Genital herpes is a viral infection that can cause blisters and open sores on the genitals caused by herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Genital herpes is common in the U.S. It is estimated that more than one of every six people aged 14 to 49 years have genital herpes.
Oral herpes (also called cold sores or fever blisters) are painful blisters that form on or near the lips and inside the mouth that are usually caused by HSV-1. Cold sores are not canker sores. Canker sores are also painful red or white sores that can form in the mouth and on the tongue, but they do not typically blister or scab over.
You get genital herpes — herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) — when it is transmitted from person to person during vaginal, oral, or anal sex.
- You get oral herpes, HSV-1, when it is passed from person to person from kissing, sharing eating utensils, or another type of close contact. People who give oral sex to people with genital herpes can get cold sores on their mouth.
- You can get herpes more easily from a person who has blisters and open sores, though it is also possible to spread the virus when no symptoms are present.
What Are Symptoms of Herpes?
Some people with herpes may never have any symptoms, or may only have mild symptoms. Other people may develop symptoms within a few weeks of being infected with the herpes virus.
Symptoms of genital herpes include:
- Blisters in the genital area
- In women, this area includes the vagina, anus, buttocks, or thighs
- In men, this area includes the penis, scrotum, anus, buttocks, or thighs
- Blisters may become painful open sores, which crust over as they heal
- Blisters on the mouth or lips
- Itching, tingling, or burning feeling in the genital or anal area
- Pain in the joints
- Change in vaginal discharge
- Flu-like symptoms
- Joint pain
- Painful urination
- Difficulty urinating
- Swollen glands
- A feeling of pressure in the area below the stomach
What Are Herpes Outbreaks?
The first time symptoms occur is usually the worst, and symptoms may last up to 2 to 3 weeks. After that, people may have outbreaks and blisters and open sores in the genital area may recur, but are usually not as severe as the first occurrence and do not last as long.
Outbreaks may happen every month or more often, or just once or twice a year. Some people may feel itching or pain beforehand when an outbreak is about to happen. Herpes outbreaks usually become less frequent over time as people age.
Symptoms of oral herpes (cold sores) may include:
- Painful blisters on the lips, mouth, nose, or throat,
- Blisters eventually open and form scabs
- Mouth and throat pain
- General ill feeling (malaise)
- Neck swelling
- Body aches
The first attack of cold sores usually happens during childhood and lasts about 12 days. After the first time, pain and blisters can return but the other symptoms do not usually recur, symptoms are milder, and they can last 8 days or less. Some people may feel pain, tingling, burning, or itching on the lips about a day before blisters form.
How Is Herpes Diagnosed?
Both genital and oral herpes are diagnosed with a physical exam and herpes can sometimes be diagnosed just by looking at the sores.
If you have blisters or sores a doctor can order tests to look for herpes:
- A sample of cells or fluid from a sore
- A blood sample to check for herpes antibodies
- A herpes blood test cannot determine who gave you the infection or how long you have been infected
Is There a Cure for Herpes?
There is no cure for herpes, but the virus usually causes the most symptoms during the first few years. After that, it causes mild to no symptoms.
Antiviral medicines may be prescribed to help reduce symptoms of genital herpes and speed up the healing of an outbreak, such as:
Home remedies to help reduce the pain of genital herpes during an outbreak include:
- Use a portable bath (“Sitz bath”) or the bathtub to sit in warm water for about 20 minutes
- Keep the genital area clean and dry
- Avoid tight clothing
- Over-the-counter (OTC) pain medicines such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may help with pain
For oral herpes (cold sores), most people will need treatment the first time they occur. People who have had cold sores before or people who have mild symptoms may not need treatment.
When needed, treatment for cold sores may include:
- Antiviral medications
- Valacyclovir (Valtrex)
- Acyclovir (Zovirax)
- Famciclovir (Famvir)
- Antiviral topical ointments
- Acyclovir (Zovirax ointment or cream)
- Penciclovir (Denavir topical)
- Pain-relieving pills and gels that go on the mouth, often available over-the-counter (OTC)
- Sucking on ice or popsicles
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