Herpes in females: Symptoms, diagnosis, and treatment

The symptoms of herpes in females are similar to those in males. Blisters, ulcers, or sores usually appear first at the site where the virus entered the body. For females, this may be around the mouth, vagina, cervix, urinary tract, or anus.

According to the Office on Women’s Health (OWH), herpes affects 1 in 5 females between the ages of 14 and 49 years.

This article will look at the symptoms, diagnosis, and treatment of herpes in females.

There are two types of herpes infection: the herpes simplex virus type 1 (HSV-1) and the herpes simplex virus type 2 (HSV-2).

According to the World Health Organization (WHO), across the world, HSV-1 affects 3.7 billion people under the age of 50 years. HSV-2 affects 417 million people between the ages of 15 and 49 years.

Herpes infections are typically asymptomatic, but they can produce symptoms in some cases.

The sections below will discuss each type of herpes in more detail.

HSV-1

According to the WHO, HSV-1 is highly contagious and often appears as oral herpes, affecting the mouth and the area around it.

A person may come into contact with HSV-1 through nonsexual contact with another person’s saliva during their childhood and teenage years.

Sometimes, HSV-1 infections can cause genital herpes, which affects the genital or anal areas. HSV-1 can spread to the genitals through oral sex.

HSV-2

Some people refer to HSV-2 as genital herpes. HSV-2 typically spreads during anal, vaginal, or oral sex.

The WHO note that HSV-2 affects more females than males. The reason for this is that the transmission from males to females is more efficient.

Herpes will last a person’s lifetime. However, many people have either mild symptoms or no symptoms at all.

If herpes is asymptomatic, some people may not know that they have it. However, even in these cases, the virus can still spread.

Initial flare

The symptoms of an initial flare will depend on the type of herpes the person has.

Genital herpes

According to the OWH, when a female first contracts herpes, the symptoms tend to occur within 2–12 days. They typically appear at the site where the virus entered the body.

The following symptoms typically last for 2–4 weeks:

• pressure in the abdomen
• flu-like symptoms, sometimes including fever
• pain in the legs or the anal or genital area
• swollen glands
• itching or burning in the genital or anal area
• unusual vaginal discharge

Following these symptoms, females may develop blisters, ulcers, or sores at the site where the virus entered the body. These blisters, or lesions, can resemble insect bites or small pimples. In time, they usually crust over and form a scab.

These lesions may appear in the following areas of the body:

• the mouth
• the cervix
• the anus
• the buttocks
• the thighs
• in or around the vagina
• the urinary tract

They can also affect any other area where the virus entered the body.

Although the initial symptoms often develop within a couple of weeks, it could take several months or years before a person experiences the next flare.

Oral herpes

The initial symptoms of oral herpes may include:

• severe flu-like symptoms
• headaches
• swollen lymph nodes
• lesions on or around the lips
• lesions inside the mouth

Recurring flares

With later flares, a person may experience symptoms for a shorter period of time. Although the symptoms are often milder, they are typically similar to those of the initial outbreak.

Over time, a person is likely to experience fewer outbreaks, and they tend to be less severe.

Genital herpes

The initial set of symptoms is often the worst.

However, during a flare, a female may experience:

• sores
• a burning sensation when urinating, if sores are present
• difficulty urinating, if sores cover the urethra
• itching and pain around the genitals

Oral herpes

Recurrent oral herpes outbreaks are common in the first year of having the infection. They tend to lessen as time goes on because the body creates antibodies to fight the virus.

The sores typically erupt on the edges of a person’s lips.

Some common symptoms include:

• skin flushing, swelling, heat, itching, or pain on the affected area
• painful, fluid-filled blisters
• leaking blisters that turn into sores

The sores typically crust over and heal after about 4–6 days.

Possible triggers of outbreaks may include:

• fever
• menstruation
• injury
• prolonged exposure to sunlight
• surgery
• stress

Herpes can spread as a result of coming into skin-to-skin contact with a person who has the virus. This can happen even if the person does not know that they have it.

According to the OWH, herpes can spread through:

• having vaginal, oral, or anal sex with someone who has the virus
• touching the genitals of a person who has the virus
• breastfeeding, if the baby comes into contact with a sore
• childbirth, with the pregnant person transmitting it to the baby

There is currently no cure for herpes. However, there are treatment options available that can help reduce the severity of future flares.

The sections below will look at some of the treatment options for genital and oral herpes.

Genital herpes

A doctor will typically prescribe antiviral medication to treat genital herpes.

A person can take antiviral medication either during a flare, to help reduce the severity and length of the symptoms, or daily, to help prevent future flares.

A person should talk to their doctor about which medications are likely to work best for them.

During a flare, it is important to take some steps to help reduce the risk of passing the virus to others and minimize the severity of the flare.

Such steps include:

• keeping any sores or ulcers clean and dry
• avoiding sexual contact
• not touching the sores
• washing the hands or any other objects that come into contact with the sores

Oral herpes

When determining the best treatment for oral herpes, a healthcare professional will take into consideration the person’s age, overall health, and tolerance for medication.

Some treatment options for oral herpes may include:

• keeping the area clean and dry
• taking oral antiviral medications
• using over-the-counter anesthetics or anti-inflammatory agents

The process of diagnosing herpes is similar for both types. The following sections will look at these processes in more detail.

Genital herpes

A healthcare professional can make an initial diagnosis by carrying out a physical examination and checking any sores or ulcers on or near the genitals, anus, or mouth.

They may use a cotton swab or another similar device to take a fluid sample from a sore, which they will then send to a laboratory. At the laboratory, a technician will check the sample for herpes.

Between flares or before symptoms are present, it may be difficult for a doctor to diagnose herpes. However, if a person thinks that they may have herpes, a doctor can run a blood test to look for antibodies to the herpes virus.

Oral herpes

To diagnose oral herpes, a doctor can examine the location and appearance of the blisters that have appeared.

They may also perform a blood test or biopsy to confirm the diagnosis.

If a person with herpes becomes pregnant, they should let their doctor know, as it is possible that herpes will pass to the baby during delivery. A doctor can take steps to help protect the baby.

If herpes passes to the baby during the birth, the baby will have neonatal herpes. Neonatal herpes is a serious condition. A baby with neonatal herpes may develop eye conditions or brain injuries. It can even be fatal.

According to the Centers for Disease Control and Prevention (CDC), during the third trimester of pregnancy, a person should avoid having sexual activity with anyone who has genital herpes or suspected herpes.

A doctor may prescribe antiviral medication later on in the pregnancy to reduce the risk of a herpes outbreak. However, antiviral prophylaxis may not decrease the risk.

A healthcare professional may perform an examination before labor. If there are any symptoms of herpes, a cesarean delivery may be necessary.

The only guaranteed way to prevent the spread of herpes is to avoid having any physical contact with a person who has the infection.

However, there are other steps that a person can take to reduce the risk, including:

• avoiding skin-to-skin sexual contact, particularly when herpes lesions are present
• using condoms or dental dams, as other forms of birth control do not prevent herpes
• taking care when having multiple sexual partners
• undergoing regular testing and asking sexual partners to, as well

People who are sexually active should see a doctor regularly to undergo screenings for sexually transmitted infections (STIs).

A person who suspects that they may have come into contact with herpes should see a doctor to get a test.

A person should also see a doctor if they experience any symptoms of genital or oral herpes. A doctor can confirm a diagnosis and discuss the treatment options.

If someone who has genital herpes becomes pregnant, they should see a healthcare provider to prevent passing the virus to the baby.

It is possible for pregnant people with genital herpes to deliver a baby safely, but a doctor needs to be aware of the situation to do this effectively.

Herpes is a virus that currently has no cure. However, treatment options are available to reduce the symptoms.

Females with herpes may not experience any symptoms of the infection, but even if this is the case, the virus can still spread to others.

Symptomatic herpes typically presents with open, painful sores or ulcers on or around the genitals, anus, or mouth.

People should practice protected sex and undergo frequent testing to reduce their risk.

Pregnant people should let their doctor know if they have herpes to help prevent passing the infection to the baby.

Herpetic whitlow: Symptoms, causes, and treatment

Herpetic whitlow, or whitlow finger, is a painful infection caused by the herpes simplex virus.

There are different strains of the herpes simplex virus (HSV), including HSV-1, the main cause of cold sores, and HSV-2, the main cause of genital herpes. Both of these strains can cause herpetic whitlow.

It forms when a type of HSV enters the skin around the finger. The infection leads to redness, soreness, and fluid-filled blisters.

This article explores the symptoms, causes, and treatment of herpetic whitlow, as well as the chances of reoccurrence.

Herpetic whitlow develops when HSV enters a finger, particularly the fingertip, often through a small cut in the skin. Less commonly, whitlow can form on a toe.

The virus infects the soft tissue and causes localized:

• pain
• swelling
• fluid-filled blisters

A person may feel a burning or tingling sensation or pain before the finger, or fingertip, swells. At this point, there may be a color change, such as reddening.

Next, one or more blisters appear and fill with liquid or pus. They are typically small and very painful to the touch. These eventually burst and scab over.

A person with herpetic whitlow may also have:

• swollen lymph nodes in the armpit or elbow area
• a fever
• red streaks surrounding or leading away from the affected finger or toe

It may be easy to mistake whitlow for paronychia, which is a bacterial or fungal infection around the nail, or another type of finger infection.

The infection develops 2–20 days after exposure to the virus, and once the infection sets in, the fluid-filled blisters tend to form within 5–6 days.

Overall, the symptoms usually resolve without treatment in 2–4 weeks.

In 30–50% of people with herpetic whitlow, the infection reoccurs over time, often in the same place. The symptoms typically follow a pattern, and the person will feel sensations of tingling, burning, or itching before the blisters form.

When whitlow reappears, it is usually less severe than the first infection. There may be fewer blisters, which may be smaller and less painful.

A person can develop herpetic whitlow through direct contact with skin containing the virus, which might be on the genitals, face, or hands. The transmission might involve:

• touching these areas of someone with active oral or genital sores
• a person touching their own cold or genital sores
• a person sucking their thumb or biting their nails during an oral herpes outbreak

People with certain jobs may have a higher risk of herpes and its complications, such as herpetic whitlow, including medical and dental professionals and anyone else who works closely with people who have herpes.

The following factors can trigger reoccurring flares of HSV infection, including herpetic whitlow:

• a fever
• a reoccurring illness
• excessive stress
• hormonal imbalances
• excessive sun exposure
• surgery
• physical, mental, or emotional trauma
• a weakened immune system

Without treatment, herpetic whitlow tends to go away in 2–4 weeks. To reduce the duration of the symptoms, a person can try antiviral medications.

These limit the appearance of symptoms by up to 4 days. Antiviral medications also prevent the virus from spreading to other parts of the body.

A person sees the best results when they receive treatment within 48 hours of the symptoms appearing.

Antivirals that treat herpetic whitlow include:

• valacyclovir pills
• acyclovir pills
• famciclovir pills
• acyclovir ointment

A key part of treatment involves easing symptoms. This might involve treating pain with an over-the-counter medication, such as acetaminophen (Tylenol) or ibuprofen (Advil).

If a secondary bacterial infection develops in the area of a whitlow infection, antibiotics may also be necessary.

If whitlow reappears, a doctor may prescribe suppressive antiviral medications, which a person takes daily. These may reduce the chances of future outbreaks.

It is worth noting that while antiviral drugs can reduce the frequency and severity of symptoms, there is no cure for an HSV infection.

People can support healing from herpetic whitlow in several ways:

• Cover the infection: Lightly covering the affected area helps keep the virus from spreading.
• Avoid a temptation to drain: Never pop or drain a blister, as this can spread the virus or leave the area open to a secondary infection.
• Wash the hands: Doing so frequently and thoroughly is key, especially before and after touching an area of whitlow. Those working in medical or dental fields should take every precaution, such as working in gloves whenever possible.