What is it?
Genital herpes is caused by infection with a virus called Herpes simplex (HSV). There are two types, HSV-1 and HSV-2, both of which can cause cold sores either in the mouth area or on the genital skin. Infection with the virus does not always result in symptoms but if it does these usually consist of blisters and ulcers on the skin’s surface.
The virus is transmitted through direct contact with each other's skin (mouth or genital). Herpes is most infectious during outbreaks, from the first signs of burning/tingling until the skin has completely returned to normal. The virus can still be shed at a time when there are no visible sores or other signs of infection. This is called "asymptomatic shedding".
Four out of five adults carry HSV-1 and about one in five carries HSV-2. Most people (about three quarters) carrying the virus are unaware that they're infected because they have no symptoms.
How can I prevent it?
Condoms can help to prevent transmission, but they are not a guarantee of complete protection, because the virus is also shed from areas not covered by the condom, (including the mouth).Dental dams for rimming can offer some additional protection.
If you have herpes, keep a record of when you have outbreaks, as you may begin to see a pattern or recognise trigger factors. Many people find that recurrences occur when they're run down, under stress or when the skin gets irritated due to friction or tight clothing. Sunlight and sunbeds may also induce an outbreak. If you do see a pattern of trigger factors, try to adjust your lifestyle to avoid them.
How do I know if I have herpes?
In most people, symptoms are mild or nonexistent. If symptoms do occur, they typically include itching/ burning/tingling of the skin, followed by redness and small blisters which break open to form little sores. The blisters can appear on the penis or anal area. They can also be inside the urethra and rectum.
The first outbreak can last two or three weeks and often feels like 'flu, with muscle aches, headaches, swollen glands and burning on passing urine. If you get your first episode of herpes in the anal/rectal area, this can cause quite severe discomfort, diarrhoea and an anal discharge. Sometimes there are no further outbreaks. Generally, HSV-1 is less likely to cause recurrences than HSV-2.
Recurrences result in fewer blisters/ sores which are much less painful and only take a few days to heal. For very many people, the frequency of recurrences declines with time.
You can be tested for herpes at a time when you have skin changes present. It is important to attend a sexual health clinic as soon as you develop symptoms. A swab will be taken from the affected areas of skin and can confirm the type of herpes virus.
Is there treatment?
During an outbreak, keep the affected area as cool and dry as possible. Bathe the area in tepid salty water or take a cool shower. If it's practical, leave the sores exposed to dry out. If you have sores around the anus, make sure you keep your stools soft by either taking plenty of dietary fibre and fluids or using a stool softener such as lactulose. Protect the area with a little vaseline before going to the toilet - and wash afterwards.
Although there is no drug to kill the virus, acyclovir is a prescription drug which is used in two situations: it helps to shorten the first outbreaks and it may also be taken daily by the very small group of people who experience frequent, prolonged or severe recurrences. Acyclovir cream is much less effective, but like any cool substance, it feels soothing.