Sexually Transmitted Disease Specialists
Genital herpes is caused by the herpes simplex virus, type 1 or type 2. Both types can infect the mouth (producing cold sores) or the genital area (genital herpes).
When a person is infected with the herpes virus, it may pass unnoticed into their body and they may be unaware that they contracted the infection. This is called "subclinical infection." In fact, many people with genital herpes are not aware that they carry the infection and can pass on the virus to others even when there is no visible evidence of blisters or sores.
When symptoms occur, they appear from time to time in episodes called outbreaks. After contracting the herpes virus, a person may experience an episode within a few days, but it may take much longer, sometimes years, before symptoms are noticed. Often, the person never develops recognizable herpes symptoms.
Most genital herpes outbreaks cause symptoms similar to the cold sores that many people experience on or around their lips or nostrils. With genital herpes, the "cold sores" usually appear on or near the genitals or anus. Sometimes they appear on the buttocks or thighs.
Outbreaks may produce small fluid-filled blisters which break open to form shallow, painful sores. These develop a scab after 1-2 weeks and then heal. Sometimes the first outbreak causes considerable pain and distress, fever or chills; future episodes are usually less severe.
Although herpes sores heal, the virus remains in the body and may produce more sores later. There are called recurrent outbreaks. Recurrent outbreaks usually occur on or near the same part of the body as the first attack, but are often shorter in duration and not as painful. The may be triggered by general illness, stress, menstruation or sexual activity. Often, no trigger is identified. In most cases, recurrent outbreaks become less frequent with time and may eventually stop altogether. Recurrent outbreaks are caused by reactivation of the dormant herpes virus already present in the body - not by being re-infected.
The virus is spread by skin-to-skin contact. Cold sores on the mouth are a potential source of genital infection during mouth-to-genital contact (oral sex). Because recurrent herpes may cause few symptoms or pass unnoticed, it is possible to pass on the virus even when there are no visible blisters or sores.
In pregnant women, herpes infection may be transmitted to the baby at delivery, causing serious illness. The obstetrician should be told of past genital herpes infections so the risk of this complication can be minimized.
Herpes is diagnosed by taking a sample from an infected area during an outbreak. The herpes virus will usually grow from a swab taken from a ruptured blister. The test can identify the strain (type 1 or type 2) of the herpes virus. Type 1 genital herpes tends to cause fewer recurrences than type 2. Blood tests also assist in herpes diagnosis, especially if no blisters are present to swab.
Genital herpes is caused by a virus, so it cannot be cured. Herpes can be treated, however. Anti-viral medications prescribed by the doctor may reduce the severity and duration of the outbreak. If outbreaks are frequent, anti-viral medications may be taken continuously to try to decrease the number of outbreaks. Anti-viral medications do not eliminate the herpes virus from the body.