Article written by Marian Nicholson, of the Herpes Viruses Association and Shingles Support Society.
It is very common….
“To be infected with a herpes simplex virus is a state of normality, not an abnormality,” says Professor George Kinghorn, a sexual health specialist.
- Genital herpes is caused by herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2).
- In the UK, around 70% of people have caught at least one type by age 25.
- Only one in three infected people develops noticeable symptoms and receives a diagnosis.
- Two in three never realise they have the virus.
- Herpes simplex is generally harmless and does not affect fertility or long-term health.
Like chickenpox and glandular fever, herpes simplex remains in the body after infection. Symptoms may recur but are usually controlled by the immune system. Infection normally stays in one area of the body.
The information here relates to herpes simplex in the genital region:
Two types
Both herpes simplex type 1 and type 2 can cause cold sores, genital herpes or whitlows, depending on where you are infected. More than half of new genital herpes is caused by type 1. Type 1 tends to recur more often on the face; you may catch it genitally, but will get very few recurrences there.
Incubation
Symptoms usually appear between 2 days and 2 weeks after infection, but they may not develop for many years. This means herpes can first appear during a long-term relationship because it was caught before the relationship began.
Symptoms
Many people have no symptoms or only very mild ones.
If symptoms occur, they may include:
- Tingling, itching or pain in the genital area.
- Swollen groin glands and flu-like symptoms.
- Small blisters or ulcers that burst after 1–2 days, leaving sores that usually heal within 3–14 days.
Diagnosis
If you think you have genital herpes, attend a Sexual Health Clinic while symptoms are present for a swab test. Find your nearest clinic at https://sxt.org.uk/. There is no test if symptoms are absent. Visits are confidential.
First episode
A first outbreak usually clears within 2–3 weeks. Antiviral tablets such as aciclovir can shorten and reduce symptoms, while antiviral creams have little benefit.
Self-care includes:
- Taking paracetamol or ibuprofen.
- Using a local anaesthetic if needed.
- Keeping the area clean and cool.
- Washing hands before and after touching sores.
- Letting sores heal naturally.
Leave sores alone as much as possible—they will heal naturally.
Recurrences
Some people have only one or two outbreaks, while others have more. Recurrences usually become milder and less frequent over time. Common triggers include stress, illness, tiredness, menstruation and excess alcohol. If sex is a trigger, a silicone-based lubricant may help.
If outbreaks are frequent, start antiviral treatment (usually aciclovir) as soon as warning symptoms begin. Early treatment is most effective; once sores appear it is less helpful.
Some people take aciclovir daily to prevent outbreaks. This suppressive treatment can be continued for as long as needed. Aciclovir is available free from UK sexual health clinics.
Healthy lifestyle changes can support the immune system and may reduce recurrences. Alternative therapies are described at herpes.org.uk
Do I need to tell partners?
There is no legal requirement in the UK to tell partners you have herpes. However, if you have recurrent symptoms, discussing it may make it easier to avoid sex during an outbreak. Our Talking to a New Partner leaflet provides more information.
How is herpes passed on?
Herpes is spread by direct skin-to-skin contact when the virus is active. Transmission is most likely when blisters or sores are present and much less likely when there are no symptoms. It can be passed during genital sex or through oral sex from someone with a cold sore. It is not spread by towels, bedding, toilets, swimming pools or blood.
Avoid sexual contact with the affected area during symptoms or warning signs such as tingling, itching or burning. Condoms reduce the risk if they cover the affected area and are used before any skin contact.
Can it spread without symptoms?
Sometimes the virus is present on the skin without visible symptoms (asymptomatic shedding). This is uncommon and becomes less frequent over time, especially in people with few recurrences and in those with genital HSV-1. Daily aciclovir can further reduce the risk.
People mostly catch this virus from a person who does not realise they have herpes.
Can you catch it again?
Most people catch only one type of herpes simplex once. If partners have the same type, reinfection is not expected. If they have different types, symptoms are usually very mild.
Pregnancy and myths
Genital herpes rarely affects pregnancy or childbirth. Women can expect a normal delivery even if they have a recurrence. A C-section is usually recommended only if the first infection occurs late in pregnancy.
Internet blood tests and online information can be misleading. If you are unsure, seek reliable advice.
In summary
Herpes simplex carries an unnecessary stigma. It is very common, usually mild, and most people never know they have it. The Herpes Viruses Association offers accurate information and support based on medical guidelines and from people with personal experience.
Medical disclaimer
This content is for general information only and is not a substitute for professional medical advice. Always consult your GP or a qualified healthcare professional if you have any concerns about your health.