Genital herpes living in children

Overview

Genital herpes is a long-term infection caused by a virus called herpes simplex. It can cause painful blisters or sores in the genital area. In children, it is usually passed from mother to baby during birth, but it can also be spread through close skin-to-skin contact.

Genital herpes in children is not common, but it can happen. Most cases are in newborns whose mothers have an active herpes infection at the time of birth.

Genital herpes can affect children of any age. Newborns are most at risk if their mother has a herpes outbreak during delivery. Older children can get the virus through close contact with an infected person's skin, but this is rare.

Symptoms

Common symptoms

• Painful blisters or sores on the genitals, buttocks, or inner thighs
• Itching or tingling before blisters appear
• Flu-like symptoms such as fever, body aches, and swollen glands

Symptoms in children

• Sores inside the mouth or on the skin if spread from a mother during birth
• Irritability, poor feeding, or fever in newborns
• Pain during urination if blisters are near the urethra

Symptoms in older adults

• Not applicable for this age group – this article focuses on children.

Causes

Main causes

• Infection with herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2)
• Transmission from an infected mother to her baby during vaginal birth
• Direct skin-to-skin contact with an infected person's sore or blister (uncommon in children beyond newborn period)

Risk factors

• Mother has active genital herpes at the time of delivery
• Child has a weakened immune system
• Skin breaks or cuts in the genital area that allow the virus to enter

When to see a doctor

See a doctor urgently if:

• If a newborn has any signs of herpes (fever, blisters, lethargy) – seek immediate medical attention
• If your child has severe pain, cannot urinate, or has a high fever with sores

Book a routine appointment if:

• If your child has any sores or blisters in the genital area that you are unsure about
• For a follow-up after an outbreak to discuss management and prevention

Diagnosis

A healthcare provider will look at the sores and may take a swab of fluid from a blister to test for the herpes virus.

Tests that may be done

• Viral culture (swab test) – takes a few days
• Polymerase chain reaction (PCR) test – more sensitive and faster
• Blood test to check for herpes antibodies (less common in children)

What to expect at your appointment

The doctor will examine your child and gently swab an open blister. The test is quick and may be slightly uncomfortable. Results usually come back in a few days. Your doctor will explain the findings and discuss next steps.

Treatment

There is no cure for genital herpes, but antiviral medications can shorten outbreaks, reduce symptoms, and lower the chance of passing the virus to others. Treatment is especially important in newborns to prevent serious complications.

Self-care at home

• Keep the area clean and dry.
• Give your child warm baths with mild soap to help soothe sores.
• Dress your child in loose, cotton underwear to avoid irritation.
• Encourage your child to drink plenty of fluids to prevent dehydration if urination is painful.

Medical treatments

Antiviral medicines are taken by mouth or given through a vein (in newborns) to fight the virus. They work best when started within 72 hours of symptoms. The doctor will decide the right medicine and dose for your child's age and health. Never share or reuse medicine.

When is surgery considered?

Not applicable. Surgery is not used to treat herpes. In very rare cases, a doctor may drain a large blister if it is causing severe pain, but that is not typical.

Living with this condition

Your child can live a normal life with genital herpes. Outbreaks may come and go, especially during times of stress, illness, or sun exposure. You can help by spotting early signs (tingling) and starting comfort measures right away.

Lifestyle tips

• Help your child avoid touching or scratching sores.
• Wash hands often with soap and water, especially after contact with sores.
• Keep your child home from school or daycare until the sores have crusted over to avoid spreading the virus (though transmission to others is very unlikely).

Diet and exercise

A healthy diet and regular exercise can support your child's immune system. There is no special diet for herpes, but staying hydrated and getting enough sleep can help reduce outbreaks.

Mental health and emotional wellbeing

A diagnosis of genital herpes can bring feelings of shame, worry, or confusion for both child and family. It is important to talk openly with your child's doctor and consider counseling. If you or your child are feeling overwhelmed, reach out to a crisis support line.

Prevention

For newborns, the best prevention is for pregnant women with known herpes to take antiviral medicine during pregnancy and to have a cesarean delivery if there is an active outbreak at the time of birth. For older children, the virus is rarely transmitted, but avoiding contact with active blisters and not sharing towels or washcloths can help.

Vaccines

There is currently no vaccine for herpes simplex virus. Researchers are working on developing one.

Screening programmes

Routine screening for herpes in children is not recommended. Testing is done only if symptoms appear or if there is known exposure.

Complications

If left untreated

• Neonatal herpes – a severe infection in newborns that can affect the brain and other organs
• Meningitis or encephalitis (inflammation of the brain) in rare cases
• Spread of the virus to the eyes or other parts of the body

Long-term outlook

With prompt treatment, most children recover well from outbreaks and go on to lead healthy lives. Newborn herpes is serious but treatable. Over time, outbreaks usually become less frequent and less severe. Your child's healthcare team will help you manage the condition and prevent future outbreaks.

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