Genital Herpes

What is Genital Herpes?

Genital herpes is caused by the Herpes simplex virus (HSV). The infection is transmitted from person to person by physical contact, usually sexual. Because sexual contact is the most common way for the infection to be spread genital herpes is usually referred to as a sexually transmitted infection or disease (STI or STD).

HSV Type I usually causes cold sores around the mouth while HSV Type II is usually responsible for genital herpes. However, HSV Type I can also cause genital herpes. Occasionally, an infection may be passed from one area of the body to another, for example, virus from a cold sore may be passed to the genital region during oral sex.

Varicella-zoster is another type of herpes virus, responsible for chickenpox and shingles.

What are the symptoms?

The first attack of genital herpes is usually more severe than subsequent episodes. Symptoms first appear within two to 14 days of becoming infected and include pain in the genital area, pain or difficulty in passing urine, fever, malaise and 'flu-like symptoms. Soon after, small blisters containing a clear fluid appear in the genital area (including in hidden areas, such as inside the rectum or vagina or on the cervix). These blisters burst leaving small ulcers which can be very painful, particularly when passing urine. The ulcers usually heal within two or three weeks.

The virus enters the nerve fibres and remains in the nerve root for a long time, sometimes for life. Some people may get sores from time to time while others may not be affected by the presence of the virus and may never get symptoms. Episodes occurring after the first attack usually last for a shorter time (around seven days) and are usually less severe. Warning symptoms before an attack are common and often include neuralgic (nerve) pain, usually down the back of the thigh, or in the buttocks, groin or ankles. This pain often occurs 12 to 24 hours before any blisters appear but can appear at the same time. Other warning symptoms for an attack include irritability, malaise and fever.

HSV can be passed on through sexual contact even if there are no blisters or ulcers present.

Available treatment

At present there is no guaranteed permanent cure for herpes. However, treatment with antiviral agents can help to shorten an outbreak of herpes and to suppress the virus, preventing further attacks. There are several antiviral agents available: aciclovir (eg, Zovirax®), famciclovir (eg, Famvir®), inosine acedoben dimepranol (Imunovir®) and valaciclovir (eg, Valtrex®). These antivirals are all available in tablet form. Aciclovir is also available in cream form which can be applied directly to the herpes.

During an attack the sores should be kept clean and dry. Bathing the area with a salt solution or adding a handful of salt to a bath can help to heal the infected area. Applying witch hazel may also be advised to help dry up the sores. A compress of crushed ice cubes may ease the pain - ice should be wrapped in clean cotton before applying and never applied directly to the sores.

Prevention of further attacks

It is encouraging to know that about half of the people who have an initial attack of herpes never have another one. As mentioned above, other people may have recurrent attacks that are shorter and milder than the first episode. There are triggers which may bring on an attack and can be avoided. Known triggers include becoming overtired or stressed, sunbathing or using sun beds, friction caused by sex or masturbation, and wearing tight clothing or nylon underwear. Some women may be more susceptible to attacks at different times in their menstrual cycle.

Further information available from:

Herpes Virus Association
41 North Road
London N7 9DP
Tel: 0845 123 2305
Internet: www.herpes.org.uk

Fact sheet provided by MIMS

Date last reviewed: October 2016


MIMS Clinics

Prescribing news and resources for key therapeutic areas, collated by the MIMS editors.

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS bulletins

News and updates straight to your inbox.

Prescribing Update: Fortnightly news bulletin
Alert:
Urgent prescribing updates
Spotlight: Disease-themed monthly round-up

Sign me up

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases

Promo Image

Clinical calculators

Handy calculators and conversions for primary care.