Genital herpes: what does it look like?

Learn how to spot genital herpes

The calling card of genital herpes are lesions. But what are they and how do they develop?

  1. Before skin symptoms even start happening, there’ll be general irritation all around the area (thighs, penis, vagina, bottom).
  2. At first, there’ll be redness.
  3. Papules will emerge: these are solid, round lumps, and less than ? inch in diameter. At first glance, these may look like insect bites or pimples. They’ll be on or around the penis, vagina or anus.  
  4. These will then turn into small, white, fluid-filled blisters (vesicles). They’re typically smaller than ¼ inch in diameter. There can be quite a lot of these, together in the same area.
  5. The vesicles will become painful sores, which’ll eventually scab over and heal, typically over 3 weeks.

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Alongside these symptoms, other common ones are

  • Swollen lymph nodes
  • Painful urination
  • Fevers, headaches and muscle soreness
  • Vaginal discharge

However, sometimes, first-time patients of genital herpes do not display these symptoms — or any other, for that matter. Sometimes, the symptoms are so mild that they go unnoticed. Unfortunately, transmission can and often does occur with asymptomatic patients.

There’s yet to be a cure for genital herpes, but recurrent infections (i.e. when it comes back) can be managed with drugs. This happens because the herpes moves to bundles of nerves in the lower spine called sacral ganglions. Recurrences can be caused by a number of things, including menstruation, exposure to UV light, stress, fever, or flu. The symptoms for recurrent genital herpes are slightly different:

  • Discomfort in the thighs, buttocks or genitals that vary in intensity: some people feel tingling briefly before the recurrence, while others feel significantly more intense, shooting pain, several days prior to the recurrence.
  • Fewer lesions
  • Overall symptoms last less long.

Almost everyone who gets genital herpes experiences at least one recurrence in the year after diagnosis.

The primary way of contracting genital herpes is through unprotected sex with a person who has it, and presumably doesn’t have visible lesions. A condom can help to protect you against genital herpes and other STIs, but it’s important to realise that a condom may not cover all the sores, and therefore, you can still contract herpes from contact with uncovered areas.

References

  1. Richwald, G, The Diagnosis and Management of Genital Herpes: The Silent Epidemic
  2. Koutsky, L, Underdiagnosis of Genital Herpes by Current Clinical and Viral-Isolation Procedures
  3. Sauerbrei A. Herpes Genitalis: Diagnosis, Treatment and Prevention. Geburtshilfe Frauenheilkd. 2016;76(12):1310-1317.
  4. Bernstein DI, Bellamy AR, Hook EW, et al. Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Clin Infect Dis. 2012;56(3):344-51.
  5. Wald A, Zeh J, Selke S et al. Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive persons. N Engl J Med 2000;342:844–50.
  6. Corey L, Wald A. Genital Herpes. In: Holmes KK, Sparling PF, Stamm WE, et al. (editors). Sexually Transmitted Diseases. 4th ed. New York: McGraw-Hill; 2008: 399–437

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