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Genital herpes

Herpes - genital; Herpes simplex - genital; Herpesvirus 2; HSV-2; HSV - antivirals

Genital herpes is a sexually transmitted infection. It is caused by the herpes simplex virus (HSV).

This article focuses on HSV type 2 infection.

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Causes

Genital herpes affects the skin or mucous membranes of the genitals. The virus is spread from one person to another during sexual contact.

There are 2 types of HSV:

You may become infected with herpes if your skin, vagina, penis, or mouth comes into contact with someone who already has herpes.

You are most likely to get herpes if you touch the skin of someone who has herpes sores, blisters, or a rash. But the virus can still be spread, even when no sores or other symptoms are present. In some cases, you do not know you are infected.

Genital HSV-2 infections are more common in women than men.

Symptoms

Many people with genital herpes never have sores. Or they have very mild symptoms that go unnoticed or are mistaken for insect bites or another skin condition.

If signs and symptoms do occur during the first outbreak, they can be severe. This first outbreak most often happens within 2 days to 2 weeks of being infected.

General symptoms may include:

Genital symptoms include small, painful blisters filled with clear or straw-colored fluid. Areas where the sores may found include:

Before the blisters appear, there may be tingling, burning, itching, or pain at the site where the blisters will appear. When the blisters break, they leave shallow ulcers that are very painful. These ulcers crust over and heal in 7 to 14 days or more.

Other symptoms may include:

A second outbreak can appear weeks or months later. It is most often less severe and it goes away sooner than the first outbreak. Over time, the number of outbreaks may decrease.

Exams and Tests

Tests can be done on skin sores or blisters to diagnose herpes. These tests are most often done when someone has a first outbreak and when a pregnant women develops genital herpes symptoms. Tests include:

At this time, experts do not recommend screening for HSV-1 or HSV-2 in adolescent or adults who have no symptoms, including pregnant women.

Treatment

Genital herpes cannot be cured. Medicines that fight viruses (such as acyclovir or valacyclovir) may be prescribed.

Pregnant women may be treated for herpes during the last month of pregnancy to reduce the chance of having an outbreak at the time of delivery. If there is an outbreak around the time of delivery, a C-section will be recommended. This reduces the chance of infecting the baby.

Follow your health care provider's advice on how to care for your herpes symptoms at home.

Support Groups

You can ease the stress of illness by joining a herpes support group. Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

Once you are infected, the virus stays in your body for the rest of your life. Some people never have another episode. Others have frequent outbreaks that can be triggered by fatigue, illness, menstruation, or stress.

Possible Complications

Pregnant women who have an active genital herpes infection when they give birth may pass the infection to their baby. Herpes can cause a brain infection in newborn babies. It is important that your provider know if you have herpes sores or have had an outbreak in the past. This will allow steps to be taken to prevent passing the infection to the baby.

The virus may spread to other parts of the body, including the brain, eyes, esophagus, liver, spinal cord, or lungs. These complications can develop in people who have a weakened immune system due to HIV or certain medicines.

When to Contact a Medical Professional

Call your provider if you have any symptoms of genital herpes or if you develop fever, headache, vomiting, or other symptoms during or after an outbreak of herpes.

Prevention

If you have genital herpes, you should tell your partner that you have the disease, even if you do not have symptoms.

Condoms are the best way to protect against catching genital herpes during sexual activity.

Related Information

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Asymptomatic
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Genital warts
Meningitis
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HIV/AIDS
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Encephalitis
Immunodeficiency disorders
Urinary incontinence

References

Habif TP. Sexually transmitted viral infetions. In: Habif TP, ed. Clinical Dermatology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 11.

Palmore TN, Henderson DK. Nosocomial herpesvirus infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 308.

Schiffer JT, Corey L. Herpes simplex virus. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Disease, Updated Edition. 8th ed. Elsevier Saunders; 2015:chap 138.

US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Serologic screening for genital herpes infection: US Preventive Services Task Force recommendation statement. JAMA;316(23):2525-2530. PMID: 27997659 www.ncbi.nlm.nih.gov/pubmed/27997659.

Whitley RJ. Herpes simplex virus infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 374.

Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137. PMID: 26042815 www.ncbi.nlm.nih.gov/pubmed/26042815.

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Review Date: 8/26/2017  

Reviewed By: Peter J. Chen, MD, FACOG, Associate Professor of OBGYN at Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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