There are two types of herpes, HSV 1 and HSV 2. They can enter the body through the delicate, moist skin of the mouth, penis, vagina and rectum.
Both types can cause:
- cold sores on the mouth
- genital herpes
- painful infections (called 'whitlows') on the fingers and hands.
You can catch genital herpes through vaginal, anal or oral sex.
Herpes is a long-term condition
Herpes remains in the body for life, lying dormant in nerves between outbreaks.
Every now and again it's reactivated causing an outbreak. These tend to be milder than the initial outbreak. Some people may take medication to control them.
Blisters are the main symptom of herpes. After getting infected you may never get blisters, get them once, or they may come back now and again. Usually they are less painful and frequent over time.
You may see signs of infection within around four to seven days after exposure, but sometimes it can be months or even years after getting infected before symptoms first appear.
A herpes blister can appear on various parts of the body:
- in or around the mouth (known as cold sores)
- sometimes on the thighs, buttocks and other areas.
You may feel tired, with flu-like aches and swollen glands. Blisters are usually worse the first time they appear.
Before blisters appear, your skin may itch, tingle or feel numb. They can be painful, especially when going to the toilet, and might cause discharge from the penis, vagina or rectum.
Blisters hold an infectious clear liquid before they burst, scab over and heal within two to four weeks.
How it's passed on
Herpes is passed on through:
- skin-to-skin contact during vaginal, anal or oral sex without condoms
- sharing sex toys.
It can also be passed from a mother to a baby.
Infection is more likely when blisters are on the skin but it sometimes happens when no blisters are present – especially before or straight after an outbreak.
You won’t see any blisters inside the vagina, throat or rectum. If you kiss or have oral sex when you have 'cold sores' on your mouth (or if you are just about to get one), you risk giving your partner herpes on their lips or genitals.
How to avoid herpes infection
Other types of contraception, such as the contraceptive pill, offer no protection against sexually transmitted infections (STIs).
Wash your hands after touching blisters, especially before handling contact lenses because herpes can cause an eye infection.
Avoid things that trigger herpes outbreaks such as a lack of sleep, sunbathing or stress.
Having herpes could make it easier for someone to get or pass on HIV. But if HIV drugs have made your viral load undetectable then herpes and other infections don’t appear to make you more likely to pass on HIV.
The herpes virus stays in your body for life but antiviral tablets can help prevent outbreaks, manage symptoms during an outbreak and make blisters heal more quickly.
Suppressive treatment may be used long-term by people who have more than six outbreaks in a year to prevent symptoms, whereas others use episodic treatment when they have an outbreak.
If blisters appear, pain-killing creams and bathing in salt water may help.
Testing for herpes
A herpes blood test exists but it’s not used routinely. Clinics will test blisters for the virus and treat the symptoms.
Most people get tested and treated for infections such as herpes at sexual health (GUM) clinics. It's free and confidential and no-one else, including your GP, will be told about your visit. Some GP surgeries also test for and treat these infections.
The more people you have sex with, especially unprotected sex, the more chance you have of getting infections such as herpes. You can have them without knowing, so regular check-ups are a good idea, especially if you're starting a new relationship and/or you want to stop using condoms with your partner.