Genital herpes

Looking after your sexual health

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and HSV-2. Both types can infect the genital and

Genital herpes anal area (genital herpes), the mouth and nose
(cold sores) and fingers and hand (whitlows).
Genital herpes is a common sexually transmitted The virus can enter the body through small
infection (STI). It’s caused by a virus called herpes cracks in the skin or through the moist soft linings
simplex. Herpes infection is very common and (mucous membranes) of the mouth, vagina,
many people have the virus without ever knowing rectum (back passage), urethra (tube where urine
it. Most people with genital herpes will only comes out) and under the foreskin.
get mild symptoms but others will get painful After an infection by the herpes simplex virus,
symptoms. some people will have an outbreak of genital
This booklet gives you information about genital herpes (see page 5). The virus then becomes
herpes, what you can do if you’re worried you dormant (inactive) but it stays in the area of the
might have the infection, and advice on how to body where you were infected. In many people
protect yourself and your partner(s). the virus will become active again from time
to time and cause further outbreaks of genital
What causes genital herpes? herpes. These are known as recurrent outbreaks
Genital herpes is caused by one of the herpes (see page 6).
simplex viruses (HSV). There are two types, HSV-1  

Contents
What causes genital herpes?................................................................................2 When will the signs and symptoms go away?.......................................10
How is genital herpes passed on?....................................................................4 Can I prevent further outbreaks?...................................................................11
Can I pass the virus to a partner when I have no signs or Do I need a follow-up appointment?..........................................................11
symptoms?.......................................................................................................................4 What happens if genital herpes isn’t treated?........................................11
What are the signs and symptoms of genital herpes?.........................5 How soon can I have sex again?.....................................................................12
What are the signs and symptoms of recurrent genital herpes?.. 6 Will I know how long I’ve had the virus?..................................................12
How will I know if I have genital herpes?.....................................................6 Should I tell my partner(s)?................................................................................12
How soon after sex can I have a check-up?..............................................7 Does genital herpes affect my fertility?......................................................13
What does the check-up involve?....................................................................7 What happens if I have genital herpes when I’m pregnant?.........13
How accurate are the tests?................................................................................7 Does genital herpes cause cervical cancer?............................................14
Where can I get a test for genital herpes?..................................................8 How can I help protect myself from genital herpes and other
Will I have to pay for tests and treatment?................................................8 sexually transmitted infections?.......................................................................14
What’s the treatment for genital herpes?....................................................8 Using a service...........................................................................................................15
Is there anything I can do to ease the discomfort?...............................9 More information and advice...........................................................................15
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How is genital herpes passed on? It’s possible to pass the virus on during periods
Genital herpes can be passed from one person of asymptomatic shedding but for most people
to another during sexual contact. Anyone who’s the risk is low. Shedding is higher in the first
sexually active can get the virus and pass it on. year after infection and in people with frequent
Herpes simplex is most likely to be passed on outbreaks. When there’s a long gap between
just before, during or straight after an outbreak. outbreaks, asymptomatic shedding is less likely to
Genital herpes can be passed on: take place.
O from one person to another during vaginal or
anal sex, or by sharing sex toys What are the signs and symptoms of
O by direct genital contact – you don’t need to genital herpes?
have penetrative sex (vaginal or anal) Many people won’t have any visible signs or
O by skin to skin contact with the affected area symptoms at all, or won’t be aware of them.
during sex, if the virus is active on the skin Some people will get symptoms within 2-14
outside of the area protected by a condom or days of coming into contact with the virus. In
dam (a latex or soft plastic square) others, the virus may be in the body for weeks,
months or years before signs or symptoms appear.
O if you receive oral sex (going down, giving
So if you get symptoms it doesn’t necessarily
head) from someone who has a cold sore or is
mean you’ve only just become infected.
just about to get one
If you do get signs or symptoms, they usually
O if a person with an active herpes sore on the follow a pattern.
hand or finger touches a partner’s vagina, You may feel generally unwell with flu-like
genitals or anal area. symptoms, which might include fever, tiredness,
If you’re pregnant it’s possible to pass the virus to headache, swollen glands, aches and pains in the
the baby if you’re having your first outbreak at the lower back and down the legs or in the groin. This
time of giving birth (see page 13). may be followed by:
If you already have one type of herpes simplex O stinging, tingling or itching in the genital or
virus it’s still possible for you to get the other type anal area
although you may not notice symptoms. O discharge from the vagina
You can’t get genital herpes from hugging,
O discharge from the urethra (tube where urine
sharing baths or towels, from clothing, from
comes out)
swimming pools, toilet seats or from sharing cups,
plates or cutlery. O small, fluid-filled blisters which could be in the
  genital or anal area, on the buttocks, or at the
top of your thighs; these burst within a day or
Can I pass the virus to a partner
two, leaving small, red sores which can be
when I have no signs or symptoms? very painful
In some people, the body can shed the virus from
the affected skin or mucous membranes without O pain when passing urine (peeing) caused by
there being any signs or symptoms of genital urine flowing over the sores.
herpes. This is called asymptomatic shedding.
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What are the signs and symptoms of on to a partner. However, effective HIV treatment
recurrent genital herpes? can suppress HIV in the body. This is known as
Signs and symptoms of recurrent outbreaks are having an undetectable viral load and means HIV
usually milder than with the first outbreak and can’t be passed on to a partner.
clear up more quickly (in about a week).
There’s often an early warning tingling sensation How soon after sex can I have a
before an outbreak. The blisters and sores are check-up?
usually fewer, smaller, less painful and heal more You can have a check-up as soon as you have signs
quickly. They normally appear in the same part of or symptoms. There’s no routine test for genital
the body as in previous outbreaks but in some herpes if you don’t have signs or symptoms.
people they may appear nearby.
What does the check-up involve?
How will I know if I have genital In many cases, a doctor or nurse may diagnose
herpes? genital herpes by looking at the affected skin.
You can only be certain you have genital herpes They’ll want to confirm this by taking a swab of
if you have a check-up when you’ve got signs or fluid from the infected area, if they can. The swab
symptoms. You could have genital herpes even if a will be sent to a laboratory. The result will usually
partner has never had an outbreak. be known within 1–3 weeks. Some clinics may be
It’s possible to have more than one sexually able to give you the result earlier, within 1–2 days.
transmitted infection at the same time. A check-up A swab looks a bit like a cotton bud, but is
for infection is recommended if: smaller and rounded. It’s wiped over the parts of
O you or a partner have a new diagnosis of the body that could be infected and easily picks
genital herpes up samples of fluid. This only takes a few seconds
and may sting for a moment if the blisters and
O you or a partner have, or think you might have,
sores are tender.
symptoms
There’s a specific blood test that can be done to
O you’ve recently had unprotected sex with a look for antibodies to the virus. This isn’t used as
new partner a routine test for genital herpes and may not be
O you or a partner have had unprotected sex reliable.
with other partners Cervical screening tests (smear tests) and
O a sexual partner tells you they have a sexually routine blood tests don’t detect the herpes
transmitted infection simplex virus.
O you have another sexually transmitted infection
O you’re pregnant or planning a pregnancy. How accurate are the tests?
No tests are 100% accurate. It’s easier to diagnose
Having genital herpes may mean you’re more
genital herpes at the beginning of an outbreak
at risk of getting HIV from a sexual partner who’s
when it’s possible to take a sample of fluid from
living with HIV. If you’re living with HIV and have
a blister or sore before it starts to heal. An
genital herpes you may be more likely to pass HIV
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accurate diagnosis will depend on the amount of a day) for five days. There are several different
virus present on the skin at the time, the stage antiviral tablets that can be used.
of the blisters or sores and the type of test used. O Some people find it helpful to take antiviral
The doctor or nurse will talk to you about how treatment when they get another outbreak of
accurate your test result might be. genital herpes. You may be given some tablets
to take at home. These need to be started as
Where can I get a test for genital soon as the outbreak begins and are usually
herpes? taken for 1–3 days.
A genital herpes test can be done at: O People who have repeated outbreaks (usually
O a genitourinary medicine (GUM) or sexual more than five in a year) may be given a long
health clinic course of the tablets to reduce the number of
O some general practices (ask a doctor or outbreaks. This is known as suppressive therapy.
practice nurse) It also reduces asymptomatic shedding (see
page 4) and for most people it stops outbreaks
O some contraception clinics and young people’s
completely, while you’re taking the tablets.
services.
O If you’re pregnant, or trying to get pregnant,
Choose the service you feel most comfortable
tell the doctor or nurse so they can talk to you
with. Testing can only be done when you have
about pregnancy and herpes simplex. If you
symptoms on the skin surface as a swab has to be
have an outbreak of herpes in pregnancy it can
taken from the affected area.
be safely treated (see page 13).
O As genital herpes is caused by a virus and not
Will I have to pay for tests and
bacteria, antibiotics won’t help.
treatment?
O The treatment you can buy for facial cold sores
All tests are free through NHS services. Treatment
isn’t suitable for genital herpes.
is also free unless you go to your general practice
when you may have to pay a prescription charge  
for the treatment. Is there anything I can do to ease
the discomfort?
What’s the treatment for genital There are several things you can do to ease the
herpes? discomfort and speed up the healing process.
The aim of the treatment is to relieve the pain, O Apply a local anaesthetic ointment such as
and to prevent the virus from multiplying. lidocaine. This will help relieve the pain. You can
O Treatment is recommended when you have the buy it from the pharmacy.
first outbreak as this may provide some relief. O Gently bathe the area using cotton wool and a
O Treatment is usually started within five days warm salt water solution (1 teaspoon of salt to
of the start of the first outbreak and while half a litre of water).
new blisters or sores are still forming. You take O Apply petroleum jelly. Be aware that this can
antiviral tablets daily (usually two or three times damage latex (rubber) condoms, diaphragms or
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caps, making them less effective. Can I prevent further outbreaks?

O Apply an ice pack. Put ice cubes in a plastic bag, Outbreaks can be triggered by different things in
wrap them in a clean towel or flannel and hold different people. If you notice a pattern, you might
on the sores for up to an hour or so. Don’t put be able to make changes that will help prevent
ice directly onto the skin. further outbreaks.
O Take a cool shower to soothe the sores. Some people find that these are triggers:
O being ill, run down, tired or stressed
O Avoid washing too often, and dab the affected
area gently to dry it. O different times in the menstrual cycle
O If urinating (peeing) is painful, urinate in a warm O friction from sex or masturbation; using a
bath or shower. lubricant can help
O Wash your hands before touching the blisters O ultraviolet light on the affected skin area (such
or sores. This helps to avoid introducing as from sunbathing or using sunbeds)
bacteria which may cause an infection and delay O tight clothing and nylon or lycra underwear
the healing process. O drinking alcohol or smoking.
O Drink extra fluids, such as water. Outbreaks can eventually stop altogether.
O Wear loose clothing. This can be within 18–24 months for many
O Use a mild pain-relieving drug, if you need to. people, although it may take much longer for
others. Suppressive therapy can prevent further
outbreaks (see page 9).
When will the signs and symptoms  
go away? Do I need a follow-up appointment?
Outbreaks of genital herpes last a different length Not necessarily. If the doctor or nurse would like
of time in each person and will depend on your to test for other sexually transmitted infections,
general state of health and whether this is the first you may be asked to go back when the outbreak
or a recurrent outbreak. The first outbreak may is over. This is a good time to ask the doctor or
last from 2–4 weeks in total. nurse any other questions you may have.
O Flu-like symptoms usually last for about a week. Contact the clinic if you have other questions or
O Individual sores take around 5–10 days to heal. are troubled by recurrent outbreaks in the future.
Once the sores start healing they’re less painful.
O Pain and irritation can last up to two weeks or What happens if genital herpes isn’t
sometimes longer. treated?
The signs and symptoms of a recurrent It’s not essential to have treatment as genital
outbreak of genital herpes usually last for a herpes will clear up by itself. However, prompt
shorter time than the first outbreak. treatment at the start of an outbreak can reduce
the time the outbreak lasts, help the healing
process and reduce the risk of you passing the
virus on to someone else.
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How soon can I have sex again? Does genital herpes affect my
It’s strongly advised that you don’t have any fertility?
sexual intercourse (including vaginal, anal or oral No. Genital herpes doesn’t affect fertility.
sex) if you know an outbreak is coming, while you
have signs and symptoms, and for a week after the
What happens if I have genital
symptoms have gone.
This is to help prevent you passing the virus herpes when I’m pregnant?
on to someone else. Having sex while you have Genital herpes can be safely treated during
blisters or sores can also delay the healing process. pregnancy.
It’s possible for the virus to be passed to the
baby during the birth or, extremely rarely, before
Will I know how long I’ve had the the baby is born.
virus? If you get genital herpes before you get
The genital herpes test can’t tell you how long the pregnant, or during the first six months of your
virus has been there. If you feel upset or angry pregnancy, the risk of passing it on to your baby
about having genital herpes and find it difficult during the birth is very low. You’ll usually be able
to talk to a partner or friends, don’t be afraid to to have a vaginal delivery. However, it’s important
discuss how you feel with the staff at the clinic or to tell your midwife or obstetrician that you have
general practice or with a support group. genital herpes so they can talk to you about your
options and help you to plan the birth. You should
Should I tell my partner(s)? also be seen by a sexual health doctor.
If the test shows you have genital herpes, it isn’t If you get genital herpes for the first time during
usually recommended that a partner has a check- the last three months of your pregnancy, especially
up unless they have signs or symptoms. You’ll within six weeks of your due date, you won’t
be advised to tell your sexual partner(s) but it’s have time to pass on immunity to your baby. This
not compulsory. The staff at the clinic or general can mean the virus may be passed to the baby
practice can discuss with you how to do this. The during vaginal delivery; you’ll be advised to have a
Herpes Viruses Association (herpes.org.uk) has caesarean delivery.
advice on talking to a sexual partner about herpes. With repeat outbreaks of genital herpes during
If a partner is pregnant, you should use pregnancy, the risk of passing the virus to the baby
condoms or dams (latex or soft plastic squares) during the birth is very low. You’ll usually be able
during sex and avoid sex for the last six weeks of to have a vaginal delivery. Treatment with antiviral
the pregnancy. This is to reduce the risk of passing tablets three times daily should be considered
on the virus to your partner and the baby (see from 36 weeks of pregnancy onwards. This can
page 13). reduce the possibility of an outbreak occurring
when you’re due to give birth.
You can get more information on genital herpes
in pregnancy from www.rcog.org.uk.
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Does genital herpes cause cervical Using a service

cancer? O Wherever you go, you shouldn’t be judged
No. Genital herpes doesn’t cause cervical cancer. because of your sexual behaviour or who you
have sex with.
How can I help protect myself from O All advice, information and tests are free.
genital herpes and other sexually O All services are confidential.
transmitted infections? O All tests are optional and should only be done
The blisters and sores are highly infectious. If you with your permission.
or a partner have cold sores or genital herpes: O Ask as many questions as you need to – and
O avoid kissing when you, or a partner, have cold make sure you get answers you understand.
sores around the mouth O The staff will offer you as much support as you
O avoid oral sex when you, or a partner, have need, particularly if you need help on how to
mouth or genital sores tell a partner.
O avoid any genital or anal contact when you, or
a partner, have genital sores or blisters, or if you More information and advice
feel an outbreak starting. The Herpes Viruses Association provides
The following measures will help protect you confidential advice and information about genital
from genital herpes and most other sexually herpes. Call 0845 123 2305 (Monday to Friday,
transmitted infections, such as HIV, chlamydia 11am-8pm) or visit herpes.org.uk
and gonorrhoea. It’s possible to get a sexually The National Sexual Health Helpline provides
transmitted infection (STI) by having sex with confidential advice and information on all aspects
someone who has the infection but has no of sexual health. The number is 0300 123 7123. It’s
symptoms. You can also have an STI yourself open Monday to Friday from 9am-8pm.
without knowing it. These steps will also help For more information on sexual health visit
protect you from getting or passing on an www.fpa.org.uk or www.sexwise.org.uk
infection without knowing it. Information for young people can be found at
O Use condoms (external/male or internal/ www.brook.org.uk
female) every time you have vaginal or anal sex.
O If you have oral sex, use a condom to cover the Clinics
penis, or a dam (latex or soft plastic square) to To find your closest clinic you can:
cover the vulva (external female genitals) or O use Find a Clinic at www.fpa.org.uk/clinics
anus. O use FPA’s Find a Clinic app (iPhone or Android).
O Visit www.sexwise.org.uk for more information Details of general practices and pharmacies
about using condoms. in England are at www.nhs.uk and in Wales at
O Avoid sharing sex toys. If you do share them, www.nhsdirect.wales.nhs.uk. In Scotland, details of
wash them or cover them with a new condom general practices are at www.nhsinform.scot and
before anyone else uses them. in Northern Ireland at www.hscni.net
A final word
This booklet can only give you general information.
The information is based on evidence-based guidance
produced by The British Association for Sexual Health and
HIV (BASHH) and The Royal College of Obstetricians
and Gynaecologist (RCOG) with kind assistance from the
Herpes Viruses Association.

the sexual health charity

www.fpa.org.uk
To order more copies of this booklet go to fpa.org.uk/shop
This booklet is produced by the sexual health charity FPA, registered
charity number 250187. Limited liability company registered in England,
number 887632. FPA does not run the Sexual Health Helpline.
© FPA October 2017
© Crown Copyright Public Health England.
ISBN 978-1-912202-09-6
The information in this booklet was accurate at the time
of going to print. Booklets are reviewed regularly. Next
planned review by October 2020.
If you’d like information on the evidence used to
produce this booklet or would like to give feedback,
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email feedback@fpa.org.uk