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Herpes Causes, Symptoms, Tests And Treatments

Doctor explaining treatments to a couple

What is herpes?

Herpes is a common infection which can cause painful blisters on the genitals and mouth areas. In 2011, over 30,000 people had an attack of genital herpes for the first time, yet 80% of people with herpes are unaware they have it due to a lack of symptoms. Most of those with the virus have mild or no symptoms at all meaning they don't get diagnosed. Herpes can appear either as genital herpes, or as cold sores on the mouth.

Whilst herpes is a long-term condition with no cure, it is possible to manage outbreaks with creams or antiviral medicines. Moreover, the longer you have had the virus, the less painful and frequent the outbreaks are likely to be. Due to the lack of symptoms in many people, it is quite hard to work out how many people have the virus, but it is thought that most people catch at least one type of the virus, sooner or later (source: herpes.org.uk).

Causes of herpes

Genital herpes is caused by a virus, known as the herpes simplex virus (HSV). There are two types of this virus: type 1 and type 2.

Type 1 is most commonly expressed as a cold sore on the lips or mouth. Type 2 is the most common cause of genital herpes. However, it is possible for either to cause an infection in either area.

In general, herpes is contracted through skin-to-skin contact, particularly if an individual has an active herpes lesion. However, even if active lesions are not present it is still possible for the virus to be shared and passed on by an infected individual.

Herpes may also be passed onto a child during birth, and neonatal herpes simplex is a serious condition. Pregnant women with herpes are advised to make sure their GP is made aware as they will need specialist management.

Symptoms of herpes

Both men and women infected with genital herpes will have stages where the virus is dormant and there is no visible sign of infection. When the virus does become active, symptoms appear in the form of blisters and lesions on and around the genitals, which can look like cold sores.

It may be comforting to know that in general, the longer someone has genital herpes, the less frequently the virus and its symptoms become active.

Herpes is most contagious when blisters are present. It's important to avoid sexual intercourse if you're displaying symptoms of herpes, in order to reduce the risk of passing the virus on. This includes avoiding oral sex as there's a chance of genital to oral transmission, which could result in your partner developing cold sores.

Testing for herpes

Genital herpes is more complex to diagnose than some other STIs. This is because there are other conditions which may look similar. Herpes is easiest to diagnose when the virus is active and you have developed blisters, so it's best to visit your GP or local GUM clinic as soon as you become aware of them.

The doctor or nurse will take a swab to test for the herpes simplex virus. It is important to note that if you think you've been exposed to the herpes virus, a negative result doesn't necessarily mean that you do not have the virus. It may be that the virus is dormant. You may nonetheless want to get tested if you have had unprotected sex with someone who had active symptoms of herpes at the time. If you're worried, you may like to have a further test if any blisters re-occur.

Treatment of herpes

Herpes must be well managed, as there is no cure for the virus. Thankfully, there are a number of treatment options available.

Antiviral medicines, the most common being aciclovir, are used to reduce the severity of a herpes outbreak. The course of tablets will normally last five days, but you may need further treatment if blisters or sores are still present after you've completed the course.

Aciclovir may be prescribed to you as an episodic treatment, used as and when you develop herpes (only if you experience six or fewer outbreaks a year), or as a longer term medicine, used to help suppress an outbreak of the virus for up to 12 months (taken twice a day). Suppressive treatment does reduce the likelihood of passing the virus on to a sexual partner but does not completely remove the risk.

Alternatively, you may also find a mild anaesthetic cream such as lidocaine helpful during an outbreak. Lidocaine applied to the affected area can help numb the skin to help reduce pain and irritation.

Herpes can be a very frustrating condition, especially if your outbreaks are frequent. Having a well-managed treatment regime will help you deal with the virus as best you can. However, if you find yourself with regular herpes outbreaks, you may need to consider HIV testing. These attacks may be an indication that you have a weakened immune system which may be caused by HIV. However, there are many other reasons why people may suffer recurring outbreaks such as other illnesses, poor lifestyle or hormonal changes (in women). If you would like to be tested for HIV, order one of our HIV blood test kits, or visit your local sexual health clinic.