Most people around the world have a form of the herpes simplex virus (HSV). HSV does not always cause symptoms, but get tested for genital herpes if you have symptoms such as itching, swelling, or painful blisters.

Genital herpes is a sexually transmitted infection (STI). It causes herpetic sores, which are painful blisters (fluid-filled bumps) that can break open and ooze fluid.

Two types of the herpes simplex virus (HSV) cause genital herpes:

  • HSV-1. This type usually causes cold sores, but it can also cause genital herpes.
  • HSV-2. This type usually causes genital herpes, but it can also cause cold sores.

The World Health Organization stated that in 2016, about 3.7 billion people under age 50 years had contracted HSV-1. In the same year, around 491 million people ages 15 to 49 years had an HSV-2 infection.

The viruses enter the body through skin abrasions or mucous membranes. Mucous membranes are the thin layers of tissue that line the openings of your body. They can be found in your nose, mouth, and genitals.

Once the viruses are inside the body, they incorporate themselves into the cells. Viruses tend to multiply or adapt to their environments very easily, which makes treating them difficult.

HSV-1 or HSV-2 can be found in bodily fluids, including:

The appearance of blisters is known as an outbreak. On average, a first outbreak will appear 4 days after contracting the virus, according to the Centers for Disease Control and Prevention (CDC). However, it can take as little as 2 days, or as much as 12 days or more, to appear.

General symptoms for those with a penis include blisters on the:

General symptoms for those with a vagina include blisters around or near the:

  • vagina
  • anus
  • buttocks

General symptoms for anyone include the following:

  • Blisters may appear in the mouth and on the lips, face, and anywhere else that came into contact with areas of infection.
  • The area that has contracted the condition often starts to itch, or tingle, before blisters actually appear.
  • The blisters may become ulcerated (open sores) and ooze fluid.
  • A crust may appear over the sores within a week of the outbreak.
  • The lymph glands may become swollen. Lymph glands fight infection and inflammation in the body.
  • The viral infection may cause headaches, body aches, and fever.

General symptoms for a baby born with herpes (contracted HSV through a vaginal delivery) may include ulcers on the face, body, and genitals.

Babies who are born with genital herpes can develop very severe complications and experience:

  • blindness
  • brain damage
  • death

It’s very important to tell a doctor if there’s a current genital herpes diagnosis or HSV is contracted while pregnant.

They will take precautions to prevent the virus from being transmitted to an unborn baby during delivery. If there are herpes blisters along the birth canal, the healthcare team may opt to deliver the baby via cesarean rather than a routine vaginal delivery.

Oral herpes and cold sores

Cold sores are a symptom of oral herpes (HSV-1).

Cold sores are blister-like sores that occur near the mouth or lips. They can also occur on other areas of the face. They typically persist for 2 weeks or more. Because there’s no cure for herpes, cold sores can come back.

Genital herpes is quite common.

Although genital herpes is typically caused by HSV-2, the infection can also be caused by HSV-1.

According to the WHO’s latest available statistics, it was estimated that 491.5 million people had an HSV-2 infection in 2016. This is over one-tenth of the world’s population ages 15 to 49 years.

The WHO also estimates that 3.7 billion people had an HSV-1 infection in the same year, which accounts for around two-thirds of the world’s population under age 50 years.

If there are no symptoms of genital herpes, the CDC does not recommend getting tested for herpes.

However, if there are symptoms of genital herpes, it’s important to see a doctor. They can make a diagnosis and discuss management strategies for the infection.

Additionally, if there’s a potential of having been exposed to HSV, or if there’s a desire to get a full STI exam and testing, it’s recommended to schedule an appointment with a doctor.

If an in-person appointment is not possible, an at-home test kit is another option to consider. However, it’s important to note that an in-person test done by a doctor may be more accurate.

A doctor can typically diagnose a herpes transmission by a visual examination of the herpes sores. Although testing is not always necessary, a doctor may confirm their diagnosis through laboratory tests.

A blood test can diagnose HSV before an outbreak occurs. However, if there has not been exposure to the virus and there are no symptoms being displayed, it’s not always necessary to be screened for HSV-1 or HSV-2 .

Treatment can reduce outbreaks, but it cannot cure herpes simplex viruses.

Medications

Antiviral drugs may help speed up the healing time for sores and reduce pain. Medications may be taken at the first signs of an outbreak (tingling, itching, and other symptoms) to help reduce the symptoms.

If there have been outbreaks, a doctor may also prescribe medications to make it less likely that future outbreaks will occur.

Home care

Use mild cleansers when bathing or showering in warm water. Keep the affected site clean and dry. Wear loose cotton clothing to keep the area comfortable.

HSV is transmitted through sexual contact, which can include:

  • vaginal sex
  • anal sex
  • any other activities that involve contact between genitals

It’s possible to contract an HSV infection through oral sex. Oral herpes can spread to the genital and anal areas, and vice versa.

Although HSV is typically transmitted through skin-to-skin contact, the virus can also be found in semen, saliva, and vaginal secretions.

The risk of contracting HSV increases in certain situations, including:

If a person is sexually active, they can lower their risk of contracting HSV by:

  • Using barrier methods, like condoms, every time they have sex.
  • Refraining from sex with someone who is displaying herpes symptoms. However, it’s important to know that HSV can be passed to another person even when symptoms are not present.
  • Talking with sexual partners about their STI status.

If a person tests positive for genital herpes, it’s recommended that they speak with a doctor. Although there’s no cure for herpes, it can be treated through antiviral medication. Antiviral medication can help reduce the severity of recurring outbreaks (both cold sores and genital warts).

Frequent, severe recurring outbreaks might be a sign of a compromised immune system. If outbreaks are occurring often, a doctor might investigate whether there’s an underlying issue affecting the immune system.

Having sex is OK if there’s a genital herpes diagnosis, but it’s best to avoid sex if there’s a herpes outbreak. To reduce the chances of transmitting HSV to a partner, use barrier methods such as condoms and dental dams during all sexual activity.

Genital herpes does not always require treatment. However, genital warts can be painful. Antiviral treatments can reduce the symptoms and severity of outbreaks.

In rare cases, herpes can cause complications. Generally, though, it does not get worse over time.

It’s normal to be concerned about the health of your baby when you have any type of STI. HSV can be transmitted to your baby if you have an active outbreak during a vaginal delivery.

It’s important to tell your doctor that you have genital herpes as soon as you know you’re pregnant.

Your doctor will discuss what to expect before, during, and after you deliver your baby. They can prescribe pregnancy-safe treatments to ensure a healthy delivery. They may also opt to deliver your baby via cesarean.

Practicing safer sex and using condoms or another barrier method every time you have sexual contact with someone is important. It will help prevent contracting and transmitting HSV and other STIs.

There’s currently no cure for genital herpes, but researchers are working on developing a cure or vaccine.

However, the condition can be managed with medication.

The disease stays dormant within the body until something triggers an outbreak. Outbreaks can happen due to being stressed, sick, or tired.

A doctor can help create a treatment plan to manage outbreaks.

Here are answers to some common questions if symptoms of genital herpes are present or there’s a positive test result for the viral infection.

What does a herpes sore look like?

Herpes sores initially look like small pus-filled bumps, similar to pimples or blisters. These sores can break open and ooze liquid, which forms a crust. It can look like one sore on its own, or there might be a cluster of sores.

Herpes sores can occur on the skin around the mouth (cold sores) or around the genitals or anus.

What are the first signs of genital herpes in a woman?

One of the first signs of genital herpes in women is itching or tingling skin, which gives way to herpes sores. This can occur near the vagina or anus.

Women might also experience flu-like symptoms, including fever and fatigue. Headaches, body aches, and lymph node swelling can also occur because of an HSV infection.

Remember, though, that it’s possible to have an HSV-2 infection without showing any symptoms.

How does genital herpes first appear?

Genital herpes sores first appear a few days after exposure. According to the CDC, the first outbreak usually appears 4 days after contracting the virus (although it can take as little as 2 days, or as much as 12 days or more).

The sores will first look like small, fluid-filled bumps or blisters. After a few days, the fluid oozes out of the bumps. The sores crust over before healing.

Is genital herpes contagious for life?

A person is more likely to transmit HSV when they’re having an outbreak — that is, when the herpes sores first appear until they’re fully healed. However, even in dormant periods (between outbreaks), it is possible to transmit HSV to a partner.

To reduce the chances of transmitting HSV during sexual contact, use a barrier method like condoms and dental dams during all sexual activity.