Genital herpes is an infection of one of two herpes simplex viruses (HSV) in the genital area—around two-thirds of the population under 50 years old worldwide has this one of these lifelong infections.
There is no cure for genital herpes.
Both strains of HSV can cause painful sores and blisters once contracted, though some people never show symptoms at all.
Once contracted, this sexually transmitted infection (STI) lies dormant in the body and can be reactivated sporadically, usually due to certain lifestyle and health issues.
One of the fundamental issues that makes it difficult to control the spread of herpes is that many people can be infected and show no symptoms.
Although there is no cure, it is rarely a dangerous or life-threatening condition.
Antiviral medications have proven effective in treating symptoms from outbreaks.
While there have been attempts at a herpes vaccine, to date none have proven effective.
In this article, I’ll talk more about what genital herpes is, how it spreads, and its symptoms.
I’ll explain how it’s diagnosed, and how it can be prevented. I’ll also talk about the current treatment options, and when you should see a doctor.
What is Genital Herpes?
Herpes is a very common virus, grouped in with STIs and STDs such as chlamydia and gonorrhea.
It is highly contagious and spread through close, direct, and intimate contact, predominantly through sexual activity.
Genital herpes can cause red, painful sores, blisters, and lesions around the genitals and rectum.
Many infected individuals do not develop symptoms, but are still contagious, which makes it particularly easy to transfer from one person to the next.
Unfortunately, once you contract any strain of herpes, the infection is lifelong and lies dormant in the body.
Initially, you will go through an acute phase, which is the most common time to develop symptoms.
Flare-ups can occur at any time, usually brought on by a weakened immune system, surgery, pregnancy, high sun exposure, or periods of physical or emotional stress.
What are the types of herpes viruses?
There are two types of herpes simplex viruses: herpes simplex virus-1 (HSV-1), and herpes simplex virus-2 (HSV-2).
HSV-1 is the strain that is primarily responsible for oral herpes, and can be contracted through kissing and sharing utensils, lipsticks, toothbrushes and other objects with an infected person.
It is the more common of the two herpes virus types, with many people being exposed to it in childhood through non-sexual contact with saliva and growing up unaware that they have it.
It can infect the mouth area, causing cold sores, but genital infections of HSV-1 are increasing, according to the Centers for Disease Control and Prevention.
HSV-2 is the strain that affects the genitals and rectum and is usually spread through vaginal sex, oral sex, or anal sex with an infected person through the exchange of genital fluids or direct contact with a herpes sore, the skin, or saliva of an infected person.
How common is genital herpes?
According to data collected in 2018 from the Centers for Disease Control and Prevention (CDC), there were 572,000 new HSV-2 infections in the United States among people below the age of 50.
The World Health Organization (WHO) reports that there are an estimated 491 million people ages 15-49 worldwide who have an HSV-2 infection.
Sexual transmission is likely to occur in people with vaginas more than people with penises, and prevalence increases with age, as the virus is lifelong and incurable.
How does genital herpes spread?
Genital herpes spreads through direct and intimate physical contact with an infected person.
It can be transferred during sexual intercourse or other sexual activity.
Generally speaking, people with vaginas are at a greater risk of contracting genital herpes, as the virus can enter the body more easily.
Both strains of HSV can be transmitted in a few different ways:
- A person who receives oral sex from a person infected with HSV-1 can develop HSV-1 on their genitals.
- A person who performs oral sex on someone who has HSV-2 can contract HSV-2 on their face.
- A person who has unprotected vaginal sex with a person who has HSV-2 can develop HSV-2 on their genitals.
- A person who gives or receives anal sex from a person infected with HSV-2 can develop anal herpes.
- In rare cases, a mother can pass genital herpes onto their child during childbirth.
You cannot get genital herpes by coming into contact with surfaces such as toilet seats, bedding, towels or swimming pools.
It is unlikely you can get genital herpes from sex toys but there is a risk if you use the toy immediately after it has been used by an infected person.
The first signs of genital herpes usually appear 2-12 days after having sexual contact with an infected person, and generally last 2-4 weeks.
Many people may be asymptomatic, meaning they do not show symptoms.
But this is not the case for everyone.
The initial outbreak is often more severe than subsequent outbreaks, and your symptoms may include:
- Painful sores or tiny white blisters on and around the genitals
- Ulcers that can be caused by ruptured blisters
- Scabs that form from ruptured blisters
- Pain during urination due to ruptured ulcers
The following symptoms may accompany the initial outbreak:
- Feeling of pressure in the abdomen
- Flu-like symptoms
- Itching or burning feeling in the genital or anal area
- Pain in the legs or buttocks
- Swollen glands
- Unusual vaginal discharge
How is Genital Herpes Diagnosed?
Genital herpes can sometimes be mistaken for syphilis, ingrown hairs, insect bites, or something else.
Visit your healthcare provider to confirm a diagnosis.
They can do a physical examination and take a swab from a blister to test if it is positive for HSV.
People with genital HSV infection who are currently experiencing symptoms should abstain from sexual activity to reduce the chance of transmission to others.
You can lessen the risk of contracting HSV-2 by:
- Always using barrier contraception during sexual activity (vaginal, anal, or oral sex) such as condoms or dental dams
- Getting regular sexual health screenings for STIs, especially when you have a new sexual partner
- Ensuring your sexual partners also undergo routine sexual health screenings
- Being in a monogamous relationship
- Abstaining from sex
Current Treatment Options
Antiviral medications, such as acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex), are the most effective treatment options for managing the severity and frequency of the symptoms of HSV-2.
These medications can also shorten the duration of the infection, which makes it less likely to pass the virus on to others.
In severe cases of genital herpes, your doctor may suggest intravenous antiviral therapy.
This involves injecting the antiviral medication directly into your bloodstream using a needle inserted into a vein.
Is there a herpes cure?
Unfortunately, there is no cure for any strain of the herpes simplex virus.
It is common for the infection to be reactivated at various periods in a person’s life brought on by stress, a weakened immune system, surgery, high sun exposure, pregnancy, menstruation, and other conditions.
Antiviral medications have proven effective in managing symptoms from outbreaks.
Why creating a cure is difficult
The herpes virus is complicated and can go undetected by the body’s immune system for years, making it problematic to find an effective cure.
While three companies in 2017 were working on a herpes vaccine, they have since abandoned their research after receiving the results from their clinical trials.
There have been attempts to develop a prophylactic or therapeutic vaccine to prevent the complications of HSV reactivation, but none to date are available and effective.
Adding to the difficulty of developing a herpes vaccine is the projected cost involved to implement it.
According to the National Center for Biotechnology Information (NCBI), if a vaccine program for HSV were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the program could cost more than $680 million.
When to See a Medical Provider
You should visit your doctor immediately if you notice any signs or symptoms of genital herpes.
Your doctor will do a physical examination.
They may wish to do additional testing to determine if you have any other STDs.
If you test positive for HSV-2, you are at a greater risk of contracting HIV.
This is because the open sores or breaks in the skin or lining of the mouth, vagina, and rectum that are symptoms of herpes can make it easier for HIV to enter the body.
Herpes also increases the number of immune cells in the lining of the genitals, which HIV targets to enter the bloodstream.
To protect yourself and your partners from STDs, undergo regular sexual health checkups from your healthcare provider or an STD clinic.
This will reduce the chances of exposing yourself or others to potentially harmful STDs, and make treatment methods more effective if caught early.
How K Health Can Help
Did you know you can get affordable primary care with the K Health app? Clinicians are able to treat herpes with medication, but patients must be diagnosed already. If you’re worried that you might have genital herpes, your clinician can refer you to a physician for an in-person visit.
Download K Health to check your symptoms, explore conditions and treatments, and, if needed, text with a clinician in minutes. K Health’s AI-powered app is based on 20 years of clinical data.
Frequently Asked Questions
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Herpes simplex virus: global infection prevalence and incidence estimates. (2016).
Developments in Vaccination for Herpes Simplex Virus. (2021).
Genital Herpes - CDC Fact Sheet. (2022).
Genital Herpes Treatment and Care. (2021).
Herpes Simplex Virus. (2000).
Herpes Simplex Virus. (2022).