Genital Herpes Overview Genital Herpes is an infection caused by the Herpes Simplex Virus (HSV) which can be passed through sexual contact and sometimes skin to skin contact. There were 508 episodes (first infections and recurrent infections) of genital herpes diagnosed in Northern Ireland GUM clinics in 2015. Causes of Genital Herpes Genital herpes is caused by the virus Herpes simplex (HSV). There are two types, HSV-1 and HSV-2. Both types can infect the genital and anal area (genital herpes) and also the mouth and nose (cold sores) and fingers and hand (whitlows). The virus enters the body through small cracks in the skin or through the moist soft lining (mucous membranes) of the mouth, vagina, rectum, urethra (tube where urine comes out) and under the foreskin. Following an infection by the Herpes simplex virus some people will experience an outbreak of genital herpes. The virus then becomes dormant (inactive) and remains in the body where you were infected. In some people the virus can become active again from time to time and cause further outbreaks of genital herpes – known as recurrent outbreaks. Symptoms of Genital Herpes First Outbreak Many people will not have any visible signs or symptoms at all, or not be aware of them. Some people will get symptoms within 4–5 days of coming into contact with the virus. In other people the virus may be in the body for several weeks, months or possibly years before any signs or symptoms appear. Therefore, when you get symptoms it doesn’t necessarily mean you’ve only just come into contact with the virus. If you do get signs or symptoms, they usually follow a pattern. You may have some or all of the following: small blisters that burst to leave red, open sores around your genitals, rectum (back passage), thighs and buttocks blisters and ulcers on the cervix (lower part of the womb) in those assigned female at birth vaginal discharge in those assigned female at birth pain when you pass urine a general feeling of being unwell, with aches, pains and flu-like symptoms These symptoms may last up to 20 days. However, the sores will eventually scab and heal without scarring. Recurrent Outbreaks Signs and symptoms of recurrent outbreaks are usually milder than with the first outbreak and clear up more quickly (in about a week). This is because your body has produced protective antibodies (proteins that fight infection) in reaction to the previous infection. Your body now recognises the virus and mounts a response that is able to fight HSV more effectively. There is often an early warning tingling sensation and you may get a flu-like illness before an outbreak. The blisters and sores are usually fewer, smaller, and less painful and heal more quickly. They normally appear in the same part of the body as in previous outbreaks but in some people they may appear nearby. a tingling, burning or itching sensation around your genitals, and sometimes down your leg, before blisters appear painful red blisters that soon burst to leave sores around your genitals, rectum (back passage), thighs and buttocks blisters and ulcers on the cervix (lower part of the womb) in AFAB people How is Genital Herpes passed on? The Herpes simplex virus is most likely to be passed on just before, during or straight after an outbreak. Genital herpes can be passed on: From one person to another during vaginal or anal sex, or by sharing sex toys. By skin to skin contact during sex. It can be passed on by close genital contact – you don’t need to have penetrative sex (vaginal or anal) to pass it on. By skin to skin contact during sex if the virus is active on the skin outside the area protected by a condom or a latex or a polyurethane square. If you receive oral sex from someone who has a cold sore or is just about to get one. If a person with herpes on the hand or finger touches a partner’s vagina, genitals or anal area. You cannot get genital herpes from hugging, sharing baths or towels, from swimming pools, toilet seats or from sharing cups, plates or cutlery Treatment for Genital Herpes The aim of the treatment is to relieve the pain, and to prevent the virus from multiplying. Treatment is recommended when you have the first outbreak as this may provide some relief. Treatment is usually started within five days of the start of the first outbreak and while new blisters or sores are still forming. It involves taking antiviral tablets daily (sometimes up to five times a day) for five days. There are several different antiviral tablets that can be used. Some people find it helpful to take antiviral treatment when they get another outbreak of genital herpes. You may be given some tablets to take at home. These need to be started as soon as the outbreak begins. People who have repeated outbreaks (usually more than six in a year) may be given longer courses of the tablets to try to reduce the number of outbreaks. This is known as suppressive therapy. Suppressive therapy can stop outbreaks completely. If you are pregnant, or trying to become pregnant, tell the doctor or nurse so they can talk to you about pregnancy and Herpes simplex. If you have an outbreak of herpes in pregnancy it is still possible to have treatment. As genital herpes is caused by a virus and not bacteria, antibiotics will not help. The treatment you can buy for facial cold sores is not suitable for genital herpes. It is not essential to have treatment as genital herpes will clear up by itself. However, prompt treatment at the start of an outbreak can be a great help – it can reduce the time the outbreak lasts, help the healing process and can reduce the risk of you passing the virus on to someone else. Is there anything I can do to ease my discomfort? Apply an ice pack. Put ice cubes in a plastic bag and then wrap them in a clean towel or flannel. Put them on the sores for up to an hour or so. Ice should not be put directly onto the skin. Put cold, wet tea bags on the sores. They are soothing and speed up healing. Take a cool shower to soothe the sores. Apply a local anaesthetic ointment such as lidocaine. This will help relieve the pain. You can buy this from the pharmacy. Avoid washing too often, and dab the affected area gently to dry it. Gently bathe the area using cottonwool and a warm salt water solution (1tsp to 1pt water). If urinating is painful, go to the toilet in a warm bath or shower. Wash your hands before touching the blisters or sores. This helps to avoid introducing bacteria which may cause an infection and delay the healing process. Drink extra fluids, such as water or soft drinks. Wear loose clothing. Use a mild pain relieving drug, if you need to. Is Genital Herpes Curable? No, Genital Herpes cannot be cured. When you’ve contracted Genital Herpes you may only have only one outbreak or you may have several (recurrent outbreaks) but even if you do not have an outbreak for a long time, Genital Herpes remains dormant in your system and can be passed onto your sexual partner(s) through unprotected sexual contact even when there’s no outbreak present. If you or your partner has had Genital Herpes you must always practice safer sex. Do I need to contact previous sexual partners? If the check-up shows that you have genital herpes then it is not usually recommended that a partner has a check-up unless they have signs or symptoms.