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By Medical Author: Shaziya Allarakha

By Medical Reviewer: Pallavi Uttekar

Herpes is a common infection caused by herpes virus. The virus causing herpes is of two types; namely, herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

Genital herpes is a type of sexually transmitted disease (STD) caused mostly by HSV-2. Although HSV-1 can cause herpes lesions in the genital area, it occurs less frequently compared to HSV-2. HSV-1 and HSV-2 spread by skin-to-skin contact. HSV-1 is spread by kissing, whereas HSV-2 spreads by skin to skin contact during sexual activity when the genital areas of two (or more) people touch. 

Genital herpes lesions can appear on or around the genitals (vulva, vagina, cervix, anus, penis, scrotum, butt and inner thighs). When the lesions are on or around the lips, mouth and throat, it is called oral herpes.

Genital herpes is contagious and can spread through direct, unclothed, skin-to-skin contact, including vaginal and oral sex performed without a condom or dental dam. Transmission can occur when a person with infection does not have any symptoms or visible lesions, but has virus present on the skin  (asymptomatic viral shedding). Thus, they may infect others without even knowing that they have the infection. The infectivity, however, is typically increased when lesions appear. 

A study suggested that in asymptomatic people, the genital HSV-2 shedding occurs on 10.2% of days, whereas in those with a symptomatic infection, the viral shedding occurs on 20.1% of days. Despite a relatively lower rate of asymptomatic viral shedding, the risk of transmission cannot be ignored since about 85 to 90 percent of the infected people do not show any symptoms of genital herpes. 

Once infected, the virus will be present in the affected person for life because the infection cannot be cured. Blisters may heal within two to three weeks of an outbreak, but the virus lies dormant inside the nerves, causing occasional flare-ups. The herpes virus dies quickly outside the body, thus, you cannot get herpes from holding hands, hugging, coughing, sneezing or sitting on the toilet seat. Herpes is not airborne. 

What are the symptoms of genital herpes?

Many people with genital herpes exhibit no symptoms or very mild symptoms that may be overlooked or mistaken for another skin condition. Herpes lesions mainly appear as one or more fluid-filled lesions (vesicles) or small blisters. The lesions typically occur on or around the genitals or anus.

Symptoms may appear 2 to 12 days after the infection. The lesions are painful and may be associated with a burning or itching sensation. Symptoms are usually worse during the first outbreak. Recurrent outbreaks may be shorter and milder than the initial one. Most people with herpes get fewer outbreaks as time goes on, and some people stop having them altogether.

The most typical symptoms of genital herpes are a group of itchy or painful blisters on the vagina, vulva, cervix (the neck of the uterus), penis, buttocks, anus or inner side of the thighs. These blisters may burst to form sores.

Other symptoms of herpes include:

• Itching

• Burning sensation, especially while passing urine

• Pain around the genitals

• Enlarged lymph nodes (swollen glands in the pelvic area, throat and armpit)

• Fever

• Malaise (feeling of being unwell)

• Chills

• Headache

• Body aches

How can I prevent getting genital herpes?

Genital herpes spreads from sexual skin-to-skin contact with an infected person through vaginal, anal and oral sex. The best way to avoid genital herpes is avoiding any contact with another person’s mouth and genitals. Practice safe sex by using protection such as condoms and dental dams to lower infection risk. 

Condoms lower your risk considerably, but may not provide 100 percent protection because herpes virus can transmit from areas not protected by condoms, such as the buttocks, cheeks, upper thighs, labia and scrotum. Although herpes spreads more easily during an outbreak, the infection can spread even when symptoms are not present. Hence, use condoms if you or your partner have herpes infection despite no symptoms. You must, however, avoid having sex (oral, anal or vaginal) during an outbreak because sores may be on parts of the body not covered by a condom. The outbreak may be preceded by symptoms such as burning, itching or a tingling feeling.

If you are infected, ask your doctor about herpes medications that can lower your risks of spreading herpes. Avoid touching the sore because this can spread the infection to other body parts. Wash your hands with soap and water if you have touched a sore accidentally or while applying medications. Avoid kissing if you have a sore in your mouth or on your lips. Having herpes also increases your risk of other sexually transmitted diseases (STDs) including human immunodeficiency virus (HIV) and vice versa. Hence, always follow safe sex practices such as wearing a condom if you have herpes or another STD.