by Rick Alan
Genital herpes is a sexually transmitted infection. It causes small, painful, fluid-filled blisters. These blisters break open and leave an indented sore or ulcer. The blisters can be found on the genitals, buttocks, or thighs. However, they can also spread to other parts of the body, such as the mouth, face, or eyes.
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Genital herpes is usually caused by the herpes simplex 2 virus. The herpes simplex 1 virus causes cold sores most often, but it can also cause genital herpes.
The virus enters the body through genital areas, the mouth, or a break in the skin. After the first outbreak, the virus moves to nerve endings at the base of the spine. It will remain there until the next outbreak.
The virus can be spread with:
The virus is most easily spread when there are blisters. However, the virus may still spread to others when there are no visible skin sores.
The strongest risk factor for genital herpes is having unprotected sex with an infected person. Other risk factors include:
Certain factors can trigger a recurrent outbreak of blisters. These factors include:
The exact cause of an outbreak is rarely known.
Symptoms depend on whether or not this is your first episode or a recurrence. The virus remains quiet between outbreaks. During this time, you may not have visible symptoms, but the virus may still be shedding. This means the virus can be spread during sex.
The number of outbreaks varies. They may decrease over time.
Primary infection is when you are first exposed to the virus. You may not have any symptoms or you may feel like you have the flu. This can include fever, muscle aches, and swollen glands. Blisters may appear in the genital area or other areas.
It may take about 2-6 weeks for the primary infection to resolve.
A recurrent infection happens when the virus is reactivated in your body. The severity of the outbreak, how long it lasts, and how much is shed all vary.
In most cases, recurrent infections are shorter and less severe. They will also tend to produce smaller and fewer ulcers. The blister or ulcer area may have pain, tingling, burning, or itching.
You will be asked about your symptoms and medical history. A physical exam will be done. If you have visible blisters and ulcers, they will be examined.
Your bodily fluids may be tested. This can be done with:
Lesions inside the urinary tract, vagina, or cervix may not be easily seen. Your doctor may do additional tests to examine these areas.
Getting treatment as soon as possible is important. Early treatment decreases the chance that you will infect others. It will also help you recover faster from an outbreak. However, it is important to keep in mind that the virus remains in your body. There are no treatments that will rid your body of the virus. There are medications to decrease the chance that you will have a recurrent infection.
Antiviral medications are used to treat genital herpes.
These medications are used to treat a primary infection or a recurrent infection. If you have a recurrent infection, the medication is most effective when it is taken as soon as possible. The medication is best when taken as soon as you notice symptoms.
If you have recurrent infections, your doctor may have you take antiviral medication every day to prevent an outbreak. This is called suppressive therapy.
It is important to learn about genital herpes and how to avoid spreading it to sex partners. Your doctor will provide you with information about the virus.
To manage discomfort, your doctor may recommend that you:
It is important that your sexual partner be tested for genital herpes and receive counseling. If your partner does have an active infection, he or she should also receive treatment.
Prevention strategies include:
If you are pregnant and have herpes, tell your doctor. Steps can be taken to help prevent your newborn from getting the infection.
American Congress of Obstetricians and Gynecologists
International Herpes Alliance
Sex Information and Education Council of Canada
Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR. 2010;59(No. RR-12):1-110.
Centers for Disease Control and Prevention Seroprevalence of herpes simplex virus type 2 among persons aged 14-49 years--United States, 2005-2008. MMWR Morb Mortal Wkly Rep. 2010;59(15):456-459.
Genital herpes: lifestyle tips. Healthy Women—National Women's Health Resource Center, Inc. website. Available at:
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Updated February 12, 2013. Accessed June 9, 2016.
Genital herpes. National Institute of Allergy and Infectious Diseases website. Available at:
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Updated January 23, 2014. Accessed June 9, 2016.
Corey L, Bodsworth N, et al. An update on short-course episodic and prevention therapies for herpes genitalis. Herpes. 2007;14:Suppl 1:5A-11A.
Herpes genitalis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114875/Genital-herpes. Updated August 22, 2016. Accessed September 28, 2016.
Herpes simplex. American Academy of Dermatology website. Available at: https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/herpes-simplex. Accessed June 9, 2016.
6/14/2012 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114875/Genital-herpes: Centers for Disease Control and Prevention (CDC). Neonatal herpes simplex virus infection following Jewish ritual circumcisions that included direct orogenital suction—New York City, 2000-2011. MMWR Morb Mortal Wkly Rep. 2012;61:405-409.
Last reviewed November 2017 by Marcie Sidman, MD
Last Updated: 11/17/2017
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