Genital herpes

When to go to a sexual health clinic

You should go to a sexual health clinic as soon as possible if you have:

• small blisters that burst to leave red, open sores around your genitals, anus, thighs or buttocks
• tingling, burning or itching around your genitals
• pain when you pee after unprotected sexual activity (this can also be a symptom of urine infection - if you need advice, see your GP
• in women, vaginal discharge that's not usual for you

Why you should go to a sexual health clinic

You can see your GP, but they'll probably refer you to a sexual health clinic if they think you might have genital herpes.

Sexual health clinics treat problems with the genitals and urine system.

They'll often get test results quicker than GP practices.

• Find a sexual health clinic

What happens at a sexual health clinic

The doctor or nurse at the sexual health clinic will:

• ask about your symptoms and your sexual partners
• use a small cotton bud (swab) to take some fluid from one of your blisters or sores for testing

The test can't:

• be done if you don't have visible blisters or sores
• tell you how long you've had herpes or who you got it from

Symptoms might usually appear four to seven days after an infection, though this can be delayed. Symptoms can occur again after an initial infection has cleared (see below).

If you have genital herpes, your previous sexual partners should get tested. The doctor or nurse at the clinic can discuss this with you.

Treatment for genital herpes

There's no cure. Symptoms clear up by themselves but the blisters can come back (an outbreak or recurrence). Treatment from a sexual health clinic can help.

Treatment the first time you have genital herpes

You may be prescribed:

• antiviral medicine to stop the symptoms getting worse – you need to start taking this within five  days of the symptoms appearing
• cream for the pain

If you've had symptoms for more than five days before you go to a sexual health clinic, you can still get tested to find out the cause.

Treatment if the blisters come back

Go to your GP or a sexual health clinic if you've been diagnosed with genital herpes and need treatment for an outbreak.

Antiviral medicine may help shorten an outbreak by one or two days, if you start taking it as soon as symptoms appear. But outbreaks usually clear up by themselves, so you may not need treatment.

Recurrent outbreaks are usually milder than the first episode of genital herpes. Over time, outbreaks tend to happen less often and be less severe. Some people never have outbreaks.

Some people who have more than six outbreaks in a year may benefit from taking antiviral medicine for 6 to 12 months. If you still have outbreaks of genital herpes during this time, you may be referred to a specialist.

How to deal with outbreaks yourself

If you've been diagnosed with genital herpes and you're having an outbreak, there are things you can do to help yourself.

These include:

• keeping the area clean using plain or salt water to prevent blisters becoming infected
• applying an ice pack wrapped in a flannel to soothe pain
• applying petroleum jelly or painkilling cream (such as 5 per cent lidocaine) to reduce pain when you pee
• washing your hands before and after applying cream or jelly
• peeing while pouring water over your genitals to ease the pain
• not wearing tight clothing that may irritate blisters or sores
• not putting ice directly on the skin
• not touching your blisters or sores unless you're applying cream
• not having vaginal, anal or oral sex until the sores have gone away

How genital herpes is passed on

Genital herpes is very easy to pass on (contagious) from the first tingling or itching of a new outbreak to when sores have fully healed.

You can get genital herpes:

• from skin-to-skin contact with the infected area – including vaginal, anal and oral sex
• when there are no visible sores or blisters
• if a cold sore touches your genitals
• by transferring the infection on fingers from someone else to your genitals
• by sharing sex toys with someone who has herpes

You can't get genital herpes:

• from objects such as towels, cutlery or cups – the virus dies very quickly when away from your skin

Protecting against genital herpes

You can reduce the chances of passing herpes on by:

• using a condom every time you have vaginal, anal or oral sex – but herpes can still be passed on if the condom doesn't cover the infected area
• avoiding vaginal, anal or oral sex if you or your partner has blisters or sores, or a tingle or itch that means an outbreak is coming
• not sharing sex toys – if you do, wash them and put a condom on them

Why genital herpes comes back

Genital herpes is caused by a virus called herpes simplex. Once you have the virus, it stays in your body.

It won't spread in your body to cause blisters elsewhere. It stays in a nearby nerve and causes blisters in the same area.

If you can, avoid things that trigger your symptoms.

Triggers can include:

• ultraviolet light – for example, from sunbeds
• friction in your genital area – for example, from sex (lubricant may help) or tight clothing

Some triggers are unavoidable, including:

• being unwell
• having a period
• surgery on your genital area
• a weakened immune system – for example, from having chemotherapy for cancer

Genital herpes and HIV

Genital herpes can be a more serious condition for people with HIV. If you have HIV and herpes, you'll be referred to a genitourinary medicine (GUM) specialist.

Genital herpes and pregnancy

Women with herpes before pregnancy can usually expect to have a healthy baby and a vaginal delivery.

If you have genital herpes during pregnancy, there's a risk your baby could develop a serious illness called neonatal herpes.

This can be fatal, but most babies recover with antiviral treatment.

The risk of your baby getting neonatal herpes is low if you've had genital herpes before. It's higher if you get genital herpes for the first time in pregnancy.

See your midwife or GP if you think you have genital herpes in pregnancy.

Genital herpes treatment in pregnancy

You may be offered antiviral treatment:

• to treat outbreaks in pregnancy
• from 36 weeks to reduce the chance of an outbreak during birth
• from diagnosis until the birth if you first get herpes after 28 weeks of pregnancy

Many women with genital herpes have a vaginal delivery. You may be offered a caesarean, depending on your circumstances.

More useful links

• How to use your health services