What is genital herpes?
Genital Herpes is a sexually transmitted disease of the genital area with genital Herpes simplex virus (HSV) type 1 or type 2, a DNA virus of the Herpes viridae family.
Herpes simplex type II virus is the most common cause of genital herpes but can be due to herpes simplex type I virus which is more commonly associated with cold sores around the mouth.
The incubation period of genital herpes varies from three to nine days if symptoms occur. However, up to 90% of primary infections may be asymptomatic.
Primary Genital Herpes Infection symptoms
The first attack of genital herpes, called primary infection, is associated with generalised illness which can be severe. The external genital skin becomes red and painful and there are typical blisters called vesicles.

Genital Herpes Picture 1
This picture shows the early stages of the herpes rash. The cluster of vesicles all appear to be on the same red base. This is different from the rash of chicken pox which has an individual vesicle on a red base.

Genital Herpes Picture 2
Genital herpes sores are clear, fluid-filled blisters that develop in an area of redness. The herpes virus is active, and transmission is likely.

Genital Herpes Picture 3
The clear fluid in the sores eventually becomes cloudy and yellow as pus forms. The genital herpes virus is active, and transmission is again probable.

Genital Herpes Picture 4
This picture shows typical genital herpes lesions on a penis, including vesicles and ulceration. Because the number of lesions is extensive this may be a first outbreak of genital herpes for this person. Typically, the first genital herpes outbreak is worse than recurrent later outbreaks.

Genital Herpes Picture 5
A further picture of herpes lesions in the later stages of healing; here is some crusting.

Genital Herpes Picture 6
Genital Herpes on the Vulva
When the blisters open they become painful ulcers.
To confirm the diagnosis, blood and viral culture tests are usually taken which is usually apparent to the doctor who will often commence treatment with an antiviral agent (e.g. acyclovir - Zovirax - Glaxo) before waiting for aboratory confirmation. At times the infection may be so painful, the illness so weakening or bladder emptying so difficult that admission to hospital is required.
Secondary Genital Herpes Infection symptoms
Repeat attacks, called secondary herpes, are less severe than primary infections.
These attacks last for from five and ten days if left untreated.
There may be symptoms of impending problems 12-72 hours before vesicle eruption, with burning and tingling sensations.
Attacks are thought to be particularly common at times of stress.
Treatment with antiviral agents at the onset of warning symptoms lessen or prevent attacks.
Sufferers should abstain from sexual intercourse during attacks to save their partner from infection.
Whilst individual attacks can be thwarted, there is no long-term cure. When attacks occur more frequently, there may be understandable depression. For the minority with such frequent attacks there is a place for regular twice daily acyclovir tablets.
If there is active genital herpes around the time of childbirth, the baby can become infected with severe consequences. It is believed that this is more dangerous with the primary infection. If there is evidence of genital herpes around the time of delivery, Caesarean section reduces the risks.
- 1 What skin conditions may affect the vulva?
- 2 Which viral infections can affect the genitalia?
- 3 What problems can occur to people with herpes simplex?
- 4 What are genital warts?
- 5 What is lichen sclerosus?
- 6 How is lichen sclerosus treated?
- 7 What could be causing my vulval irritation?
- 8 How could my vulval irritation be treated?
- 9 What is a Bartholin's cyst / abscess?
- 10 How is a Bartholin's cyst / abscess treated?
- 11 What is vulvodynia?
- 12 How can my vulvodynia be treated?
- 13 What is vestibulitis?
- 14 How can my vestibulitis be treated?
- 15 Where can I obtain further information?
- 16 Support Groups.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
Answers to FAQs on women's health, patient information and medical advice by David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist (Gynecologist - OBGYN), Department of Obstetrics and Gynaecology, Whipps Cross University Hospital, London
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