Updated October 2013

Definition

Genital Herpes is a sexually transmitted infection (STI) caused by the Herpes Simplex Virus (HSV).

Causes

There are two types of virus that cause herpes: HSV-1 and HSV-2. HSV-1 is the virus that causes cold sores and can also infect the genitals through unprotected oral sex. HSV-2 usually infects the genital area.

Signs and Symptoms

Most people who get herpes are not aware of the infection. They may have no symptoms or mild symptoms that can be mistaken for other conditions like a cut, rash, or skin irritation. If there are symptoms during the first outbreak they can be quite severe and usually appear within 2 weeks after infection. Typically, one or more blisters appear around the genitals or rectum. The blisters break and leave painful ulcers (sores) that may take two to three weeks to heal. New blisters and sores can appear during this time. There may also be fever, flu-like symptoms, swollen glands, and painful urination.

The herpes virus stays in the body indefinitely and can cause future outbreaks. People with HSV-2 can typically get four to five outbreaks a year. There are usually fewer outbreaks with HSV-1. The number of outbreaks tends to decrease with time and repeat outbreaks are usually milder and shorter. With repeat outbreaks, a person may notice symptoms such as tingling or burning even before the sores appear. Sometimes a person may not have a noticeable outbreak until years after they first get the infection.

Herpes can be spread to other parts of the body (including the eye), so it is important to wash and dry your hands carefully if you touch herpes sores.

Diagnosis and Tests

If a person has symptoms, a doctor or nurse can swab the blister(s) and send the fluid to the laboratory for testing. Often health care providers diagnose herpes by recognizing the symptoms. There are no good screening tests for herpes. Blood tests are sometimes used to help with diagnosis.

Risk Factors

Women who have genital herpes can still get pregnant, have a healthy pregnancy and a healthy baby. However, if genital herpes is contracted late in the pregnancy there is a greater risk of passing the infection onto the baby. If there are sores at the time of delivery, a C-section is usually done. It is important for a woman to talk with her doctor or midwife about how to reduce the risk of passing herpes to the baby during delivery. Fortunately, infections in babies are rare.

Complications

Genital herpes can make it easier for a person to get infected with HIV. It can also increase the risk of transmitting HIV.

Transmission

Herpes is spread by skin-to-skin contact and contact with oral and genital fluids. You can get herpes without having sex. The sores release the virus but a person can also “shed” virus when there are no visible sores. This means that a person can infect a partner even when there are no symptoms or when a person does not know they are infected.

Generally, a person can only get HSV-2 infection during genital-to-genital contact with someone who has HSV-2. HSV-2 rarely causes infection on or in the mouth. HSV-1 mostly causes infection in the mouth and on the lips (cold sores or “fever blisters”). A person with a history of cold sores can infect their partner’s genitals through oral sex. If they have HSV-1 on the genitals, they can infect their partner through skin-to-skin genital contact.

Treatment

There is treatment but no cure. Treatment with antiviral medication works best when you take it in the first 24 hours after an outbreak starts. It can also help the sores to heal more quickly. Medication taken every day (“suppressive therapy”) can also help prevent outbreaks and lower the risk of passing the infection to an uninfected partner.

Prevention/Self-care Tips

Here are some things you can do to feel better:

  • Keep the sores clean by washing with warm water.
  • Try to keep the sores dry.
  • Use a hair dryer set on low to dry sores that are sensitive.
  • Apply an ice pack to the sore(s) as needed to numb them.
  • Wear loose-fitting clothing and cotton underwear.
  • If urinating is painful, run warm water over the sores while urinating, or while in the shower or bath.
  • Take Tylenol or Advil.
  • Do not use creams unless they are prescribed by your healthcare provider.

Information for Sexual Partners

You need to tell your sexual partner(s) before you have sexual contact, including oral sex. Latex condoms used consistently can help reduce the risk of genital herpes but are not completely protective. If you have symptoms or sores, avoid any sexual contact until the sores are completely healed and symptoms have gone away. Healed skin means the scab has fallen off and the skin looks normal. Avoid kissing or oral sex when you have a cold sore. Daily antiviral medication can help reduce the risk of passing on the infection.

More Information

Call the AIDS and Sexual Health InfoLine at 416-392-2437

SAFER SEX: To reduce your risk of getting a sexually transmitted infection (STI),
use a condom every time you have vaginal, anal or oral sex