Genital Herpes
Genital herpes is a sexually transmitted disease. Genital herpes is most often caused by the herpes simplex virus type 2, also known as HSV-2. This virus infects the genital area and is transmitted through sexual contact with a person who is already infected with HSV-2. Many people with HSV-2 are not aware that they are infected, and the infected partner does not have to actively be experiencing a herpes outbreak to transmit the virus.
Genital herpes can also be caused by the herpes simplex virus type 1, commonly known as HSV-1, which is the virus that causes cold sores on and in the mouth. Genital herpes caused by HSV-1 is generally the result of mouth-to-genital contact. Genital HSV-2 outbreaks do not occur as frequently as genital HSV-1 outbreaks.
Outbreaks of genital herpes are indicated by one or more blisters or sores around or on the infected person’s genitals or rectum. Herpes is spread by skin-to-skin contact, and contact with a partner’s herpes sores greatly increases the chance of transmission. Even if an infected person has no signs of an outbreak, the herpes virus can also sometimes be transmitted at the sight of infection through a process known as viral shedding. Rates of herpes infection are on the rise in the UK, and rates among women have been increasing in recent years.
There is no cure for herpes, but reducing the chance of transmitting or being infected with genital herpes is fairly simple. The virus cannot survive for long outside of the body, so transmission from casual contact is very unlikely. People that have genital herpes should avoid sexual contact with their partners while having an outbreak, and those who do not have the virus can greatly reduce their chances of infection by limiting their numbers of sex partners. Latex condoms reduce the likelihood of transmitting the herpes virus but do not completely eliminate it.
Herpes Symptoms
Most people are completely unaware of what’s happened when they’ve been infected with genital herpes, and many remain unaware for years. If signs of infection do occur, they can be very obvious. The first outbreak will generally appear within fourteen days of infection, and the sores from this outbreak usually heal within a month. The first outbreak may also be accompanied by flu-like symptoms such as swollen glands, sore joints, and fever. Most people infected with the herpes virus experience none of these symptoms, including sores. Those that do have an outbreak of herpes sores often mistake them for a rash or insect bites.
Identifying herpes sores can be tricky. Many people experience a tingling or tender sensation on the area of the skin where the sores will appear. In time, this sensation can become useful for predicting when an outbreak is going to occur and thus reducing the chances of infecting sexual partners.
When sores do appear, they often look similar to the cold sores that occur around the mouth with HSV-1. They may look like a cluster of pimples or a group of watery, small blisters. Eventually, the sores will rupture and scab over without leaving a scar within a few weeks. A second outbreak, generally less severe, often occurs around the time the larger, first outbreak is starting to heal.
People diagnosed with their first outbreak of HSV-2 usually have between four and five more episodes in the first year. Outbreaks can be triggered by stress, and usually decrease in frequency over time. Herpes can be dangerous for people with suppressed immune symptoms, such as those with HIV or those undergoing chemotherapy. Herpes is thought to play a role in the spread of HIV, and open herpes sores can make people more susceptible to contracting HIV. Individuals with HIV who also have herpes can more easily spread HIV, especially to those with rashes or open sores.
Herpes is also extremely dangerous for infants, so expecting mothers should take special care not to contract herpes during pregnancy. Women who are infected with genital herpes are usually advised to deliver by caesarean to avoid transmitting the virus to the baby during delivery.
Herpes Treatment
At present time, herpes does not have a cure. Some drugs have, however, been effective in minimizing the frequency of outbreaks and shortening the durations of those outbreaks when they do occur. Herpes medications can provide relief from the painful and emotionally-distressing side effects of the herpes virus. These drugs are similarly effective, and mostly vary in cost and number of pills to be taken daily. Treatments generally consist of long-term, suppressive treatments or single treatments for severe outbreaks. The main drugs prescribed in the UK for genital herpes include Aciclovir, Famciclovir, and Valaciclovir.
Comparison Table of Herpes Medications
| Medication | Aciclovir | Famciclovir | Valaciclovir |
| How to take it |
Acute attacks: 400mg tabs three times daily for 5 days as soon as symptoms such as pain, blisters or itch start to develop |
Acute attacks: 250mg tabs three times daily for 5 days as soon as symptoms such as pain, blisters or itch start to develop |
Acute attacks: 500mg tabs twice daily for 5 days as soon as symptoms such as pain, blisters or itch start to develop |
|
Suppressive treatment: 400mg tabs twice daily long term |
Suppressive treatment: 250mg tabs twice daily long term |
Suppressive treatment: 500mg tabs once daily long term |
How quickly will an acute attack take to go?
Generally, acute recurrent attacks will take the full duration of the course to improve. Some people will improve very quickly indeed whereas others will take longer and may require a longer course of treatment. If you are unlucky enough to have frequent recurrent attacks, you may wish to purchase a few courses of treatment so you can start treatment immediately when a new attack appears.
What else can I do during an attack to help myself?
Using an anaesthetic ointment such as 5% lidocaine available on prescription here may help with the surface pain. Warm salt baths will keep the area clean and can be soothing. Taking simple painkillers such as ibuprofen or Paracetamol can be helpful. In severe cases, you can take up to 8 tablets of 500mg Paracetamol in a 24 hour period together with 400mg ibuprofen three times daily.
Help with Herpes
Patients who have the herpes virus are also advised to keep their immune systems as healthy and strong as possible. When patients have good overall health, they often experience milder and less frequent symptoms from viral infections. Maintaining a healthy diet, exercising, and getting a proper amount of sleep are all important factors in minimizing the symptoms of genital herpes.
Both HSV-1 and HSV-2 can be aggravated by stress. Outbreaks often occur after or during periods of stress, and patients who learn how to deal with stress effectively can lessen the frequency of their outbreaks. Although many people are infected with HSV-2, genital herpes has a social stigma that can cause stress in personal relationships.
Accepting that one has been infected with genital herpes can take time, and some patients find counselling helpful. The social stress associated with HSV-2 often lessens over time, and this reduced stress can also result in fewer outbreaks. People who are infected with HSV-2 are encouraged to seek a combination of healthy lifestyle, medication, and stress-relieving activities such as yoga or meditation to keep their symptoms to a minimum and enjoy their lives to the fullest. Consulting a doctor is the first step in treating genital herpes, so start your consultation today to begin getting the best treatment possible.
