Herpes (HSV) symptoms, causes & treatments
Reviewed by Dr Bhavini Shah
Herpes is a common viral infection caused by the herpes simplex virus (HSV). HSV-1 typically causing cold sores and HSV-2 causing genital herpes. It is transmitted through skin-to-skin contact, even without visible symptoms. Symptoms include painful blisters on the genitals or mouth, flu-like symptoms, and painful urination, though many people experience mild or no symptoms. While there is no cure, antiviral medications can manage outbreaks, which tend to become less frequent and severe over time.
What is herpes simplex virus (HSV)?
It’s thought that 67% of the population under 50 years old have herpes (HSV-1). 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.
Symptoms of HSV-1
If you contract HSV-1 (oral herpes) then it is likely that you will experience no initial symptoms until developing your first cold sores. Children are more likely to develop symptoms from the primary infection than adults. The most common symptoms include:
- Cold sores
- Sore throat
- Swollen glands
- Sores in the mouth
- Flu-like symptoms
- Fever
- Nausea
- Headache
For most people infected with HSV-1, usually the only symptom they experience is a cold sore. This is a small, sore blister that forms around the mouth, usually on the bottom lip. It lasts for seven to 10 days and will nearly always clear up on its own without medical treatment.
Symptoms of HSV-2
It’s estimated that 491 million people worldwide aged between 15 and 49 have the herpes simplex virus type 2 (HSV-2. If you contract HSV-2 then it is likely that you will experience no initial symptoms. The first time you have an outbreak of symptoms, you can expect the following:
- Small, painful blisters around the genitals, rectum, cervix, thighs and/or buttocks that burst leaving open sores
- Pain urinating
- Flu-like symptoms
- Women may also experience unusual vaginal discharge
These symptoms typically last for around three weeks. The sores should scab and heal on their own, leaving no scarring. However, once you have been infected and experienced an outbreak of symptoms, you can expect further episodes of genital herpes in the future.
Causes and transmission of herpes
The herpes virus is very contagious and is transmitted through intimate skin-to-skin contact such as kissing and oral sex. If the herpes simplex virus is on your skin it is easily passed onto another person via the moist skin around your mouth, genitals or anus.
- The virus dies very quickly when it is away from human skin, which means it cannot be contracted by sharing cutlery or towels
- It can be spread through the sharing of sex toys without washing between uses
- Herpes may also be passed onto a child during birth
Herpes is highly contagious
The herpes simplex is most contagious during its “blister” phase when the sores are open and weeping. Dental dams and condoms can help to protect against transmission during oral sex, as can cold sore patches.
To avoid contracting or spreading the herpes simplex virus, you should be very wary of engaging in intimate contact during an outbreak. As soon as you or your partner feel the tingling, itching sensation that indicates a flare-up of symptoms, you should refrain from kissing, any genital or anal contact.
Herpes can be harder to remove for some
Recurrences of herpes symptoms are usually caused by the following triggers:
- Being unwell
- Fever
- Tiredness
- Stress
- Excess sunlight or ultraviolet light (e.g. sunbeds)
- Having a weakened immune system (e.g. from HIV)
- In women, menstruation
- Trauma to the affected area
Diagnosis and 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.
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.
A negative result may be because the virus is dormant.
If you have had unprotected sex with someone who had active symptoms of herpes at the time you may want to get tested.
If you're worried, you may like to have a further test if any blisters re-occur.
Treatment options for herpes
There are several treatments available for the herpes simplex virus, however none of them are permanent cures.
Treatment | Suitable for | How to use | Advantages | Disadvantages |
| Antiviral creams (cold sore creams) | If you’ve had cold sores in the past | When you feel symptoms starting (indicated by a tingling, itchy sensation around the mouth), apply the cream immediately. |
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| Antiviral tablets | Most prescribed for genital herpes Sometimes used to treat severe cases of cold sore | The usual prescription antiviral tablet given for primary outbreaks of genital herpes is aciclovir, which should normally be taken for five days. |
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| Cold sore patches | For cold sores that have already developed | Place a small plaster over a cold sore. It can take up to 10 days for a cold sore to disappear. |
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| Anaesthetic cream or gel | Genital blisters caused by herpes | Apply directly to the affected area as needed. |
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| Home remedies | Mild symptoms |
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Herpes can be a very frustrating condition, especially if your outbreaks are frequent. There are many other reasons why people may suffer recurring outbreaks such as other illnesses, poor lifestyle or hormonal changes (in women).
Having a well-managed treatment regime will help you deal with the virus as best you can. If you have genital herpes and you would like to learn about the treatments offered by Online Doctor, visit our online sexual health clinic.
Can herpes be cured?
No, there is no cure for herpes. Whilst herpes is a long-term condition with no cure, it is possible to manage outbreaks with herpes treatments such as creams or antiviral medicines. Moreover, the longer you have had the virus, the less painful and frequent the outbreaks are likely to be.
What happens if I leave herpes untreated?
If you don’t treat an outbreak of herpes, the symptoms will clear on their own. However, this can take longer than if you use a treatment. Speak to your GP or use an online service to find treatments to help manage herpes.
Genital herpes and pregnancy
Herpes can 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.
Living with herpes
Millions of people have herpes and live completely normal lives. You’re not alone, and there’s no need to feel embarrassed about having a common infection. There are treatments you can use to help manage symptoms and things you can do to prevent your partner(s) from getting herpes too. In time outbreaks usually become less often and less painful.
If you have herpes and need more support speak to your GP, visit your local sexual health clinic or talk to a clinician in your Patient Record.
References
https://www.who.int/news/item/28-10-2015-globally-an-estimated-two-thirds-of-the-population-under-50-are-infected-with-herpes-simplex-virus-type-1
https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus
https://herpes.org.uk/
https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/genital-herpes/
https://www.nhs.uk/conditions/genital-herpes/
