What is herpes?
Genital herpes affects the skin or mucous membranes of the genitals. It’s caused by the herpes simplex virus (HSV). HSV is spread from one person to another during sexual contact.
• HSV-2 most often causes genital herpes. HSV-2 can be spread through secretions from the mouth or genitals.
• HSV-1 usually affects the mouth and lips and causes cold sores or fever blisters. However, it can spread from the mouth to the genitals during oral sex.
You may become infected with herpes if your skin, vagina, penis, or mouth comes into contact with someone who already has herpes.
You are most likely to get herpes if you touch the skin of someone who has herpes sores, blisters, or a rash. However, the herpes virus can still be spread even when no sores or other symptoms are present. Sometimes, the person does not even know they are infected.
Genital HSV-2 infections are more common in women than men.
What are the symptoms of herpes?
Many people with genital herpes never have sores, or they have very mild symptoms that go unnoticed or are mistaken for insect bites or another skin condition.
If signs and symptoms do occur during the first outbreak, they can be quite severe. This first outbreak usually happens within two days to two weeks of being infected.
General symptoms may include:
• Decreased appetite
• General sick feeling
• Muscle aches in the lower back, buttocks, thighs, or knees
• Swollen and tender lymph nodes in the groin during an outbreak
Genital symptoms include the appearance of small, painful blisters filled with clear or straw-colored fluid. They are usually found:
• In women: on the outer vaginal lips (labia), vagina, cervix, around the anus, and on the thighs, or buttocks
• In men: on the penis, scrotum, around the anus, on the thighs, or buttocks
• In both sexes: on the tongue, mouth, eyes, gums, lips, fingers, and other parts of the body
• Before the blisters appear, the person may feel the skin tingling, burning, itching, or have pain at the site where the blisters will appear.
• When the blisters break, they leave shallow ulcers that are very painful. These ulcers eventually crust over and slowly heal over 7 - 14 days or more.
Other symptoms that may occur include:
• Painful urination
• Women may have vaginal discharge or, occasionally, be unable to empty the bladder and require a urinary catheter
A second outbreak can appear weeks or months later. It is usually less severe and goes away sooner than the first outbreak. Over time, the number of outbreaks may decrease.
Once you have HSV-2, the virus hides within nerve cells and remains in the body. It can remain "asleep" (dormant) for a long time.
The virus can "wake up" (reactivate) at any time. This may be triggered by:
• Genital irritation
• Physical or emotional stress
Some people have genital herpes attacks only once a year, while others have them so often the symptoms never seem to go away. Repeated attacks are generally milder in men.
How is herpes treated?
Genital herpes cannot be cured. However, antiviral medication can relieve pain and discomfort during an outbreak by healing the sores more quickly. These drugs appear to help during first attacks more than they do in later outbreaks. Medicines used to treat herpes include acyclovir, famciclovir, and valacyclovir.
For repeat outbreaks, start the medication as soon as the tingling, burning, or itching begins, or as soon as you notice blisters.
People who have many outbreaks may take these medications daily over a period of time. This can help prevent outbreaks or shorten their length. It can also reduce the chance of giving herpes to someone else.
Pregnant women may be treated for herpes during the last month of pregnancy to reduce the chance of having an outbreak at the time of delivery. If there is an outbreak around the time of delivery, a C-section will be recommended to reduce the chance of infecting the baby.
Possible side effects from herpes medications include:
• Nausea and vomiting
Home care for herpes sores:
• Do NOT wear nylon or other synthetic pantyhose, underwear, or pants. Instead, wear loose-fitting cotton garments
• Gentle cleansing with soap and water is recommended.
• Taking warm baths may relieve the pain (afterward, keep the blisters dry)
If one of the sores develops an infection from bacteria, ask your doctor if you need an antibiotic.
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