Genital herpes overview

Overview

Genital herpes is a common sexually transmitted infection (STI) caused by a virus. It can cause painful sores or blisters in the genital area, but many people have no symptoms at all. Once you have the virus, it stays in your body for life. While there is no cure, treatments can help manage outbreaks and lower the risk of passing it to others.

Yes, genital herpes is one of the most common STIs worldwide. The World Health Organization estimates that hundreds of millions of people under age 50 have HSV type 2. Many do not know they carry the virus.

Anyone who is sexually active can get genital herpes, regardless of age, gender, or sexual orientation. It is most common in people in their late teens through their 30s. People with a weakened immune system may have more frequent or severe outbreaks.

Symptoms

Common symptoms

• Small, painful blisters or sores on the genitals, buttocks, or inner thighs
• Itching or tingling in the genital area before blisters appear
• Pain when passing urine (if sores are near the urethra)
• Flu-like symptoms such as fever, headache, and muscle aches during the first outbreak
• Swollen glands (lymph nodes) in the groin

Symptoms in children

• Genital herpes in children is rare and may be a sign of sexual abuse. Symptoms are similar to adults: painful blisters, itching, and discomfort when urinating.
• If a newborn gets herpes from the mother during birth (neonatal herpes), it can be much more serious, with symptoms like fever, fussiness, poor feeding, and seizures. This is a medical emergency.

Symptoms in older adults

• In older adults, genital herpes outbreaks may be less severe but can take longer to heal due to a naturally weaker immune system.
• Shingles (caused by a different herpes virus) is more common in older adults; it is not the same as genital herpes.

Causes

Main causes

• Genital herpes is caused by infection with the herpes simplex virus (HSV), usually type 2 (HSV-2) or sometimes type 1 (HSV-1).
• The virus enters the body through tiny breaks in the skin or mucous membranes during sexual contact.

Risk factors

• Having unprotected sex (vaginal, anal, or oral) with someone who has the virus
• Having multiple sexual partners
• Having a weakened immune system (due to HIV, chemotherapy, or some medicines)
• Being a woman – women are more likely to get genital herpes from a male partner than the other way around

When to see a doctor

See a doctor urgently if:

• If you have painful blisters or sores in your genital area that you haven't had before
• If you are pregnant and have symptoms or have been exposed to herpes
• If you have trouble urinating or feel like you cannot empty your bladder

Book a routine appointment if:

• If you have had genital herpes and notice a new outbreak that does not get better with your usual care
• If you want to talk about ways to reduce the risk of passing herpes to a partner

Diagnosis

A doctor or nurse can usually diagnose genital herpes by looking at the sores. If needed, they may take a swab from a blister to confirm the virus is present. In some cases, a blood test can detect antibodies to HSV, but this is not done routinely.

Tests that may be done

• Swab test – a gentle cotton swab is rubbed over a blister to collect a sample. The sample is sent to a lab to check for the herpes virus.
• Blood test – checks for antibodies against HSV. This can show if you have been infected in the past, even if you never had symptoms.

What to expect at your appointment

The swab test may be slightly uncomfortable but is usually quick. Results can take a few days. The doctor will explain what the results mean and, if you have herpes, discuss treatment and how to manage the condition.

Treatment

There is no cure for genital herpes, but treatments can help manage symptoms, shorten outbreaks, and lower the chance of passing the virus to others. Treatment depends on how often you have outbreaks and how severe they are.

Self-care at home

• Keep the area clean and dry to help sores heal. Gently wash with plain water and pat dry.
• Wear loose-fitting cotton underwear to reduce irritation.
• Apply a cold pack or ice wrapped in a cloth to the area to soothe pain.
• Take over-the-counter pain relievers (like paracetamol or ibuprofen) to ease discomfort and fever – ask a pharmacist for advice.
• Avoid sexual contact during an outbreak until sores are completely healed.

Medical treatments

Doctors may prescribe antiviral medicines that can be taken either as a short course during an outbreak or every day to prevent future outbreaks (suppressive therapy). These medicines help reduce symptoms and lower the risk of spreading the infection. Only a healthcare provider can decide if these are appropriate for you. Do not share medicines or take them without a prescription.

When is surgery considered?

Surgery is not used to treat genital herpes.

Living with this condition

Living with genital herpes means learning to recognize early signs of an outbreak (like tingling or itching) so you can start treatment quickly. Over time, many people find that outbreaks become less frequent and less bothersome. It is important to talk openly with sexual partners about your status and how to reduce risk.

Lifestyle tips

• Manage stress – high stress can trigger outbreaks. Try relaxation techniques like deep breathing, meditation, or gentle exercise.
• Get enough sleep and eat a balanced diet to support your immune system.
• Avoid tight clothing that rubs against the genital area during an outbreak.

Diet and exercise

There is no special diet that cures herpes, but eating well and staying active can help keep your immune system strong. Some people find that certain foods (like those high in the amino acid arginine) may trigger outbreaks, but this is not proven for everyone. A healthy lifestyle overall is the best approach.

Mental health and emotional wellbeing

It is common to feel embarrassed, anxious, or angry when first diagnosed with genital herpes. Many people worry about rejection by partners. Over time, these feelings often improve as you learn more about the condition and how common it is. If feelings of sadness or worry are affecting your daily life, talk to a counsellor or a trusted healthcare professional.

Prevention

You can reduce the risk of getting or passing genital herpes by using condoms every time you have sex. Keep in mind that condoms do not cover all skin that could have the virus, so they reduce the risk but do not eliminate it. If you have genital herpes, taking daily suppressive antiviral medicine (if prescribed by your doctor) also lowers the chance of passing the virus to a partner.

Vaccines

There is no vaccine currently available to prevent genital herpes. Research is ongoing.

Screening programmes

Routine screening for genital herpes is not recommended for people without symptoms. Blood tests for HSV are not part of standard STI testing. Talk to your doctor if you have concerns about possible exposure.

Complications

If left untreated

• If left untreated, outbreaks may last longer and be more painful.
• Pregnant women can pass the virus to their baby during childbirth, which can cause serious illness in the newborn (neonatal herpes). Treatment during pregnancy reduces this risk.
• People with genital herpes are more likely to get or pass on HIV, because sores make it easier for the HIV virus to enter the body.

Long-term outlook

For most people, genital herpes is a manageable condition. Outbreaks become less frequent and less severe over time. With proper care, you can have a normal sex life and healthy relationships. Many people with the virus never have symptoms or only have one or two outbreaks in their lifetime.

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