Herpes
Health Services > Sexually Transmitted Infections > Herpes

• Type I usually affects the face or lips, and is known as a "cold sore" or a "fever blister".
• Type II is called "genital herpes," because it usually affects the genitals.

The first sign of herpes usually appears within 2-21 days after contact with the virus. It is possible to have very mild symptoms with an outbreak. Common symptoms of herpes infection are:

• A tingly sensation, itchiness, pain, swelling, and redness where the virus entered the body.
• Painful swollen glands in the groin.
• Vague pain or discomfort in the abdomen, lower back or upper thighs sometimes occurs just before blisters appear. During the first outbreak a mild fever and muscle aches are common.
• Tiny bumps or blisters filled with clear liquid which break in 2-5 days and leave tender open sores. Several days later the sores begin to dry up and scab, and eventually heal.
• Herpes blisters or sores can occur on the face, lips, vaginal area, rectal area, penis, scrotal area or thighs. In women, sores can occur deep in the vagina on the cervix. Outbreaks on the cervix are often accompanied by a heavy watery vaginal discharge.

In most cases, people get herpes through direct physical contact with a sore on another person who is having a herpes outbreak. A herpes outbreak is very contagious from the first tingly or itchy sensation until the dry scab falls off. It is possible (though not common) to spread the herpes virus when no symptoms are present. The risk of passing the infection to a sexual partner when no symptoms are present is thought to be about 1-2%.

The herpes virus stays in the body after the blisters heal. Later, the virus can cause a new outbreak of blisters in the same place. About half of the people with herpes never have another outbreak. Others may have outbreaks every few months or years, or as often as every month. Physical stress or emotional stress can trigger repeat outbreaks.

Women with herpes should have a Pap smear at least once a year. Herpes Simplex can sometimes cause a mildly abnormal pap smear. The herpes virus does not cause cervical cancer.

SAFER SEX IF YOU OR YOUR PARTNER HAS HERPES

When Symptoms Are Present

• Remember that the virus is most contagious from the first sign of an outbreak until the blisters are completely healed.
• Except for washing or applying medication, avoid all contact with blisters. Wash your hands with plenty of soap and warm water after touching the affected area. Intercourse should be avoided during an outbreak.
• While sleeping, wear loose underwear or pajamas to cover blisters.
• With rare exceptions, herpes is not spread by contact with towels, underwear, and similar items. But to be safe, it is best not to share these during an outbreak.
• When sores or breaks in the skin are present, HIV infection is more easily transmitted if there is sexual contact with an HIV-infected partner.

When Symptoms Are Not Present

• Let sexual partner(s) know that you have herpes.
• Provide your partner with written information about herpes.
• Use condoms when you have sex.
• You might want to consider taking daily antiviral medication. Studies have shown that people with herpes who take an antiviral drug once a day can reduce the risk of transmitting the virus to their sexual partners by nearly 50%. (Read more.)

PREGNANCY AND HERPES

Men who have herpes should use a condom if they have intercourse with a pregnant woman to protect her from the virus. If a woman has an outbreak of herpes in the birth canal or vaginal opening at the time of delivery, she must deliver the baby by Caesarean section. This protects the baby from the virus, which can cause serious health problems in newborns. If you (or your partner) have herpes and one of you is pregnant, be sure to tell your health care provider.

TAKING CARE OF SYMPTOMS

The most effective treatment for herpes is a medication called Zovirax. Zovirax speeds healing, and is safe and effective at reducing pain, irritation and itching. Zovirax capsules are available by prescription and should be taken by all persons having a first outbreak. Zovirax is also taken to reduce symptoms if subsequent outbreaks occur. An ointment is also available, but is much less effective than the capsules. For people who have frequent outbreaks, Zovirax capsules may be taken daily to prevent symptoms. Your Clinician can give you advice regarding a treatment plan that will work best for you.

During a herpes outbreak, some discomfort and inconvenience can be prevented. Keep irritated skin cool, clean and dry and wear cotton underwear. Aspirin, sitz baths or ice packs may help relieve pain or itching. Many people find that soaking in a bath with Epson salts is soothing when sores are present.

If you have herpes, you may be able to help your body resist outbreaks by reducing your physical and emotional stress. Eat a healthy diet with plenty of fruits and vegetables, get adequate sleep and exercise, avoid smoking and heavy drinking, and find ways to reduce the emotional stress in your life.