First the Facts

  • Genital herpes is a common sexually transmitted infection (STI)
  • Herpes can also affect the face and cause ‘cold sores’
  • Herpes is caused by ‘herpes simplex virus’ (HSV) and there are two types – HSV-1 and HSV-2 (either can affect the face or genitals)
  • Most people with genital herpes do not know that they have it as they do not have any symptoms
  • Rarely, genital herpes causes serious complications
  • Although the symptoms of genital herpes will subside, the virus stays in the body permanently and can cause the symptoms to return

How Is Herpes Transmitted?

  • Herpes is transmitted by skin-to-skin contact. This can be through having unprotected vaginal, oral, or anal sex with someone with herpes, or it can be transmitted from mouth to mouth through kissing or sharing cutlery
  • Genital herpes can also be transmitted when someone with oral herpes (‘cold sores’) has contact with their partner’s genitals
  • Occasionally, herpetic lesions on the fingers can form a ‘herpetic whitlow’ and herpes can be transmitted if there is contact with a whitlow
  • If active lesions are present, the chance of passing on herpes is increased; however, it is still possible to pass on the virus without ulcers (or ‘cold sores’) being present on the skin
  • Anyone can have genital herpes – you do not need to have had a lot of partners
  • You cannot get herpes from hugging, toilet seats, or sharing towels
  • Condoms may reduce the risk of catching genital herpes, but transmission is still possible
  • Herpes can also be passed from mother to baby during childbirth. There is a higher chance of this if you are within 6 weeks of childbirth. The mother’s immune system will make ‘antibodies’ to help fight the virus, and these can cross the placenta to the baby, but this can take several weeks.

What Are the Signs of Genital Herpes?

  • Over 75% of people with herpes will not know that they have it as they have no symptoms
  • People who do develop symptoms of genital herpes may notice the following:
    • Flu-like illness
    • Painful blisters and ulcers in the genital area
    • Swollen glands in the groin area
    • Pain and burning when passing urine

How Can I Protect Myself?

  • The use of condoms for vaginal and anal sex as well as condoms or dental dams for oral sex can help to prevent transmission
  • However, it is still possible to catch herpes when taking these precautions

Where and When Can I Get a Test?

In the UK, herpes is not routinely tested for if there are no symptoms because people without symptoms do not need treatment.

You should get a test if:

  • You have any of the symptoms listed above
  • A partner has told you they have genital herpes, and you have symptoms

You can get a test at:

  • A sexual health or genitourinary medicine clinic
  • Some young person’s / contraception clinics
  • Some GP surgeries

Getting tested involves:

  • A healthcare professional taking a swab from any ulcerated areas
  • In some clinics, it may be possible to take your own swabs
  • A blood test for herpes is occasionally carried out to test for antibodies which will indicate a previous infection

What Happens If I Have Herpes?

  • If you have had genital ulcers for less than 6 days, suggestive of genital herpes, you are likely to be offered treatment with an antiviral medication called aciclovir.
  • Aciclovir helps to clear the infection
  • You will be advised to keep the affected area clean by bathing it daily with salty water
  • If it is painful to pee/pass urine, it can help to pass urine in a warm bath or shower
  • You may also be given a local anaesthetic ‘numbing’ gel (lidocaine) to reduce pain associated with the ulcers, and this can be particularly helpful when it is painful to pass urine
  • You will be offered testing for other STIs
  • You should tell your sexual partner(s) about your genital herpes as this has been shown to reduce the risk of transmission. It also means that sexual partners can get tested and receive treatment if they need it.

When Is It Safe to Have Sex Again?

  • Avoid having sex with a new partner until any blisters/ulcers have completely healed because the risk of passing on the infection is highest when you have an active infection
  • However, it is still possible to pass on herpes when it is inactive, and therefore condoms use is advisable
  • If you and your regular partner(s) have the same virus, then there is no risk of transmission

Will I Get Genital Herpes Again?

  • Herpes virus can hide in the body to avoid being killed by your immune system
  • Even after your symptoms have subsided, the virus stays dormant in the nervous system
  • This means that in some people the virus can be reactivated and cause symptoms again (recurrence)
  • With recurrent infections, the symptoms are usually less severe than with the first episode. Therefore, many people do not require treatment with anti-viral agents
  • You can seek treatment for repeated episodes of herpes if you wish. This is called suppression therapy and can either prevent infection or speed up how quickly you recover from recurrences
  • Preventive treatment involves taking the same medication as mentioned before (aciclovir) every day without stopping for 6–12 months or longer, depending on the individual circumstances

What If I Don’t Get Treated for Herpes?

  • Without treatment, the body’s immune system will eventually cause the symptoms to resolve, but it may take longer
  • Very rarely, herpes can cause a serious brain infection called herpes encephalitis. This is usually in people whose immune system is not fully functioning, including the very young and the elderly
  • Genital herpes in pregnancy can sometimes be harmful to the baby, so it is important that you go to a clinic if you are pregnant

What If I Am Pregnant?

  • It is important to treat genital herpes if you are pregnant because the infection can be passed on to the baby during childbirth
  • The virus does not cause harm to the baby whilst you are pregnant
  • Depending on when you get genital herpes during pregnancy (and whether it is your first episode or not), you may need to have a caesarean section rather than a vaginal delivery
  • The medication used for genital herpes (aciclovir) is safe to use in pregnancy


Written by: Dr Nikki Kersey and Dr Paula Briggs
Last updated: January 2021

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