GENITAL HERPES & FACIAL HERPES (cold sores)

What is it?

Herpes is a an extremely common long-term infection caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus;


1. HSV-1, the most common type which causes facial (known as "cold sores") and genital herpes.

2. HSV-2, which usually causes genital herpes


Facial herpes and genital herpes have the same symptoms and are managed in the same way.

How do you get it?

Herpes is spread through direct skin-to-skin contact, through kissing, and oral-to-genital and genital-to-genital sex with someone who has the herpes virus. This means you don't need to have penetrative sex to pass the infection on. You are not always infectious, and most of the time the virus is inactive.

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    Herpes can be spread through oral, vaginal or anal intercourse. If you touch a cold sore with your finger and then perform digital sex on another person, you can infect them that way. You can also transfer facial herpes to someone’s genitals during oral sex.


    Herpes is at its most contagious when the infected individual has a sore or can feel one coming on, but it can still be spread when no symptoms are present.

Symptoms

Genital herpes often causes only mild or no symptoms because the immune system controls the virus. 80% of people with genital herpes do not know they have it. Symptoms usually occur within a month of contracting the virus; however, in some people they won’t see symptoms until years later.

  • First outbreak

    Some people may experience more severe symptoms the very first time they get herpes. These may be flu-like symptoms with pain and multiple blisters on or around the genitals and pain when peeing. 


    These symptoms usually start between two days and two weeks of having it transmitted by a partner. Most commonly this happens from a partner who may not have symptoms and may not be aware they have herpes. If you experience symptoms these will heal up completely after a week or two.

  • Recurrences (ongoing outbreaks)

    Some people may get outbreaks or recurrences after their first episode which are usually mild and infrequent small outbreaks of blisters. Herpes can show up as blisters or sores, but it can also just produce a mild rash. Whatever symptoms do appear may be on the thighs, buttock, back, fingers, and of course the genitals.


    Outbreaks are usually mild but some are uncomfortable and can be quite painful or itchy. You may also experience pain or itching when urinating, cold or flu-like symptoms, and feel very tired or run down.

Is it serious?

Although genital herpes has no cure, it can be easily managed and does not lead to other serious health problems. The emotional impact of a diagnosis is often far worse than the physical symptoms.

  • In people with a vagina

    Herpes is not linked to cervical cancer, or infertility, and people with herpes can have normal pregnancies and vaginal deliveries.


    Herpes can be passed on to babies, which can be serious, but this is very rare. If you are pregnant and you or your partner has herpes, tell your midwife or health care provider.

How do you get tested?

There are no reliable tests for herpes unless you have symptoms. If you have symptoms your nurse or doctor or sexual health clinic can confirm the presence of the herpes simplex virus with a swab test, in which a sample of the fluid from a blister, or a swab from ulcers, is taken and sent away for analysis. 

  • Can I get a blood test?

    A blood test is not 'accurate' enough to be used as a 'herpes test' as there is a reasonable risk of false negatives and false positives. It is not a helpful tool in assisting most patients. 


Treatment

There is no cure for genital herpes, but the symptoms can be controlled using antiviral medicines. Daily medication can prevent recurrences of the herpes virus and reduce the risk of transmission to partners. If you experience ongoing herpes outbreaks, ask your doctor or nurse or sexual health clinic about 'suppressive therapy'.

    Prevention

    Condoms used correctly every time you have sex from start to finish will provide some protection from herpes and offer good protection from many other sexually transmitted infections. However, herpes may be present in areas of skin that are not covered by condoms, so it is possible for herpes to be transmitted even if a condom is used.

    Telling your sexual partner/s

    There are no black and white rules for telling your partner you have herpes, and everyone needs to make their own decisions depending on the situation, but the fact is more people are accepted by new partners than rejected for having genital herpes.

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      As many as one in three adults has the virus that causes genital herpes. Around 80% of people infected with genital herpes don't know they have the virus because they have very mild symptoms or none at all.


      If you are diagnosed with genital herpes, you may reconsider some aspects of sexual intimacy; for example, using non-genital forms of sexual contact when skin blisters or herpes ulcers are present. It also means considering if, when and how you tell your partner. 


      It's natural to be concerned about telling a new partner that you have genital herpes. Fear of being rejected and perhaps being uncomfortable about sexual health concerns makes it a tricky subject to bring up. However, it is more likely that your partner will respect your openness and honesty and it will be an opportunity to take your relationship to a deeper level of trust and understanding.


      Some people choose not to tell casual partners. They don't have sex during an outbreak and practice safe sex by using condoms. And this is an OK decision. It is not common practice to notify partners if you have a history of facial "cold sores".


      In a relationship, "not telling" can cause anxiety and stress affecting your emotional and sexual health.


      For most people the anxiety over not telling is worse than the telling itself and they find their partners both supportive and understanding. By telling your partner, you are opening up the opportunity to have an honest and shared discussion about other sexual health concerns.


      Your health professional can help you deal with this situation, or read more on our page on How to tell a partner about STIs?

    New Zealand Herpes Foundation


    Find out more about herpes on our sister site NZ Herpes Foundation.