genital herpes is not the only thing you could have picked up. Don’t use the fact that you don’t have symptoms as an excuse not to go for STI tests. If you’ve had unprotected sex, don’t wait and hope for the best, have a test as soon as you can. 

Genital herpes testing is free and you can get one at Brook services, GUM or sexual health clinics or at some GP surgeries.

Cervical smear tests and routine blood tests will not detect herpes.

Treatment of genital herpes

Genital herpes will clear by itself however, by seeking treatment early on, you can significantly reduce the time the outbreak lasts and it can help the healing process. It also reducing the risk of you passing it on to someone else.

There are two key parts to treating genital herpes:

Antivirals

The treatment works by preventing the virus from multiplying but it does not clear the virus from your body completely.

Treatment is usually started within five days of the start of the first outbreak, while blisters are still forming. Treatment involves taking antiviral tablets daily for five days. There are various types of antivirals that may be prescribed. Common ones include aciclovir, famciclovir and valaciclovir

Antibiotics will not work because genital herpes is a virus not a bacteria. The treatment you buy for oral cold sores will not work either.

Some people find that another course of antivirals helps with further outbreaks. For people who have multiple outbreaks (usually more than six a year), they may be given longer courses of medication. This is known as suppressive treatment. This means taking antiviral medication for a longer time period. The doctor and nurse will advise if this is the appropriate therapy for you.

Things you can do to help

Antivirals are only designed to stop the virus multiplying and will not help your discomfort in the short term. For this, there are a few simple things you can do to ease discomfort and speed up the healing process:

  • Apply an ice pack or ice cubes in a plastic bag (do not apply ice directly to skin)
  • Take a cool shower to soothe the blisters
  • Apply a local, over-the-counter anaesthetic cream such as lidocaine
  • Avoid washing too often and carefully pat the area dry
  • Gently bathe the area with warm salt water (dilute one teaspoon to one pint of water)
  • If weeing is painful, go to the toilet in a warm bath or shower
  • Wash your hands before and after touching the infected area to avoid introducing bacteria
  • Keep hydrated and drink extra fluids
  • Wear loose, cotton clothing 
  • Use an over-the-counter painkiller to help with pain and discomfort

The antivirals you will be prescribed are safe to use with hormonal contraception (like the pill, patch, injection or implant) but talk to the person prescribing the treatment to make sure.

It is strongly advised that you do not have any sexual contact before or during an outbreak and for a week after your symptoms have completely gone. If you find out that you do have genital herpes and your partner is experiencing symptoms, it is recommended that they seek treatment too. 

The staff at Brook or sexual health clinics can advise you on how to tell you partner. You can also visit the Herpes Viruses Association which has helpful information and advice.

Page last reviewed: June 2015
Next review due: June 2017