Herpes is an infection caused by HSV (herpes simplex virus). This virus affects the external genitalia, anal region, mucosal surfaces, and skin in other parts of the body.

Herpes is a long-term condition. However, many people never have symptoms even though they are carrying the virus.

Symptoms include blisters, ulcers, pain when urinating, cold sores, and vaginal discharge. Although there is no cure for herpes, it can be treated using medications and home remedies.

In this article, we discuss the symptoms of herpes, how to treat it, and how to avoid it.

Fast facts about herpes

-There are two types of herpes simplex viruses: HSV-1 (herpes type 1, or oral herpes) and HSV-2 (herpes type 2, or genital herpes).
-More than 50 percent of people in the United States have HSV-1.
-Around 15.5 percent of people in the U.S. aged 14-49 have HSV-2.
-Receiving oral sex from somebody who has cold sores around their mouth significantly raises the risk of becoming infected.
-It is impossible to get genital herpes from a toilet seat.

Symptoms

Most people do not experience symptoms for months or years after becoming infected. Those who do have symptoms during the initial period will usually notice them about 4 days after exposure (the average range is 2-12 days).

Many people with HSV have recurring herpes. When a person is first infected, the recurrences tend to happen more frequently. Over time, however, the remission periods get longer, and each occurrence tends to become less severe.

Primary infection symptoms

Primary infection is a term used for an outbreak of genital herpes that occurs when a person is first infected. The symptoms can be quite severe and may include:

-blisters and ulceration on external genitalia, in the vagina, or on the cervix
-vaginal discharge
-pain and itching
-tender, enlarged lymph nodes
-pain when urinating
-high temperature (fever)
-malaise (feeling unwell)
-cold sores around the mouth
-red blisters on the skin

In most cases, the ulcers will heal, and the individual will not have any lasting scars.

Recurrent infection symptoms

Symptoms that occur in a recurrent infection tend to be less severe and do not last as long as they do in the primary infection stage. Typically, symptoms will last no more than 10 days and include:

-burning or tingling around genitals before blisters appear
-women may have blisters and ulceration on the cervix
-cold sores around the mouth
-red blisters

Eventually, recurrences happen less often and are much less severe.

Causes

When HSV is present on the surface of the skin of an infected person, it can easily be passed on to someone else through the moist skin that lines the mouth, anus, and genitals. The virus may also spread to another individual through other areas of skin, as well as the eyes.

A human cannot become infected with HSV by touching an object, work surface, washbasin, or towel that has been touched by an infected person. Infection can occur in the following ways:

-having unprotected vaginal or anal sex
-having oral sex with a person who gets cold sores
-sharing sex toys
-having genital contact with an infected person

The virus is most likely to be passed on just before the blister appears, when it is visible, and until the blister is completely healed. HSV can still be transmitted to another person when there are no signs of an outbreak, although it is less likely.

If a mother with genital herpes has sores while giving birth, it is possible that the infection will be passed on to the baby.

Treatment

There are a variety of treatment options. These include:

Home remedies

Several home remedies can help, including:

-taking painkillers, such as acetaminophen or ibuprofen
-bathing in lightly salted water helps relieve symptoms
-soaking in a warm sitz bath
-applying petroleum jelly to the affected area
-avoiding tight clothing around the affected area
-washing hands thoroughly, especially after touching the affected area
-refraining from sexual activity until symptoms have gone
-If urinating is painful, apply some cream or lotion to the urethra

Some people find that using ice packs can help. Never apply ice directly to the skin, always wrap it in a cloth or towel first.

Medication

No drug can get rid of the herpes virus. Doctors may prescribe an antiviral, such as acyclovir, which prevents the virus from multiplying. Antiviral medications will help the outbreak clear up faster and will also help reduce the severity of symptoms.

Doctors usually prescribe antivirals the first time a person has symptoms. As recurrent outbreaks are usually mild, treatment is not usually necessary.

Episodic treatment and suppressive treatment

Episodic treatment is generally for people who have less than six recurrences in 1 year. Doctors may prescribe a 5-day course of antivirals each time symptoms appear.

Doctors prescribe suppressive treatment if a person experiences more than six recurrences in a year. In some cases, a doctor my recommend that the individual takes daily antiviral treatment indefinitely. The aim here is to prevent further recurrences. Although suppressive treatment significantly reduces the risk of passing HSV to a partner, there is still a risk.

Prevention tips

To reduce the risk of developing or passing on genital herpes:

-use condoms when having sex
-do not have sex while symptoms are present (genital, anal, or skin-to-skin)
-do not kiss when there is a cold sore around the mouth
-do not have many sexual partners

Some people find that stress, being tired, illness, friction against the skin, or sunbathing may trigger recurrences of symptoms. Identifying and avoiding these triggers may help reduce the number of recurrences.