The herpes virus can cause cold sores around the mouth, but can also affect the genitals. Dr Joe Kosterich talks about genital herpes, including what it feels like, what it looks like, how long it lasts, what can cause it to come back and how to treat it.
The herpes virus is a set of two viruses, herpes one and two, and they can cause cold sores. A virus doesn’t get as excited about which part of the body it sits on as, perhaps, we do. Exactly the same viruses, one or two, can and do affect the genitals. When it’s around the mouth, or the nose or eyes, we call it cold sores, and it’s not too big a deal – you know, granny used to have cold sores, and so what. When it affects the genitals, people do get quite spooked by it. The important thing to be aware of is that it is exactly the same virus doing exactly the same thing, but on a different part of the body. So if you start to think about it in those terms, suddenly it may not seem quite so fearsome.
What do we actually experience if we do get herpes or cold sores? Generally speaking, you’ll get some tingling or a burning sensation for a day or so, and that will followed up by some blisters coming up. Those blisters will generally be clear fluid-filled blisters; you may get one or two, you may get a group of them. They’ll be in a particular spot. They may be on one side of the penis; in women they may be on a particular area of the labia. If people get recurrent episodes of herpes, then it will generally be in exactly the same spot and people will know when it’s coming because they’ve had it before.
In much the same as cold sores are there for about a week, genital herpes will be there for about a week and then they’ll go away. If you do get spots or blisters coming up around the genitals, especially if you haven’t had them before, it’s a good idea to go along and see your doctor and get it tested to find out whether it is herpes or exactly what you do have.
Some people may get an episode and then they’ll never have it again for the rest of their lives; some people may get episodes from time to time. Much like with cold sores, there are certain things that tend to make it more likely that it’ll come back. This includes stress; for some people, colds and illnesses; some people if they’re tired; some people when they get sunburnt, and no, you don’t have to be skinny dipping for that, just general sunburn can do it; and for women, they can get recurrent herpes if it’s around the time of their period.
For other people, they may get recurrent episodes of herpes. For these people, there are medications that can be used to suppress the virus. These are tablets that are on prescription, so have a chat to your doctor about them. They do need to be taken day-in day-out, so for people who get an episode once every few years, they’re probably going to say, “Look, it’s not worth my while” – and quite rightly so – to take a tablet every day. For people who get it once a month, or something like that, then they may well feel that it is worth their while to take something to restrict that. The tablets don’t guarantee that you never get herpes, but they make them less frequent and generally a little less severe.
How do you get herpes? In much the same way as one can get cold sores, it will be from someone who has active lesions or sores. Again, pretty much common sense in this regard: if you do have active herpes or cold sores, then it’s a good idea not to have intercourse and just keep to yourself for that period of time. It does pass; it’s not going to be forever. Condoms are helpful, but if you do have active cold sores, then it really is a better idea not to bother for that period of time.
There is no specific cure, as we touched on. The tablets that are used to prevent or reduce the occurrence of herpes can be used to treat episodes. They will shorten the course, but it doesn’t mean that they’ll never come back or that they’ll go away instantly. There are also some creams that are available over-the-counter that can be used.
To sum up, remember that herpes is not a big deal. It’s not pleasant, it’s nicer not to have it, but you’re not going to die of it. Even if you get episodes, they will settle. They may settle by themselves and there are treatments that you can use. Abstinence from sex whilst the lesions are there is important, but other than that, it doesn’t mean that you have to be a hermit for the rest of your life. Don’t get too spooked, but use your common sense. When you’re thinking herpes, just think cold sores in another part of the body; it won’t feel quite so fearsome.
For more information on different types of sexually transmitted infections, prevention of STIs, treatments and effects on fertility, see Sexually Transmitted Infections (STIs).