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Genital Herpes

What causes genital herpes?

Genital herpes is an infection caused by either of two viruses, both called Herpes Simplex. Herpes Simplex 1 (HSV-I) usually infects the mouth or lip (cold sores or fever blisters), but also accounts for about half of genital infections. Herpes Simplex II (HSV-II) predominantly causes genital infections and is almost always transmitted sexually. Both strains can cause infection in other locations. The symptoms, complications, and treatment are the same.

Genital Herpes
Genital Herpes
Blisters
Genital Herpes
Genital Herpes
Blisters
Genital Herpes
Genital Herpes
Ulcers

What are the symptoms of genital herpes?

Symptoms usually appear two days to two weeks after exposure to the virus. Numbness, tingling, itching, or burning at the location of the developing infection are usually the first symptoms. Within two or three days, small, painful, red areas or bumps will appear on the infected area. These areas or bumps soon develop into blisters filled with clear fluid. This fluid becomes yellow and thick, and the blisters may rupture, leaving small, shallow, painful ulcers with a reddened border. Fever, headaches, and muscle aches are common. Many people develop painful lymph nodes in the groin. Most women experience painful urination and have a vaginal discharge.  One third of the men will have ulcers inside the penis, causing extreme pain with urination and a discharge in some cases.

People who have never had fever blisters or any other herpetic infection usually have severe symptoms. Their blisters and open sores are usually more extensive and more painful and last from two to three weeks. Those who have already been exposed to herpes have a less severe first episode, the blisters are fewer, the pain less, and the duration of the ulcers is shorter. After the symptoms and signs of the initial infection disappear, the virus travels to a group of nerve cells near the spine or brain, called ganglia, where it rests in an inactive, or latent, state. When the virus returns to an active form, the disease erupts where it occurred initially.

How often will break-outs occur?

Recurrences affect over 75% of people infected with herpes. The average rate of recurrence is 3-5 episodes a year.  Recurrences may be linked to stress, fever, menstrual periods, or may be triggered by the friction of intercourse or masturbation.

Recurrent episodes of genital herpes are usually mild, with no fever, headaches, or bowel/bladder problems. Often the blisters or sores last only2-3 days. Recurrent outbreaks are often preceded by what is called a "prodrome" tingling or itching which may occur for several hours or days before the appearance of the lesions. This syndrome varies from person to person and may vary from episode to episode. It can also occur without lesions developing.

Can I be tested to see if I have herpes?

The sores can be tested for the presence of the herpes virus.  If the sores are healing, the culture may be negative because the virus might have already left the area. There are blood tests, also.

How is herpes transmitted?

The Herpes virus thrives in warm moist areas. It cannot tolerate drying and cannot be spread by clean dry towels or sheets. Washing thoroughly with soap and water kills the virus on body surfaces. It cannot be caught from water in swimming pools or hot tubs. While the virus may survive for several hours on toilet seats, it would be extremely rare for the infection to be transmitted in this manner. Transmission of genital herpes by means other than sexual is so rare that it is virtually nonexistent.

Herpes is most contagious when the infection is active (when lesions are present). Genital-to-genital contact or oral-genital contact during this time results in a 75% chance of contracting the disease. One should avoid intercourse or contact with the infected area during the prodrome and while the lesions are present (blisters, ulcers, or scabs), and for several days after their disappearance. Transmission is still possible when the virus is in its inactive stage but is less likely. Like most sexually transmitted diseases, transmission of herpes is largely preventable by using latex condoms correctly and consistently. 

How is herpes treated?

There is no cure for herpes, but there are treatments to decrease the pain and discomfort of the lesions and to speed the healing process:

  • Acyclovir, Valtrex and other medications in that class may be used to decrease the severity and duration of the initial or recurrent outbreak and to prevent or decrease the number of recurrences. In general, the goal of treatment is to decrease the discomforts associated with an outbreak. Aspirin, acetaminophen, or ibuprofen every four hours may help reduce pain and fever.
  • Domeboro tablets or packets and Aveeno (available without prescription) may be soothing.
  • Water: The burning that occurs with urination may be decreased by drinking large amounts of water to dilute the urine acidity, by urinating in a tub filled with water, or by pouring water over the genitals while urinating.
  • General hygiene: It is important to keep the area clean and dry. Women should avoid tight fitting pants or panty-hose and should wear underwear that wicks moisture away from the body.  It is important to wash your hands carefully after touching the sores (this is true for fever blisters also) or using the toilet so that you will not spread the virus to any other part of your body or to someone else.

Adapted from the University of South Carolina Student Health Services