Genital herpes is the most common ulcerative sexually transmitted infection (STI) in the UK. There's a very good chance that you might have it without even noticing.
Herpes affects sexually active men and women and is passed on through unprotected vaginal, anal, and oral sex. The infection is caused by the herpes simplex virus (HSV), which remains in the body indefinitely. It stays inactive for the majority of the time however, when reactivated, it will cause an outbreak.
There are two types of the herpes simplex virus, which are known as:
- HSV-1 – causes oral herpes, which affects the skin around the mouth.
- HSV-2 – causes genital herpes, which affects the skin around the genital area
The rate of genital herpes diagnoses has increased gradually since 2007 in both females and males.
In 2019, there were 468,342 new STI diagnoses made at sexual health services. Of the most commonly diagnosed STIs, there were 34,570 diagnoses of genital herpes, accounting for 7% of all new diagnoses.
It is estimated that over two thirds (>66%) of adults under the age of 50 carry the herpes simplex virus.
How to Tell If You Have Herpes?
Many people who contract herpes will experience very mild symptoms, while other people’s symptoms may be painful. The only sure way to know if you have herpes is to get tested for it.
1 in 3, who will experience evident symptoms, will likely seek medical attention and receive a diagnosis. While the others, who have mild symptoms or no symptoms at all, are unlikely to seek medical attention right away and may go undiagnosed.
It is important to be regularly screened for sexually transmitted disease. It is often recommended that sexually active adults should be screened annually for diseases such as chlamydia, gonorrhoea, syphilis and HIV.
Herpes can be diagnosed following an STI Blood test, which you can get at sexual health or GUM clinics. You can also buy STI testing kits online which can be delivered discreetly to your door – you simply provide a blood sample, post it to a laboratory and receive your test results via email or text.
What are the symptoms of herpes?
The symptoms of HSV-1 and HSV-2 are similar, though the site of infection is often the differentiating factor.
HSV-1 primarily causes cold sores on the lips, though they can also appear on the chin or neck in some circumstances.
HSV-2 usually causes genital herpes, which is characterised by ulcers and small grouped blisters around the genitals.
Both strains of human simplex virus (HSV) can cause blisters on the fingers called Herpetic Whitlow's. These are rare and usually occur when you touch an infected blister or sore.
During the first outbreak of herpes, the blisters that develop are at their worst. Before they appear, your skin may feel itchy, tingly or go numb. The blisters can also cause discharge from the vagina, penis or rectum, making it painful when going to the toilet.
It is important not to pop or drain the blisters yourself.
Here’s what to do if a blister bursts:
- Once the blister has drained, wash the area with soap and warm water. Avoid using alcohol or other chemicals.
- Pat down the skin which remains. Do not remove the flap of skin from the blister.
- Use an antibiotic cream around the blister to protect the area from infection.
- Apply a dressing such as a bandage or gauze over the burst blister. You can also use a plaster or dressing strip (which you can cut to length) to cover the affected area.
If you require assistance or advice, speak to a pharmacist.
A burst blister will scab over and typically heal within four weeks' time. Keep the area clean and avoid picking at the skin around the blister.
If you suspect your blister has become infected, see your GP. Infected blisters, which are often look red, feel hot and are filled with green or yellow pus, require specific treatment to prevent the risk of skin or blood infections.
Also, during the initial outbreak of herpes, you may experience flu-like symptoms such as: a fever, body aches, headaches and nausea. These symptoms typically occur 21 to 25 days after the initial infection.
You can tell you have a herpes outbreak when these symptoms flare up again. This will happen from time to time, although they are usually less severe than the first outbreak. The occurrence of outbreaks also generally decreases over time.
How do you get Herpes?
The infection enters the body through small cracks in the skin. It can also enter through the mouth, vagina, rectum, urethra and under the foreskin
Herpes is passed through:
- Any skin-to-skin touching with infected areas.
- Sharing kitchen utensils or glassware with an infected person.
- Unprotected vaginal, anal, or oral sex.
- If you are pregnant, herpes can also be passed onto your baby.
Remember, you can still catch herpes even if your sexual partner does not have any visible sores or other symptoms.
While condoms can reduce the risk of contracting or transmitting the herpes virus, they do not offer complete protection. This is because the condom does not cover all the areas where the infection may be present.
During a herpes breakout, you should avoid sexual contact until your symptoms have completely cleared.
What is The Treatment for Herpes?
The common treatment for herpes is an antiviral, such as aciclovir, famciclovir (Famvir) or valaciclovir (Valtrex). Your doctor will be in the best position to determine which treatment is most suitable for you.
For cold sores, antiviral creams can be used to help speed up the healing process.
Genital herpes will require a short course of antiviral tablets.
Although the herpes virus remains in your body for the rest of your life, antiviral medication will help to manage any symptoms during an outbreak. The treatments will also be able to clear up the outbreak faster.
As well as taking the antiviral medication, you can help ease your symptoms by:
- Keeping the infected area clean by using salt water to wash it gently.
- Using an ice pack wrapped in a flannel or towel to help soothe your skin.
- Drinking plenty of fluids, which will make it less painful when you pass urine and also dilute it.
Things to avoid when your herpes symptoms are active:
- Vaginal, anal, or oral sex until the sores and blisters have completely gone away.
- Tight fitting clothes that may irritate any blisters or sores and ultimately make them worse.
- Applying ice directly on your blisters or sores.
- Touching your blisters or sores, unless you are applying cream. In this case always ensure you wash your hands with antibacterial soap first.
- Intimate contact including kissing, sexual contact and sharing of utensils and glassware should be minimised to mitigate the risk of contraction until the visible symptoms have completely cleared.
Herpes during pregnancy and childbirth
If you have genital herpes during pregnancy or childbirth, there is a risk that the virus will be passed on to your child – this is known as neonatal herpes. Instances of neonatal herpes in the UK are rare.
During breastfeeding, a mother can pass on the herpes virus if they feed their child from a breast which has visible herpetic blisters, or feed their child expressed milk from a breast with visible herpetic blisters.
Furthermore, the NHS advise “...not [to] kiss a baby if you have a cold sore to reduce the risk of spreading the infection.”
It is important to inform your doctor or midwife if you have had genital herpes in the past.
For more information about neonatal herpes, see the NHS website here.
Should I worry about herpes?
While the symptoms of herpes are unpleasant, the condition is not in itself life-threatening and the virus is manageable with appropriate medication. Unfortunately, there is currently no cure for herpes, nor is there an effective herpes vaccine.
As the first herpes outbreak is usually the most severe, it can take a few weeks to completely heal. Any outbreaks that follow tend to be less harsh on the body and will typically pass within a few days of starting treatment.
During outbreaks, it’s important to keep the affected areas clean and be conscious to the condition, so that you can take appropriate measures to prevent the risk of passing the virus on to other people. This includes abstaining from sexual activity or kissing while symptoms are present, regularly using condoms, keeping your hands clean and avoiding skin-to-skin contact with infected areas.
Always wash your hands after applying any creams and cover up any burst blisters with sterile dressings to further reduce the risk of skin-to-skin contact.
For further practical advice on reducing the risk of contracting herpes, speak to your doctor.