Genital herpes is an infection with the herpesvirus, called herpes simplex. Herpes simplex virus is also responsible for cold sores that occur on the face.
How you catch genital herpes
How do I know if I have herpes?
- The first attack is the worst, and starts between 2 and 12 days after you caught the infection (usually about 4 days).
- Later attacks (recurrences) are less severe.
- Some people never get recurrences, some people get them occasionally and a few people get them regularly.
- The severity of the attacks varies a lot between individuals. At one end of the spectrum, some people have really troublesome attacks. At the other end of the spectrum, the attack may be so mild that the person does not notice any symptoms, which is how people end up carrying the herpesvirus unknowingly.
First herpes attack
Later attacks (recurrences)
Why recurrences occur
How recurrences of herpesvirus happen
First genital infection with herpes simplex virus causes sores
Herpesvirus travels up nerves to the nerve ganglion where it lies low
At a later date, herpesvirus may travel down nerves to the genital skin, causing a ‘recurrent attack’ of herpes
Recurrent attack heals, and herpesvirus retreats to the ganglion again
At a later date, herpesvirus may travel down to the genital skin again, causing another recurrent attack. This may happen several times
- emotional stress
- physical stress – for example, having another illness
- damage to the genital skin
There are two types of herpes simplex virus; recurrences are more likely if you have type 2 than type 1. Recurrences are slightly more likely in men than in women.
What to do if you have an attack of herpes
- If you are female, look at the section on painful vulva.
- If this is your first attack, go at once to your nearest genitourinary medicine clinic to check that you really do have herpes. There are many other causes of rash or discomfort in the genital area. For example, people sometimes mistake herpes for jock itch or conditions causing anal pain.You do not need a doctor’s letter to go to the clinic. If you are anxious about going to the clinic, look at the section on visiting the clinic. The advantage of the clinic is that they will test you for other genital infections, they may also be able to give you some treatment to take away with you and they have counsellors (‘health advisors’) who can talk to you about the whole subject. However, if you prefer, you could see your family doctor instead.
- There is no cure for herpes, but if this is your first attack your doctor will probably prescribe medication to reduce symptoms and speed healing (such as aciclovir, famciclovir or valaciclovir).
- If this is your first attack, recognize that you will be feeling excessively miserable (which is part of the viral illness). Do not force yourself to go to work - stay home until the worst has passed and pamper yourself as much as possible.
- Do not share your towel or flannel with anyone – there is no strong evidence that herpes is transmitted this way, but better to be on the safe side.
- Put two handfuls of ordinary salt into a bath of warm water and sit in it for a while.
- If passing urine is painful, do it into the warm bath while gently holding the lips of the vagina apart. Take plenty of drinks.
- Drying the genital area with a hairdryer on the cool setting may help to ease discomfort.
- According to the UK Herpes Viruses Association, applying a cold, wet teabag helps. They say that Earl Grey is best!
- Paracetamol (acetaminophen) will help to relieve pain.
- If appropriate (for example, you are home alone), leave the sores exposed to the air to prevent irritation from knickers or underpants.
- You could try a herbal cream, such as aloe vera, melissa (a type of mint) or propolis (made by bees from the resin of Canadian poplar trees). These remedies are available from health food stores. But remember that there is very little scientific evidence to back the use of these remedies, their quality is not always controlled and some people may react badly to herbal creams.
- Do not have sex until the sores have completely healed – if this is your first attack, this could be about 3 weeks. One reason is that you are most likely to pass the infection on when you have the sores. Another reason is to protect yourself – open sores give other infections (such as HIV) easy access to your bloodstream.
- After the sores have healed and you start having sex again, use plenty of lubrication to protect your skin from too much friction. Look at the section on vaginal dryness for advice on lubricants.
What to do if you keep getting recurrences
- Talk to your doctor about some anti-herpes drug therapy. This medication is most effective if you take it as soon as the attack starts, so your doctor may give you some to keep at home in readiness. For a really severe problem, your doctor might suggest that you take the anti-herpes medication continuously, and will discuss the pros and cons with you.
- Look after your genital skin between recurrences. For sex, use plenty of lubrication to protect your skin from too much friction; look at the section on vaginal dryness for advice on lubricants. Try to avoid over-vigorous sex or over-vigorous masturbation. There is general advice for women in the section on Vaginal and vulval problems – dos and don’ts.
- Keep your immune system in good shape by eating plenty of fresh fruit and vegetables, taking plenty of rest and not smoking.
- Try to keep the problem in proportion. The UK Herpes Viruses Association has a very helpful booklet called Herpes Simplex - the Guide, which will help you feel better about yourself.
Dr Phil Hammond discusses herpes in rhyme in his Expert Guide to Herpes
Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Friday, June 11th 2010
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In the UK in 2007, more than 26,000 people visited a clinic for a first attack of genital herpes
In the UK, genital herpes increased by 20% between 2006 and 2007