Genital herpes affects the skin or mucous membranes of the genitals. It caused by the herpes simplex virus (HSV). HSV is spread from one person to another during sexual contact.
HSV-2 most often causes genital herpes. HSV-2 can be spread through secretions from the mouth or genitals.
HSV-1 usually affects the mouth and lips and causes cold sores or fever blisters. However, it can spread from the mouth to the genitals during oral sex. For more information on HSV-1, see: Herpes labialis
You may become infected with herpes if your skin, vagina, penis, or mouth comes into contact with someone who already has herpes.
You are most likely to get herpes if you touch the skin of someone who has herpes sores, blisters, or a rash. However, the herpes virus can still be spread even when no sores or other symptoms are present. Sometimes, the person does not even know they are infected.
Genital HSV-2 infections are more common in women than men.
Many people with genital herpes never have sores, or they have very mild symptoms that go unnoticed or are mistaken for insect bites or another skin condition.
If signs and symptoms do occur during the first outbreak, they can be quite severe. This first outbreak usually happens within 2 days to 2 weeks of being infected.
A test called PCR performed on fluid from a blister shows small amounts of DNA. It is the most accurate test to tell whether the herpes virus is present in the blister.
Blood tests check for antibody levels to the herpes virus. These blood tests can identify whether someone has ever been infected with the herpes virus, even between outbreaks. It may be positive even if they've never had an outbreak.
Genital herpes cannot be cured. However, antiviral medication can relieve pain and discomfort during an outbreak by healing the sores more quickly. These drugs appear to help during first attacks more than they do in later outbreaks. Medicines used to treat herpes include acyclovir, famciclovir, and valacyclovir.
For repeat outbreaks, start the medication as soon as the tingling, burning, or itching begins, or as soon as you notice blisters.
People who have many outbreaks may take these medications daily over a period of time. This can help prevent outbreaks or shorten their length. It can also reduce the chance of giving herpes to someone else.
Pregnant women may be treated for herpes during the last month of pregnancy to reduce the chance of having an outbreak at the time of delivery. If there is an outbreak around the time of delivery, a C-section will be recommended to reduce the chance of infecting the baby.
Possible side effects from herpes medications include:
Nausea and vomiting
Home care for herpes sores:
Do NOT wear nylon or other synthetic pantyhose, underwear, or pants. Instead, wear loose-fitting cotton garments
Gentle cleansing with soap and water is recommended.
Taking warm baths may relieve the pain (afterward, keep the blisters dry)
If one of the sores develops an infection from bacteria, ask your doctor if you need an antibiotic.
Once you are infected, the virus stays in your body for the rest of your life. Some people never have another episode, and others have frequent outbreaks.
In most outbreaks, there is no obvious trigger. Many people, however, find that attacks of genital herpes occur with the following conditions:
General illness (from mild illnesses to serious conditions, such as operations, heart attacks, and pneumonia)
Immunosuppression due to AIDS or medication such as chemotherapy or steroids
Physical or emotional stress
Trauma to the affected area, including sexual activity
In people with a normal immune system, genital herpes remains a localized and bothersome infection, but is rarely life-threatening.
Pregnant women who have an active genital herpes infection when they give birth may pass the infection to their baby.
The risk of passing the infection to the baby is highest if the mom first becomes infected with genital herpes during pregnancy. The risk for severe infection in the baby is much lower in recurrent outbreaks.
Babies of women who become infected during pregnancy are at risk for premature birth. The baby may develop brain infection (meningitis, encephalitis) , chronic skin infeciton, severe developmental delays, or death.
Women with a history of genital herpes who have occasional or no outbreaks rarely spread the infection to their babies.
The herpes virus may spread to other parts of the body, including the brain, eyes, esophagus, liver, spinal cord, or lungs. These complications often develop in people who have a weakened immune system due to HIV or certain medications.
You are more likely to get HIV if you have an active genital herpes infection and have sex with someone who is HIV positive.
Calling your health care provider
Call your health care provider if you have any symptoms of genital herpes, or if you develop fever, headache, vomiting, or widespread symptoms during or after an outbreak of herpes.
The best way to avoid genital herpes is to avoid all sexual contact, including oral sex.
Being in a long-term, mutually monogamous relationship with someone who has been tested and has never been infected with the virus can also help reduce your chances of becoming infected.
Condoms remain the best way to protect against catching genital herpes during sexual activity with someone who is infected. Using a condom correctly and consistently will help prevent the spread of the disease.
Only latex condomes will work to prevent infection. Animal membrane (sheepskin) condoms won't work because the virus can go right through them.
The female condom has been tested and shown to reduce the risk of trasmitting herpes, as well.
A latex condom should be used during ALL sexual contact, even if the infected person does not have any sores or blisters at that time. However, you may still get genital herpes when using a condom.
Anyone who has genital herpes should tell their partner that they have the disease, even if they do not have symptoms.
Daniel Levy, MD, Infectious Disease, Maryland Family Care, Lutherville, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Health Solutions, Ebix, Inc.