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Herpes Incubation Period in Women: Understanding First Episode Genital Herpes

How long does it take for herpes symptoms to appear. What are the first signs of a herpes outbreak. Can herpes lie dormant for years. How can you prevent herpes transmission.

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The Incubation Period of Herpes: What You Need to Know

Herpes simplex virus (HSV) is a common viral infection that affects millions of people worldwide. One of the most crucial aspects of understanding this condition is recognizing its incubation period. The incubation period refers to the time between contracting the virus and the appearance of the first symptoms.

For herpes, this period typically ranges from 2 to 10 days after exposure. However, it’s important to note that some individuals may carry the virus for years without experiencing any noticeable symptoms. This variability in symptom onset can make it challenging to pinpoint the exact moment of infection.

Factors Influencing the Incubation Period

  • Individual immune system response
  • Viral strain (HSV-1 or HSV-2)
  • Location of infection (oral or genital)
  • Previous exposure to the virus

Understanding these factors can help healthcare providers and patients better manage the condition and prevent its spread.

Recognizing the First Signs of Herpes: A Comprehensive Guide

When the herpes virus becomes active, it often presents with a cluster of symptoms that can vary in intensity from person to person. Identifying these early signs is crucial for prompt treatment and minimizing discomfort.

Common Initial Symptoms of Herpes

  1. Tingling or itching sensation in the affected area
  2. Appearance of small, painful blisters
  3. Flu-like symptoms (fever, body aches, fatigue)
  4. Swollen lymph nodes
  5. Pain or burning during urination (if genital herpes)

Are these symptoms always indicative of herpes. While these signs are common in herpes outbreaks, they can also be associated with other conditions. Therefore, it’s essential to consult a healthcare provider for an accurate diagnosis.

The Duration of the First Herpes Outbreak: What to Expect

The initial herpes outbreak is often the most severe and prolonged. Typically, the first episode can last anywhere from 2 to 4 weeks. During this time, individuals may experience more intense symptoms compared to subsequent outbreaks.

Why is the first outbreak usually more severe. The body’s immune system is encountering the virus for the first time during the initial outbreak. As it learns to recognize and fight the infection, symptoms may be more pronounced and last longer.

Timeline of a Typical First Outbreak

  • Days 1-2: Prodromal symptoms (tingling, itching)
  • Days 2-4: Appearance of blisters
  • Days 4-6: Blisters burst and form painful sores
  • Days 7-14: Sores begin to heal and crust over
  • Days 14-28: Complete healing without scarring

It’s important to note that this timeline can vary between individuals, and some may experience shorter or longer outbreaks.

Herpes and the Immune System: A Complex Relationship

The severity and frequency of herpes outbreaks are closely linked to the strength of an individual’s immune system. People with compromised immune systems may experience more frequent and severe outbreaks compared to those with robust immunity.

Conditions That Can Affect Herpes Outbreaks

  • HIV/AIDS
  • Diabetes
  • Leukemia
  • Chronic stress
  • Certain medications (e.g., chemotherapy drugs)

How does a weakened immune system impact herpes outbreaks. When the immune system is compromised, it becomes less effective at suppressing the herpes virus, allowing it to replicate more freely and cause more frequent or severe symptoms.

The Dormancy of Herpes: Understanding Viral Latency

One of the most intriguing aspects of the herpes virus is its ability to remain dormant in the body for extended periods. After the initial infection, the virus retreats to nerve cells where it can lie inactive for months or even years.

Can herpes reactivate after years of dormancy. Yes, the herpes virus can reactivate at any time, even after long periods of inactivity. Various triggers, such as stress, illness, or hormonal changes, can cause the virus to become active again, leading to a recurrent outbreak.

Factors That Can Trigger Herpes Reactivation

  • Physical or emotional stress
  • Hormonal changes (e.g., menstruation, pregnancy)
  • Weakened immune system
  • Exposure to UV light
  • Certain foods or medications

Understanding these triggers can help individuals manage their condition and potentially reduce the frequency of outbreaks.

Recurrent Herpes Outbreaks: What Changes Over Time?

As individuals experience multiple herpes outbreaks, they often notice changes in the pattern and severity of their symptoms. Generally, recurrent outbreaks tend to be less severe and shorter in duration compared to the initial episode.

Why do subsequent outbreaks differ from the first. After the initial infection, the body develops antibodies specific to the herpes virus. These antibodies help the immune system respond more quickly and effectively to future viral activations, often resulting in milder symptoms.

Characteristics of Recurrent Herpes Outbreaks

  • Shorter duration (typically 3-7 days)
  • Less severe symptoms
  • Fewer blisters or sores
  • Quicker healing time
  • Possible decrease in frequency over time

Some individuals may find that their outbreaks become less frequent or even stop altogether as they age, though the virus remains in their system.

Preventing Herpes Transmission: Essential Strategies

While there is currently no cure for herpes, there are several effective strategies to reduce the risk of transmission. Understanding these preventive measures is crucial for individuals with herpes and their partners.

Key Prevention Strategies

  1. Use of barrier methods (condoms, dental dams) during sexual activity
  2. Avoiding sexual contact during outbreaks
  3. Taking antiviral medications as prescribed
  4. Open communication with sexual partners about herpes status
  5. Regular testing for sexually transmitted infections

Is it possible to completely prevent herpes transmission. While these strategies significantly reduce the risk, it’s important to note that no method is 100% effective. The herpes virus can be transmitted even when no visible symptoms are present, a phenomenon known as asymptomatic shedding.

The Role of Antiviral Medications in Managing Herpes

Antiviral medications play a crucial role in managing herpes infections. These drugs work by inhibiting viral replication, which can help reduce the severity and duration of outbreaks, as well as decrease the risk of transmission.

Common Antiviral Medications for Herpes

  • Acyclovir
  • Valacyclovir
  • Famciclovir

How do antiviral medications affect herpes outbreaks. These medications can help shorten the duration of outbreaks, reduce the severity of symptoms, and in some cases, suppress outbreaks altogether when taken as daily suppressive therapy.

While antiviral medications are highly effective, they do not cure herpes. The virus remains in the body, and outbreaks may still occur, albeit less frequently and with reduced severity.

Treatment Approaches

  1. Episodic therapy: Taking medication at the first sign of an outbreak
  2. Suppressive therapy: Daily medication to reduce outbreak frequency
  3. Combination therapy: Using both approaches based on individual needs

The choice of treatment approach depends on factors such as outbreak frequency, severity of symptoms, and personal preferences. Consulting with a healthcare provider is essential for determining the most appropriate treatment plan.

The Psychological Impact of Herpes: Coping and Support

Beyond its physical manifestations, herpes can have significant psychological effects on those affected. The stigma associated with sexually transmitted infections, concerns about disclosure to partners, and anxiety about future outbreaks can all contribute to emotional distress.

Common Psychological Challenges

  • Anxiety and depression
  • Feelings of shame or guilt
  • Fear of rejection by partners
  • Stress about potential transmission
  • Impact on self-esteem and body image

How can individuals cope with the psychological impact of herpes. Coping strategies may include seeking support from mental health professionals, joining support groups, educating oneself about the condition, and practicing self-care and stress management techniques.

Resources for Support and Education

  1. Online support forums and communities
  2. Local support groups
  3. Counseling services
  4. Educational materials from reputable health organizations
  5. Open communication with healthcare providers

It’s important to remember that herpes is a common condition that affects millions of people worldwide. With proper management and support, individuals can lead fulfilling lives and maintain healthy relationships despite having herpes.

Herpes and Pregnancy: Special Considerations

For pregnant women with herpes, there are additional considerations to ensure the health and safety of both mother and child. The primary concern is the potential for neonatal herpes, a rare but serious condition that can occur if the baby is exposed to the virus during childbirth.

Key Points for Managing Herpes During Pregnancy

  • Inform healthcare providers about herpes status
  • Regular monitoring for outbreaks
  • Possible use of antiviral medications
  • Consideration of cesarean delivery if active outbreak during labor
  • Importance of partner testing and prevention

Can herpes affect fertility or pregnancy outcomes. While herpes generally does not affect fertility or the ability to have a healthy pregnancy, it’s crucial to manage the condition carefully during pregnancy to minimize risks to the baby.

Healthcare providers may recommend antiviral therapy during pregnancy, especially in the third trimester, to reduce the risk of an outbreak during delivery. The decision to use medication during pregnancy should be made in consultation with a healthcare provider, weighing the potential benefits against any risks.

Future Directions in Herpes Research and Treatment

While current treatments for herpes are effective at managing symptoms and reducing transmission risk, research continues to explore new avenues for improved therapies and potential cures.

Promising Areas of Research

  1. Therapeutic vaccines to boost immune response
  2. Gene editing techniques to target the dormant virus
  3. Novel antiviral compounds with improved efficacy
  4. Immunomodulatory therapies
  5. Preventive vaccines to protect against initial infection

What is the likelihood of developing a cure for herpes. While a cure remains elusive, ongoing research shows promise in developing more effective treatments and potentially a vaccine to prevent initial infection. However, it’s important to note that the complex nature of the herpes virus makes developing a cure challenging.

In the meantime, advances in diagnostic techniques, such as more sensitive and specific tests, continue to improve our ability to detect and manage herpes infections. Additionally, ongoing research into the mechanisms of viral latency and reactivation may lead to new strategies for controlling outbreaks and reducing transmission.

Living with Herpes: Empowerment Through Knowledge and Self-Care

While a herpes diagnosis can initially feel overwhelming, many individuals find that with time, education, and proper management, the condition becomes a manageable aspect of their lives. Empowerment through knowledge and self-care is key to living well with herpes.

Strategies for Empowered Living

  • Stay informed about the latest research and treatment options
  • Practice good physical and mental health habits
  • Develop a support network of trusted friends, family, or support groups
  • Be open and honest with partners about your herpes status
  • Work with healthcare providers to develop a personalized management plan

How can individuals maintain a positive outlook while living with herpes. Focusing on overall health, maintaining open communication in relationships, and remembering that herpes is a manageable condition can help individuals maintain a positive perspective and lead fulfilling lives.

It’s also important to remember that having herpes does not define a person’s worth or ability to have healthy, loving relationships. Many people with herpes have successful partnerships and lead satisfying lives.

The Importance of Self-Advocacy

  1. Educate yourself about your rights and options
  2. Communicate openly with healthcare providers
  3. Seek second opinions when necessary
  4. Participate actively in treatment decisions
  5. Connect with advocacy groups for support and resources

By taking an active role in their care and advocating for their needs, individuals with herpes can ensure they receive the best possible care and support.

How long does it take for herpes symptoms to show up?

The first symptoms of herpes may become noticeable around 2–10 days after contracting the infection. But, some people can have the herpes virus for many years before symptoms appear.

Herpes is a viral skin infection caused by the herpes simplex virus (HSV). Symptoms may not appear immediately after a person contracts the virus. When herpes symptoms do appear, they can affect the genital or oral area

There are two types of HSV: type 1, which mainly causes oral herpes, and type 2, which tends to cause genital herpes. However, both types can occur in both areas.

In this article, learn about the first signs to look out for. We also provide a general timeline of symptoms and provide information on when to see a doctor.

Share on PinterestA person may experience flu-like symptoms during an outbreak of herpes.

Some people do not experience any symptoms after contracting herpes. If symptoms do appear, the first to show are usually herpes sores.

These sores can appear as blisters around the mouth, rectum, or genitals. They can break open and be painful, leaving sores that can take a few weeks to heal.

Other symptoms can include:

  • a burning sensation when urinating, if the urine passes over a herpes sore
  • difficulty urinating due to sores blocking the urethra
  • itching and pain around the genitals

Some people refer to the first visible signs of herpes as an “outbreak.” During the first outbreak of herpes, people may also have flu-like symptoms, including:

  • fever
  • headaches
  • body aches
  • swollen glands
  • tiredness

If a person already has a condition that affects their immune system, they may experience longer lasting and more painful symptoms.

Examples of conditions that can affect the immune system include:

  • diabetes
  • HIV and AIDS
  • leukemia

In some cases, a person with herpes may not experience any symptoms of the virus for many years. In other cases, the first symptoms can appear around 2–10 days after a person contracts the virus.

The first outbreak of herpes can last for around 2–4 weeks. After this time, the sores will gradually heal without leaving any scars. People usually find that the first outbreak of herpes is the longest and most painful.

Some people have repeat outbreaks. These are more common in the first year after contracting the virus. In repeat outbreaks, people may find that their symptoms clear up in about a week.

People may start to notice signs of an outbreak before it happens. Doctors refer to these symptoms as “prodromal” symptoms. A person who experiences prodromal symptoms can begin taking treatments and other precautions in preparation for the outbreak.

Some typical prodromal symptoms of herpes include an itching, burning, or tingling sensation around the genitals, as well as shooting pains in the hips, buttocks, or legs.

Over time, people may experience fewer outbreaks with milder symptoms. Some people may eventually stop experiencing herpes outbreaks altogether.

The herpes virus can lie dormant in the body for years before people experience any symptoms.

After people have the first outbreak of herpes, the virus then lies dormant in the nervous system. Any further outbreaks are due to the virus reactivating, which causes symptoms to appear.

Symptoms are usually less severe during repeat outbreaks. Sores also clear up more quickly, often within 3–7 days. This is due to the antibodies the body produces to fight the first outbreak of herpes. The body can then use these antibodies to respond more quickly to future outbreaks.

There is currently no cure for herpes. Even if a person stops experiencing symptoms, the virus will remain inside their body.

It is also important to point out that herpes is transmissible even when no sores or other symptoms are present. For this reason, early prevention is advisable.

The herpes virus may be spread by direct skin-to-skin contact with the affected area. As a result, people can contract herpes from engaging in vaginal, anal, or oral sex with a person who has the herpes virus.

To help reduce the chance of this happening, people can use condoms or dental dams during sex.

Condoms and dental dams do not offer complete protection against the herpes virus, as herpes can live on areas around the genitals. However, these methods do reduce the likelihood of contracting the infection or passing it on.

A person who has herpes can also take other steps to reduce the chance of passing it on to a sexual partner. Such steps include telling their sexual partner that they have herpes before having sex.

Both people can then take additional steps to reduce the likelihood of transmission. These steps may include:

  • not having sex during an outbreak of herpes, as the virus can transfer more easily through sores
  • waiting until all sores are completely healed before having sex again
  • looking out for prodromal symptoms of an outbreak, and not having sex during this time
  • always using condoms or dental dams during sex, even when no herpes symptoms are present
  • washing hands with soap and water after touching a herpes sore, to prevent the virus spreading to other areas
  • not kissing people when mouth sores are present — particularly people with weaker immune systems

Taking daily antiviral medication can also reduce the likelihood of passing on the infection. A person can talk to their doctor about this treatment option.

It is important to note that people with genital herpes have a higher chance of contracting HIV from a sexual partner who has HIV. Using a condom during sex can help lower this likelihood.

People should see their doctor if they think they might have herpes, or if they have any symptoms of herpes. Getting tested for herpes is also important to rule out other sexually transmitted infections.

People can visit their doctor or a sexual health clinic for a test. If people have any sores or blisters present, a healthcare provider will use a swab to take a sample from the sores. The sample will indicate whether or not the sores are due to a herpes infection.

Some people may be concerned that they have the herpes virus but no symptoms. In such cases, a doctor might be able to order a blood test to check for the virus in a person’s blood. However, the Centers for Disease Control and Prevention (CDC) do not recommend routine testing.

You can also consider purchasing an at-home herpes testing kit.

People may notice the first symptoms of herpes around 2–10 days after contracting the infection. In some cases, however, people may have the herpes virus for many years before noticing any symptoms.

The main symptoms of herpes are sores around the mouth or genitals and flu-like symptoms including headache and fatigue.

After the initial outbreak of herpes, some people may have repeated outbreaks. These are likely to be shorter and less painful than the first.

People who have herpes should take the necessary precautions to avoid passing it on to others. This includes using condoms or dental dams during sex and not having sex during an active outbreak.

If people notice any symptoms of herpes, they should see their doctor. The doctor will carry out the necessary tests to check whether a person has herpes or another condition.

Genital herpes | Office on Women’s Health

Genital herpes is a sexually transmitted infection (STI) (PDF, 187 KB). Genital herpes is usually spread by having vaginal, oral, or anal sex. One in five women ages 14 to 49 has genital herpes.1 There is no cure for herpes. But you can take medicine to prevent outbreaks and to lower your risk of passing genital herpes to your partner.

What is genital herpes?

Genital herpes is an STI (PDF, 187 KB) caused by the herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2). HSV-1 and HSV-2 cause the same symptoms, are both contagious, and are treated with the same medicine. But, they are different in some ways:

  • HSV-1 most often causes infections of the mouth and lips, called cold sores or “fever blisters.” Symptoms are often milder than genital herpes, and you may get fewer outbreaks.2 It can spread to the genital area during oral sex and cause genital herpes. If HSV-1 spreads to the genital area, it is still HSV-1.
  • HSV-2 is the most common cause of genital herpes. It is spread through vaginal, oral, or anal sex. HSV-2 can spread to the mouth during oral sex. If HSV-2 spreads to the mouth or lips during oral sex, it is still HSV-2.

Who gets genital herpes?

Genital herpes is more common in women than men. One in five women ages 14 to 49 has genital herpes, compared with one in 10 men ages 14 to 49.3

A woman’s anatomy (body) puts her more at risk for genital herpes than men. Small tears in vaginal tissue can make it easier to get genital herpes.

Genital herpes is also much more common in African-American women. One in two African-American women between the ages of 14 and 49 is infected with HSV-2 that causes genital herpes.3

How do you get genital herpes?

Genital herpes is spread through:

  • Vaginal, oral, or anal sex. The herpes virus is usually spread through contact with open sores. But you also can get herpes from someone without any symptoms or sores.
  • Genital touching
  • Childbirth from a mother to her baby
  • Breastfeeding if a baby touches an open sore

Does a cold sore on my mouth mean I have genital herpes?

No, a cold sore on your mouth usually means you have herpes simplex virus type 1 (HSV-1). You can get HSV-1 by kissing someone or sharing utensils, towels, razors, or lipstick with someone who has HSV-1.

HSV-1 cannot turn into HSV-2 (the type of genital herpes spread by sexual contact), but you can get a cold sore on your mouth from HSV-2 if you give oral sex to someone with HSV-2. Cold sores caused by HSV-1 or HSV-2 are contagious. You can spread it to other people or other parts of your body if you touch an open sore and then touch another part of your body. That means if you have a cold sore and give oral sex to someone, that person will get the herpes virus on his or her genitals.

Avoid touching your cold sore as much as possible. If you touch your cold sore, wash your hands right away to avoid spreading the infection to other parts of your body or other people.

What is the difference between genital herpes and genital warts?

Both genital herpes and genital warts are STIs, are spread through skin-to-skin contact, and are caused by a virus. But the viruses that cause genital herpes and genital warts are different:

  • Herpes simplex virus (HSV) is the virus that causes genital herpes.
  • Human papillomavirus (HPV) is the virus that causes genital warts.

There is no cure for either genital herpes or genital warts. But, different medicines can help manage the symptoms of herpes and treat the complications of HPV infections that can cause genital warts.

What are the symptoms of genital herpes?

Most women with genital herpes do not know they have it. But, if you get symptoms with the first outbreak of genital herpes, they can be severe. Genital herpes also can be severe and long-lasting in people whose immune systems do not work properly, such as women with HIV.

Within a few days of sexual contact with someone who has the herpes virus, sores (small red bumps that may turn into blisters) may show up where the virus entered your body, such as on your mouth or vagina. Some women might confuse mild sores for insect bites or something else. After a few days, sores become crusted and then heal without scarring. Sometimes, a second set of sores appear soon after the first outbreak, and symptoms can happen again.

The first signs of genital herpes usually show up two to 12 days after having sexual contact with someone who has herpes. Symptoms can last from two to four weeks. There are other early symptoms of genital herpes:

  • Feeling of pressure in the abdomen
  • Flu-like symptoms, including fever
  • Itching or burning feeling in the genital or anal area
  • Pain in the legs, buttocks, or genital area
  • Swollen glands
  • Unusual vaginal discharge

If you have any symptoms of genital herpes, see a doctor or nurse.

How is genital herpes diagnosed?

Often, your doctor can diagnose genital herpes by looking at visible sores. Your doctor or nurse may also use a cotton swab to take a fluid sample from a sore to test in a lab.

Genital herpes can be hard to diagnose, especially between outbreaks. Blood tests that look for antibodies to the herpes virus can help diagnose herpes in women without symptoms or between outbreaks.

A Pap test is not used to detect genital herpes.

How is genital herpes treated?

Herpes has no cure. But antiviral medicines can prevent or shorten outbreaks during the time you take the medicine. Also, daily suppressive therapy (for example, daily use of antiviral medicine) for herpes can lower your chance of spreading the infection to your partner.

Your doctor will either give you antiviral medicine to take right after getting outbreak symptoms or to take regularly to try to stop outbreaks from happening. Talk to your doctor about treatment options.

During outbreaks, you can take the following steps to speed healing and prevent spreading herpes to other parts of your body or to other people:

  • Keep sores clean and dry.
  • Try not to touch the sores.
  • Wash your hands after any contact with the sores.
  • Avoid all sexual contact from the time you first notice symptoms until the sores have healed.

Can genital herpes come back?

Yes. Genital herpes symptoms can come and go, but the virus stays inside your body even after all signs of the infection have gone away. The virus becomes “active” from time to time, leading to an outbreak. Some people have outbreaks only once or twice. Other people may have four or five outbreaks within a year. Over time, the outbreaks usually happen less often and are less severe.

Experts do not know what causes the virus to become active. Some women say the virus comes back when they are sick, under stress, out in the sun, or during their period.

What should I do if I have genital herpes?

If you have genital herpes:

  • See a doctor or nurse as soon as possible for testing and treatment.
  • Take all of the medicine. Even if symptoms go away, you need to finish all of the antiviral medicine.
  • Tell your sex partner(s) so they can be tested and treated if necessary.
  • Avoid any sexual contact while you are being treated for genital herpes or while you have an outbreak.
  • Remember that genital herpes is a lifelong disease. Even though you may not have a genital herpes outbreak for long periods of time, you can still pass the virus to another person at any time. Talk with your doctor or nurse about how to prevent passing the virus to another person.

How does genital herpes affect pregnancy?

  • If you get genital herpes during pregnancy, you can spread genital herpes to your baby during delivery.
  • If you had genital herpes before pregnancy, your baby is still at risk of getting herpes, but the risk is lower.

Most women with genital herpes have healthy babies. But babies who get herpes from their mother have neonatal herpes. Neonatal herpes is a serious condition that can cause problems in a newborn baby such as brain damage, eye problems, or even death.

Can pregnant women take genital herpes medicine?

Researchers do not know if all antiviral medicines for genital herpes are safe for pregnant women. If you are pregnant, make sure you tell your doctor or nurse that you have genital herpes, even if you are not having an outbreak.

Can I breastfeed if I have genital herpes?

Yes, you can breastfeed if you have genital herpes, but not if you have a herpes sore on one of your breasts. If you have genital herpes, it is possible to spread the infection to any part of your breast, including your nipple and areola.

If you have any genital herpes sores on one or both of your breasts:

  • You can keep breastfeeding as long as your baby or pumping equipment does not touch a herpes sore.
  • Do not breastfeed from the breast with sores. Herpes is spread through contact with sores and can be dangerous to a newborn baby.
  • Pump or hand-express your milk from the breast with sores until the sores heal. Pumping will help keep up your milk supply and prevent your breast from getting overly full and painful. You can store your milk to give to your baby in a bottle for another feeding. But if parts of your pump also touch the sore(s) while pumping, throw the milk away.

Can genital herpes cause other problems?

For most women, genital herpes does not usually cause serious health problems.

Women with HIV can have severe herpes outbreaks that are long-lasting. Herpes also may play a role in the spread of HIV. Herpes sores can make it easier for HIV to get into your body. Also, herpes can make people who are HIV-positive more likely to spread the infection to someone else.

How can I prevent genital herpes?

The best way to prevent genital herpes or any STI is to not have vaginal, oral, or anal sex.

If you do have sex, lower your risk of getting an STI with the following steps:

  • Use condoms. Condoms are the best way to prevent STIs when you have sex. Because a man does not need to ejaculate (come) to give or get some STIs, make sure to put the condom on before the penis touches the vagina, mouth, or anus. Other methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from STIs.
  • Get tested. Be sure you and your partner are tested for STIs. Talk to each other about the test results before you have sex.
  • Be monogamous. Having sex with just one partner can lower your risk for STIs. After being tested for STIs, be faithful to each other. That means that you have sex only with each other and no one else.
  • Limit your number of sex partners. Your risk of getting STIs goes up with the number of partners you have.
  • Do not douche. Douching removes some of the normal bacteria in the vagina that protects you from infection. This may increase your risk of getting STIs.4
  • Do not abuse alcohol or drugs. Drinking too much alcohol or using drugs increases risky behavior and may put you at risk of sexual assault and possible exposure to STIs.

The steps work best when used together. No single step can protect you from every single type of STI.

Can women who have sex with women get genital herpes?

Yes. It is possible to get genital herpes, or any other STI, if you are a woman who has sex only with women.

Talk to your partner about her sexual history before having sex, and ask your doctor or nurse about getting tested if you have signs or symptoms of genital herpes. Use a dental dam during oral sex and avoid sexual activity during an outbreak.

Did we answer your question about genital herpes?

For more information about genital herpes, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:

  • National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), CDC, HHS 
    Phone Number: 800-232-4636
  • National Institute of Allergy and Infectious Diseases (NIAID), NIH, HHS 
    Phone Number: 866-284-4107 (TDD: 800-877-8339)
  • Herpes Resource Center, ASHA
    Phone Number: 800-230-6039

Sources

  1. Centers for Disease Control and Prevention. (2017). Genital Herpes – CDC Fact Sheet.
  2. Kriebs, J.M. (2008). Understanding Herpes Simplex Virus: Transmission, Diagnosis, and Considerations in Pregnancy Management. Journal of Midwifery and Women’s Health; 53(3): 202–208.
  3. Centers for Disease Control and Prevention. (2016). 2015 Sexually Transmitted Diseases Surveillance – Figure 51.
  4. Cherpes, T.L., Meyn, L.A., Krohn, M.A., Hillier, S.L. (2003). Risk factors for infection with herpes simplex virus type 2: role of smoking, douching, uncircumcised males, and vaginal flora. Sexually Transmitted Diseases; 30(5):405–410.

The Office on Women’s Health is grateful for the medical review by:

  • Centers for Disease Control and Prevention (CDC) staff

All material contained on these pages are free of copyright restrictions and maybe copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U. S. Department of Health and Human Services. Citation of the source is appreciated.

Page last updated:
January 6, 2023

Genital herpes in children: methods of treatment, methods of prevention

Genital herpes is an infectious disease induced by herpes simplex viruses HSV-1 and HSV-2, manifested by a chronic long-term course, followed by periodic exacerbations with a specific lesion of the skin of the genitals and mucous membranes of the genital organs, characterized by the appearance of herpetic vesicles.

Human herpes simplex virus overview

Herpes simplex virus is a DNA-containing foreign agent whose primary route of transmission in adults is sexual. Genital herpes is more commonly caused by HSV-2. Often, children are characterized by the defeat of the herpes virus type 6 with the development of a sudden exanthema.

Causes and modes of transmission

The causes of the pathology in children are different, and the ways of transmission of the infection differ from those in adults. Infection occurs as follows:

  1. Ascending infection that develops as a result of the chronic course of the disease in the mother and is transmitted to the fetus during pregnancy with placental abruption, blood flow disorders.
  2. Intrauterine infection occurs when a large viral load in the body of a pregnant woman.
  3. Infection during childbirth or antenatal in this case, during the passage of the child through the birth canal of the mother and contact with her mucosa, the transmission of the disease is possible even in a chronic or asymptomatic form.
  4. Contact from adults (carriers of herpes infection) during kissing, during breastfeeding and the presence of a large amount of HSV in the mother’s blood.
  5. Contact household, in which the child becomes infected by interacting with the affected areas of the skin or mucous membranes of the mother, as well as through household items (shared towel, nipple).
  6. Sexual, when the infection is transmitted sexually – characteristic of adolescents. HSV infection comes from sexual partners.

Features of the clinical picture and the course of the disease

The clinical picture is most pronounced during the initial contact of the child’s body with the pathogen, depending on this, primary and secondary forms are distinguished.

Primary genital herpes

Develops after an incubation period of 2-14 days and manifests as a primary reaction to infection. The disease proceeds with vivid symptoms, especially severe in newborns with immunodeficiency.

Any primary form of infection with the herpes simplex virus, regardless of the clinical form and location of the lesion, ends with the penetration of the virus into the nerve ganglia of the dorsal roots and ends with an acute illness. The mother infected with herpes viruses can contribute to the primary infection of the child.

Secondary genital herpes, or recurrent

Recurrent disease occurring at any age after the initial infection. Relapses are formed against the background of the presence of developed antibodies in the body, so the symptoms will be less pronounced. Usually, recurrent herpes occurs against the background of a weakening of the immune forces of the child’s body (after a long illness, vaccination, emotional stress, etc.).

The course of the disease is also different, which can be:

  1. Asymptomatic. Atypical clinical forms, when, in the absence of clinical symptoms, the child is able to infect other people, that is, the infection is hidden.
  2. The usual course of a herpes-associated infection is characterized by local lesions of the skin and mucous membranes (there are few rashes, they quickly disappear).
  3. A severe course, aggravated by reduced immunity, leads to the spread and generalization of the disease with the occurrence of frequent relapses and short remissions. Herpetic eruptions are localized throughout the body in large numbers, heal for a long time, bring severe discomfort.

Clinical signs of genital herpes

The primary form begins with localized symptoms – the appearance of vesicles (vesicular rash) on the labia minora and labia majora, perineum, scrotum, vaginal mucosa. Further, dysuric phenomena, pain in the inguinal region, and pathological discharge along the course of the rash are added. Rashes of a new wave of infection appear, redness, swelling, single or grouped elements of the rash can be noted in the affected area, which disappear by 6–12 days.

Children with primary infection may complain of general malaise, nausea, abdominal pain, fever. This symptomatology is especially pronounced in the first few days after infection and during the incubation period. Active production of the virus and its release from the cervix or urethra occurs within a week from the day the first elements of the rash appear.

The secondary form has a persistent and long relapsing course. In the clinic of manifestations of a herpes infection, both an asymptomatic form and the occurrence of extensive herpes erosions with a tendency to merge can be present. Relapses occur against the background of a decrease in the immune response of the body about 5-8 times a year. There is also a more frequent exacerbation of the infection, in this case, the symptoms of genital herpes are pain, burning sensation, severe itching, so neuroses can be observed.

Genital herpes infection and HSV cause:

  • formation of adhesions in the external genitalia;
  • in the cervix, urethra induces cervicitis, colpitis, urethritis, as well as damage to the bladder with the development of cystitis;
  • in the uterus – the formation of herpetic endometritis and salpingo-oophoritis.

In some cases, genital herpes in children is manifested by an increase and soreness of the lymph nodes, the appearance of erosions and the addition of infections to them.

Diagnostic measures

Diagnostic methods include history data (time and duration of the onset of the first symptoms, whether someone in the family is sick, the number of exacerbations per year with secondary herpes), examination and detection of a characteristic rash for human HSV, laboratory diagnostic studies.

The following methods of laboratory diagnostics are used:

  • isolation of viruses in cell culture;
  • detection of viruses by immunofluorescent method;
  • determination of HSV antigen in vesicle fluid;
  • serological RSK-reactions;
  • enzyme immunoassay;
  • polymerase chain reaction.

The screening method for the detection of genital herpes is the PCR and ELISA method aimed at identifying the viral antigen and identifying all classes of specific antibodies to it. The presence of antibodies can determine the exacerbation or remission of the disease. The “gold standard” for diagnosing herpes in children is a virological method with the determination of sensitivity to antiviral drugs. This method has 100% specificity and allows you to isolate a pure culture of the pathogen.

Treatment of genital herpes in children

Today, 90% of the world’s population is carriers of the human herpes simplex virus. It is impossible to completely eradicate the virus from the body due to its affinity for the nervous tissue.

The principles of therapy that promote effective treatment include several tasks:

  • prevention of the generalization of the process;
  • prevention of complications;
  • reduction in the frequency of relapses of the disease.

Various methods are used to treat herpes-associated infection in children:

  1. Drug treatment, which includes etiotropic and symptomatic therapy, immunotherapy and immunocorrection.
  2. Methods of non-drug exposure: physiotherapeutic methods of treatment (excluding ultraviolet radiation), personal hygiene, regimen and diet.

Antiviral therapy is the main treatment for herpes in children:

  1. Aciclovir in tablet form and as an ointment. The drug is highly sensitive to the enzymatic metabolic processes of the HSV virion, which allows it to selectively bind to infected cells, practically without affecting healthy ones (1%). Acyclovir interferes with the assembly of daughter viral units, disrupting the possibility of their reproduction and thereby reducing the viral load on the body.
  2. It is possible to use other drugs from this group: Famvir, Valaciclovir. The drugs are available both in tablet form for systemic effects, and in the form of ointments for localized application to the elements of the rash.
  3. Immunotherapy uses targeted immunoglobulins, which include intra- and pentaglobins, as well as antiherpetic immunoglobulin. The possibilities of using interferons are being studied.

Combinations of an antiviral agent and immunoglobulins have been successfully used.

To avoid the attachment of bacterial microflora, it is recommended to lubricate the affected skin with antiseptic agents (Miramistin, Chlorhexidine).

In severe cases of primary herpes, detoxification therapy is used intravenously.

Herpes recurrence in children

Genital herpes in children is characterized by persistent recurrent course up to 8 times a year on average. The number of exacerbations directly depends on the state of the child’s immune system, therefore, to avoid relapses, it is recommended:

  • adherence to sleep and nutrition;
  • reduction of viral and bacterial infections;
  • hardening;
  • observance of the rules of personal hygiene.

Recurrent genital herpes is characterized by subsidence of clinical symptoms, but it is important to pay attention to the manifestation of them in a child in order to prevent the development of complications.

Consequences and complications of herpes virus infection

Prolonged persistence of the pathogen (chronic infection) in the body of a child, if not properly treated, can lead to:

  • neurotic conditions, decreased performance and school performance;
  • the occurrence of relapses monthly, and in some cases more often;
  • accession of secondary bacterial processes with the development of suppuration, and in severe situations – sepsis;
  • participation in the future in the carcinogenesis of the development of cancer of the cervix, prostate, bladder;
  • the development of secondary infertility in case of damage to the body of the uterus with the formation of chronic endometritis or urethritis in boys

Preventive measures

As specific prophylaxis drugs, many countries are studying the HSV vaccine, but drugs show insufficient effectiveness and duration of action. The constant use of the vaccine has been shown to lead in some cases to the development of autoimmune diseases.

An important issue in the prevention of genital herpes in children is the screening of pregnant women who are carriers of the infection, as well as their treatment for exacerbations before childbirth and the prevention of infection of the fetus during childbirth, which exponentially reduces the likelihood of infection of the newborn. Transmission of HSV and the risk of fetal infection during childbirth occurs during mucosal contact. Neonatal herpes is characterized by frequent lesions of the mucous membranes, however, these infections are dangerous for the development of systemic complications in the form of encephalitis and meningitis in newborns.

One of the main aspects of preventing the transmission of genital herpes in adolescent children is the elimination of the influence of adverse conditions:

  • refusal of fast food, alcohol and smoking in adolescents.
  • talks about sexual development and use of barrier contraceptive methods among adolescents, avoidance of promiscuity
  • compliance with the daily routine

Secondary methods should include timely detection and treatment of infection in order to reduce and prevent the development of complications and prevent exacerbation of the disease.

FAQ

After how many days will the rash go away?

Mild genital herpes usually clears up within 10 days of the onset of the rash. In severe cases, healing time varies depending on the extent of the process and the treatment received.

Genital herpes in Voronezh in the Renaissance clinic

The causative agent of the disease is herpes simplex virus (HSV) . Of the two types of HSV, the causative agent of genital herpes is mainly the second type – HSV-2. This type of virus is detected in 50-70% of women with genital herpes. The first type (HSV-1) affects mainly the skin and mucous membranes of the lips, eyes, nose, etc. However, it is possible to develop genital herpes when exposed to HSV-1 or as a result of a mixed infection of HSV-1 and HSV-2. The frequency of asymptomatic virus carriers is 7%.

CAUSES OF GENITAL HERPES

The main reservoir of infection in men is the genitourinary tract, in women – cervical canal . Primary infection with the herpesvirus type 1, as a rule, occurs by airborne droplets. Secondary infection (superinfection) of the genitals with the herpes virus usually occurs as a result of sexual contact. The highest rate of age-related incidence was registered in the age group of 20-29 years, while the average age of the disease in men is 27 years, in women – 23 years. The risk factors for the occurrence of herpetic infection include promiscuity in sexual relations, a large number of sexual partners, and a low social standard of living. Adolescents who begin early sexual activity are at increased risk of genital herpes.

A characteristic feature of a herpetic infection is the duration of the presence of this pathogen in the body (maybe throughout life) and the tendency to relapse. This feature is associated with the prolonged existence of the virus in the mucous membranes, and most importantly, with its persistence in the nerve ganglia.

During pregnancy, HSV-2 may be one of the causes of recurrent miscarriage and fetal malformations.

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SYMPTOMS OF GENITAL HERPES

Diseases caused by HSV-2 are often asymptomatic. However, often the clinical picture is pronounced, and signs of the disease usually appear after an incubation period of 3-7 days. Local manifestations occur in the vulva, vagina, cervix, often in the urethra and in the perineum. There are reports of the release of HSV from the contents of the uterus, fallopian tubes and bladder. The most typical localization is the lower parts of the reproductive system (vulva, vagina and cervix).

A characteristic sign of HSV is the appearance of individual or multiple vesicles against the background of hyperemic, edematous mucous membrane of the affected area. The size of the vesicles is 2-3 mm; a group of them occupies from 0.5 to 2.5 cm of the affected surface. This stage of the disease is short-lived (2-3 days), the vesicles subsequently open, and irregularly shaped ulcers form on their basis. Ulcers are covered with a yellowish coating, heal within 2-4 weeks. without scarring. The rash of vesicles and the formation of ulcers are accompanied by complaints of itching, pain, burning, the occurrence of which is associated with changes in nerve receptors and conductors of pain sensitivity. Often, patients complain of heaviness in the lower abdomen, as well as dysuric phenomena. With pronounced manifestations of the disease, there are complaints of malaise, headache, irritability, sleep disturbance; subfebrile condition and enlargement of regional lymph nodes are sometimes observed.

RECURRENT HERPES

Recurrences of genital herpes are observed in 50-70% of women after the disappearance of the primary manifestations of the disease. The frequency of relapses and the duration of remissions are very variable – from once every 2-3 years to monthly exacerbations. With a mild form of chronic herpetic infection, exacerbations occur no more than 1-3 times a year, with moderate – 4-6 times a year. A severe course is characterized by a monthly exacerbation of the disease.

Various factors contribute to the occurrence of relapses: hypothermia, sexual intercourse, stressful situations, overwork, the occurrence of other diseases. For example, relapses of genital herpes often occur against the background of influenza and other respiratory pathological processes. Symptoms of genital herpes during relapses may be less pronounced compared to the primary disease.

ROUTES OF TRANSMISSION OF GENITAL HERPES

Genital herpes is transmitted sexually, and the source of infection can be not only patients with clinically pronounced symptoms, but also carriers of the herpes simplex virus. Domestic transmission is extremely rare.

DIAGNOSTICS OF GENITAL HERPES

Recognition of genital herpes is facilitated by anamnesis, complaints and objective examination data. The diagnosis is facilitated in the early stages of the disease in the presence of vesicles and erosions (their groups) not complicated by secondary infection, formed shortly after the destruction of the walls of the vesicles. Diagnostics genital herpes infection is based on the detection of HSV or its antibodies in the patient’s blood serum. Serological studies can help in the diagnosis only if it is possible to identify specific IgM and IgG to HSV : IgM appear 2 weeks after infection and are determined up to 2 months; IgG are produced from the 14th day and remain in the body throughout life, during the period of exacerbation they increase many times, during periods of remission they return to the baseline. The detection of antibodies is not considered an accurate diagnostic criterion because they may be the result of a previous extragenital herpes infection.

The preferred method is the detection of HSV in the discharge from the affected organs. From the vagina and cervix, the material is taken by superficial scraping, from the uterine cavity – by aspiration, from the urethra – a smear.

For express diagnostics, methods of fluorescent antibodies and immunoperoxidase method are used. They use the method of growing the virus (from scrapings, smears) in tissue culture with the subsequent study of its properties. Apply the electron microscopic method of recognition of HSV

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Zatsepin Mikhail Anatolyevich

Gynecologist-endocrinologist, ultrasound diagnostician

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Kogteva Elena Viktorovna sher-gynecologist, Doctor of ultrasound diagnostics

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Pokidko Tatyana Nikolaevna

Obstetrician-gynecologist, Ultrasound diagnostician

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Novikova Anastasia Leonidovna

Gynecologist

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Pankova Alina Aleksandrovna

Gynecologist

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TREATMENT OF GENITAL HERPES

Treatment of genital herpes is a difficult task due to the lack of agents that have a direct, specific effect on the virus. Treatment is also difficult due to the possibility of reinfection. It should be emphasized that none of the known antiviral drugs is able to eliminate the virus from the body. Therefore, the treatment of genital herpes is carried out in a complex and is aimed at blocking the reproduction of the virus while simultaneously stimulating the factors of specific and nonspecific resistance of the body. In each case, the choice of a treatment complex is determined by the clinical form and stage of genital herpes, the presence of concomitant diseases, the immunological state of the body, previous treatment and its effectiveness.

PREVENTION

Vaccine therapy with herpes vaccine (recurrence of at least 2 months) is carried out only after a course of restorative and symptomatic treatment. The vaccine is administered intradermally on the flexor surface of the forearm, 0.3 ml. 1 time in 3 days, only 5 injections, then a break for 2 weeks and another 5 injections of 0.3 ml. 1 time in 7 days.