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Genital herpes: Diagnosis and treatment


How is genital herpes diagnosed?

If you have a herpes sore, your dermatologist can often diagnose you by looking at the sore and taking a swab from the sore. A lab test can tell whether the sore contains the herpes simplex virus (HSV), which is what causes genital herpes.

If you don’t have a sore or any symptoms, the Centers for Disease Control (CDC) doesn’t recommend testing for most people. You can learn whether you should be tested if you don’t have symptoms at:

Genital herpes screening FAQ (Centers for Disease Control)

How is genital herpes treated?

There is no cure for genital herpes, but treatment can help. Self-care can relieve symptoms and help sores heal. Medicine can shorten an outbreak and also relieve symptoms.

Self-care for genital herpes

Dermatologists recommend the following self-care tips for their patients who have an outbreak:

  • Keep sores clean and dry.

  • Wear loose-fitting cotton underwear.

  • If an area feels painful, place a cold compress on it.

  • To cleanse and sooth painful sores, reduce itchiness, or decrease tenderness, take an Epsom salts bath. You want to soak for 10 to 20 minutes.

Medicine for genital herpes

To treat genital herpes, your dermatologist may prescribe one of these antiviral medicines:

  • Acyclovir

  • Famciclovir

  • Penciclovir

  • Valacyclovir

Taking medicine is recommended for anyone who has a weakened immune system. With a weakened immune system, your body will likely need help to get rid of sores and symptoms. Without medicine, sores may not clear and symptoms can linger. You should continue taking the medicine until all sores have completely healed.

Medicine works best when started within 24 hours of getting a herpes sore.

If one of the medicines listed above fails to bring relief, you may need another medicine. For a severe infection, getting acyclovir through an IV may be necessary. Other antiviral medicines may also be an option.

Antiviral medicine can be taken daily

For some people, taking an antiviral medicine every day works best because they have:

  • Frequent outbreaks

  • A partner who doesn’t have the virus

Frequent outbreaks

Even if you treat an outbreak, you can have new outbreaks. Some people have several outbreaks a year. If you have six or more outbreaks a year, your dermatologist (or other doctor) may recommend taking an antiviral medicine every day.

Taken daily, this medicine can reduce how often you have an outbreak. Studies show it’s safe to take daily and can reduce outbreaks by 70% to 80%.

A partner who doesn’t have the virus

If your partner doesn’t have the virus that causes genital herpes, taking an antiviral medicine every day can decrease the risk of passing the virus to your sexual partner.

Even when taking medicine, you can still give your partner the virus. You can reduce this risk by skipping sex when you have sores and wearing a condom when you don’t.

If you decide to take medicine daily, you’ll likely take it every day for at least one year. At the end of one year, your dermatologist (or other doctor) should re-evaluate you to see if you still need to take an antiviral every day.

What is life like for someone who has genital herpes?

The virus that causes genital herpes stays inside your body forever. While many people carry this virus, some don’t know that they have it because they never have an outbreak.

If you have an outbreak, taking an antiviral medicine can shorten the outbreak and relieve symptoms. Some people have several outbreaks. For most people, the outbreaks become less severe and occur less often with time.

Anyone who has been infected with the virus, however, can spread the virus to others during sex. Even if you never have an outbreak, you can still spread the virus.

Related AAD resources


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References
Centers for Disease Control. “Genital Herpes - CDC Fact Sheet (Detailed).” Last accessed December 19, 2016.

Fatahzadeh M and Schwartz RA. “Human herpes simplex virus infections: Epidemiology, pathogenesis, symptomatology, diagnosis, and management.” J Am Acad Dermatol 2007; 57:737-63.

Madkan V Sra K, et al. “Human herpesviruses.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008:1075-6.

Marques AR, Straus SE, “Herpes simplex.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008: 1199-1204.

US Preventive Task Force. “Serologic screening for genital herpes infection: US Preventive Services Task Force recommendation statement.” JAMA. 2016; 316(23):2525-30.

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