Genital herpes – self-care Information | Mount Sinai

Herpes – genital – self-care; Herpes simplex – genital – self-care; Herpesvirus 2 – self-care; HSV-2 – self-care

Future Outbreaks

One type of herpes virus stays in the body by hiding within nerve cells. It can remain “asleep” (dormant) for a long time. The virus can “wake up” (reactivate) at any time. This can be triggered by:

• Fatigue
• Genital irritation
• Menstruation
• Physical or emotional stress
• Injury

The pattern of outbreaks varies widely in people with herpes. Some people carry the virus even though they’ve never had symptoms. Others may have only one outbreak or outbreaks that occur rarely. Some people have regular outbreaks that occur every 1 to 4 weeks.

Self-care

To ease symptoms:

• Take acetaminophen, ibuprofen, or aspirin to relieve pain.
• Apply cool compresses to sores several times a day to relieve pain and itching.
• Women with sores on the vaginal lips (labia) can try urinating in a tub of water to avoid pain.

Doing the following may help sores heal:

• Wash sores gently with soap and water. Then pat dry.
• Do not bandage sores. Air speeds healing.
• Do not pick at sores. They can get infected, which slows healing.
• Do not use ointment or lotion on sores unless your provider prescribes it.

Wear loose-fitting cotton underwear. Do not wear nylon or other synthetic pantyhose or underwear. Also, do not wear tight-fitting pants.

Medicine

Genital herpes cannot be cured. Antiviral medicine (acyclovir and related drugs) may relieve pain and discomfort and help the outbreak go away faster. It may also reduce the number of outbreaks. Follow your provider’s instructions about how to take this medicine if it has been prescribed. There are two ways to take it:

• One way is to take it for about 7 to 10 days only when symptoms occur. This typically shortens the time it takes for symptoms to clear up.
• The other is to take it daily to prevent outbreaks.

Generally, there are very few if any side effects from this medicine. If they occur, side effects may include:

• Fatigue
• Headache
• Nausea and vomiting
• Rash
• Seizures
• Tremor

Reducing Outbreaks

Consider taking antiviral medicine daily to keep outbreaks from developing.

Taking steps to keep yourself healthy can also minimize the risk for future outbreaks. Things you can do include:

• Get plenty of sleep. This helps keep your immune system strong.
• Eat healthy foods. Good nutrition also helps your immune system stay strong.
• Keep stress low. Constant stress can weaken your immune system.
• Protect yourself from the sun, wind, and extreme cold and heat. Use sunscreen, especially on your lips. On windy, cold, or hot days, stay indoors or take steps to guard against the weather.

Preventing the Spread of Herpes

Even when you do not have sores, you can pass (shed) the virus to someone during sexual or other close contact. To protect others:

• Let any sexual partner know that you have herpes before having sex. Allow them to decide what to do.
• Use latex or polyurethane condoms, and avoid sex during symptomatic outbreaks.
• Do not have vaginal, anal, or oral sex when you have sores on or near the genitals, anus, or mouth.
• Do not kiss or have oral sex when you have a sore on the lips or inside the mouth.
• Do not share your towels, toothbrush, or lipstick. Make sure dishes and utensils you use are washed well with detergent before others use them.
• Wash your hands well with soap and water after touching a sore.
• Consider using daily antiviral medicine to limit viral shedding and reduce the risk of passing the virus to your partner.
• You may also want to consider getting your partner tested even if they have never had an outbreak. If you both have the herpes virus, there is no risk for transmission.

When to Call the Doctor

Contact your provider if you have any of the following:

• Symptoms of an outbreak that worsen despite medicine and self-care
• Symptoms that include severe pain and sores that do not heal
• Frequent outbreaks
• Outbreaks during pregnancy

Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 23.

Whitley RJ, Gnann JW. Herpes simplex virus infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 350.

Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. PMID: 34292926 pubmed.ncbi.nlm.nih.gov/34292926/.

Last reviewed on: 11/10/2022

Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Genital herpes – Better Health Channel

About genital herpes

Genital herpes is a common sexually transmissible infection (STI) caused by the herpes simplex virus (HSV). There are two forms of HSV – HSV1 and HSV2. HSV1 occurs more commonly around the mouth, but it can also occur on the genitals. HSV2 occurs mainly in and around the genital area.

It is estimated that about one in eight people have HSV 2 and about 80% of those infected may be unaware that they have HSV2. It’s often not possible to tell when a person first acquired the HSV infection as the first symptoms may appear weeks to years later, if at all.

There is no cure for genital herpes, but medication can help manage and reduce the severity of symptoms, and also reduce the frequency of recurrences and reduce the risk of spread.

Many people are anxious about herpes, but it’s important to remember that it only affects the skin for relatively short periods of time, and most people only have a few recurrences.

Pregnant women with genital herpes should discuss this with their antenatal care provider, as herpes infection can be transmitted to the baby during pregnancy and delivery, leading to serious illness.

Genital herpes is spread by skin-to-skin contact

The herpes virus is spread by skin-to-skin contact and can be transmitted during vaginal, oral or anal sex. The infection can occur anywhere on the genitals, in areas around the groin or pubic area, and in or around the anus. Cold sores on the mouth can cause genital infection during oral sex for those who do not already have the cold sore virus.

The virus can be spread when someone with HSV has an ‘episode’ or an outbreak – characterised by having a sore, blister, ulcer or skin split (this is known as viral shedding). It can also be spread between episodes, when there is no sore, blister, ulcer or skin split present – called asymptomatic viral shedding.

During viral shedding the virus is on the skin surface and can be spread through genital skin-to-skin contact, or from the mouth or face to genital skin during contact.

Symptoms of genital herpes

Many people who have genital herpes may not be aware they have the infection, because they may not have any symptoms.

The first episode of herpes can cause considerable pain and distress. Symptoms of the first episode may include:

• flu-like symptoms – such as feeling unwell, headaches and pains in the back and legs, with or without enlarged glands in the groin
• small blisters around the genitals – these break open to form shallow, painful ulcers, which scab over and heal after one to two weeks
• small cracks in the skin with or without an itch or tingling
• redness or a distinct rash
• some people also have considerable pain and swelling in the genital area, and hence may have additional pain and difficulty passing urine.

Recurrent episodes of genital herpes

Recurrences are usually less painful and shorter in duration than the first episode of genital herpes. Over time, episodes usually become less frequent and may eventually stop altogether. Infections caused by HSV1 are less likely to recur in the genital area than infections caused by HSV2.

Recurrences may be triggered by:

• stress
• menstruation
• sexual activity
• general illness
• low immunity (such as during cancer treatment)
• no apparent reason noted.

Diagnosis of genital herpes

If you think you have herpes, your doctor will need to take a swab from the affected area to confirm the diagnosis. On rare occasions, your doctor will also do a blood test to help with the diagnosis. Discuss this with your doctor.

Treatment for genital herpes

There is no medication to cure your body of the herpes virus. Treatment is aimed at easing symptoms, reducing the frequency of recurrences and reducing transmission.

Symptoms can be improved by:

• salt baths
• ice packs to the affected area
• pain-relieving medication – such as paracetamol
• antiviral medication – such as acyclovir, famciclovir and valaciclovir. These can reduce the severity of an episode if taken early enough (preferably as soon as you become aware of any symptoms appearing). Topical antivirals usually used for cold sores on the lips or face are not suitable for use on the genitals.

Preventing recurrences of genital herpes

If you have frequent episodes, antiviral medication may be taken daily to reduce the likelihood of symptoms. You will need a prescription from your GP.

Prevention of genital herpes

The best protection against STIs is to always use barrier protection such as condoms, female condoms and dams (a thin piece of latex placed over the anal or vulvar area during oral sex). Because herpes is spread by skin-to-skin contact, condoms will reduce the risk of transmission, but it will not protect sexual partners completely as condoms do not cover the entire genitals.

Using lubricant with a condom during sex will also reduce the risk of trauma to the genital skin. This has been shown to reduce HSV transmission, especially in the first six months of a sexual relationship. Silicone-based lubricants are recommended.

Remember that herpes transmission can occur when symptoms are present (such as a sore or blister), but may also occur even if there are no genital symptoms through asymptomatic viral shedding.

For people who have frequent episodes of genital herpes, antiviral medication, taken daily, helps to reduce transmission of herpes to a sexual partner.

Pregnancy and genital herpes

Herpes infection may be transmitted to the baby during pregnancy and delivery, leading to serious illness. Although this is not common, let your midwife or obstetrician know if you have ever had a diagnosis of genital herpes, in the past or during your pregnancy.

Support and advice for genital herpes

If you have just found out you have genital herpes, you may feel shocked and may have a lot of questions. It may help you to gather as much information as you can about herpes. This can help you to make fully informed decisions about your treatment, safe sex and preventing further recurrences. Talking to a counsellor about your concerns may also help.

Where to get help

• Your GP (doctor)
• Sexual Health Victoria (SHV)External Link. To book an appointment call SHV Melbourne CBD Clinic: (03) 9660 4700 or call SHV Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly.
• Melbourne Sexual Health CentreExternal Link Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
• Thorne Harbour HealthExternal Link (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840
• Ballarat Community Health Sexual Health ClinicExternal Link Tel. (03) 5338 4500
• Bendigo Community Health Sexual Health ClinicExternal Link Tel. (03) 5434 4300 Or (03) 5448 1600
• Gateway Health Clinic 35External Link, Wodonga Tel. (02) 6022 8888 or 1800657 573
• Sunraysia Community Health ServicesExternal Link Tel. (03) 5022 5444
• Barwon Health Sexual Health ClinicExternal Link Tel. (03) 5226 7489
• 1800MyOptionsExternal Link Tel:1800 696784 is a statewide phone service for information about sexual health as well as contraception and pregnancy options

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