Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus (HSV).
This article focuses on HSV type 2 (HSV-2) infection.
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.
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.
General symptoms may include:
Genital symptoms include the appearance of small, painful blisters filled with clear or straw-colored fluid. They are usually found:
Other symptoms that may occur include:
A second outbreak can appear weeks or months later. It is usually less severe and goes away sooner than the first outbreak. Over time, the number of outbreaks may decrease.
Once you have HSV-2, the virus hides within nerve cells and remains in the body. It can remain "asleep" (dormant) for a long time.
The virus can "wake up" (reactivate) at any time. This may be triggered by:
Some people have genital herpes attacks only once a year, while others have them so often the symptoms never seem to go away. Repeated attacks are generally milder in men.
Tests can be done on skin sores or blisters to diagnose herpes. These tests are most often done when someone has a first outbreak and when a pregnant women develops genital herpes symptoms.
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:
Home care for herpes sores:
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:
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 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.
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.
Anyone who has genital herpes should tell their partner that they have the disease, even if they do not have symptoms.
Herpes - genital; Herpes simplex - genital; Herpesvirus 2; HSV-2
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Workowski KA, Berman S; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010 Dec 17;59(RR-12):1-110.
Schiffer JT, Corey L. Herpes simplex virus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 136.
Eckert LO, Lentz GM. Infections of the Lower and Upper Genital Tract: Vulva, Vagina, Cervix, Toxic Shock Syndrome, Endometritis, and Salpingitis. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 23.
Updated by: 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.
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