Herpes

What is herpes?

Herpes is a very common infection caused by a virus called the herpes simplex virus (HSV).

There are two types of herpes viruses: HSV-1 and HSV-2.

Herpes is a manageable skin problem, which is limited to certain areas. Symptoms of herpes can come back again, however, it doesn’t usually cause serious problems.

Both types of herpes virus can cause painful small blisters/sores around the mouth (known as cold sores) and/or around the genital area or bottom (genital herpes).

Up to 3 in 4 Australian adults carry HSV-1 which usually causes cold sores. HSV-1 can also cause genital herpes (about 50% of genital herpes is caused by HSV-1).

Up to 1 in 5 sexually active adults have genital herpes caused by HSV-2.

It is possible to have both an HSV-1 and HSV-2 infection.

Once you get herpes, it stays in your body. But it might not always cause symptoms.

What are the symptoms?

Many people with herpes don’t even know they have it because the symptoms are very mild or don’t happen at all.

Sometimes, symptoms are mistaken for chafing, another type of rash or some other minor discomfort.

If there are symptoms, they can show up days, weeks, months, or even years after being infected.

Oral herpes symptoms (blisters/cold sores) happen in or around the mouth or lips. Genital herpes symptoms usually happen around the genitals or bottom.

Symptoms can be different for each person, but can include:

• itching, stinging or tingling in the affected area
• small bumps or blisters that can break open and crust over
• burning or difficulty passing urine (wee)
• discharge.

The first episode of herpes is usually the longest and most painful and can cause flu-like symptoms including fever, headache, body aches and swollen lymph nodes.

Recovery is usually fast once the herpes symptoms have healed. People can have repeat outbreaks (called recurrences), usually in the same area. These outbreaks are often shorter, less painful, and go away faster than the first one.

Over time, many people may have no symptoms at all.

How is herpes spread?

Herpes enters the body through tiny scrapes in the skin or through the moist soft lining of the mouth, genitals or anus (bottom).

Herpes is passed on through direct skin-to-skin contact with these surfaces.

The virus can be passed on when there are no visible symptoms, which is why it’s hard to know exactly when or how you got it.

A first episode doesn’t necessarily mean it was passed on from a current partner. You might never know where, when, or who gave you the infection.

Herpes is usually passed on through close body contact, including:

• through vaginal or anal sex, or by sharing sex toys
• through oral sex, or by kissing someone who has a cold sore or is just about to get one
• any rubbing of genital skin (not protected by a condom/dam) during sexual activity.

Herpes is most contagious during an active episode, especially if sores or blisters are present. Even if there are no symptoms, there may still be a small chance of passing on herpes to a partner through kissing, oral, vaginal or anal sex.

Remember – if your sexual partner/s has cold sores on their mouth, you can get genital herpes through oral sex.

You can’t pass on herpes from hugging, using a toilet seat or showers, washing machines or swimming pools.

How is herpes tested?

If you have symptoms, a doctor/nurse can take a sample from the blister/sore (a swab) to test for herpes. A positive swab result confirms that you have herpes.

A negative test may mean that you don’t have the infection, or it may mean that the virus was not present on the skin when the swab was collected.

There is also a blood test, but it’s not very reliable because it only shows if you’ve ever been exposed to the herpes virus. This could be oral or genital herpes, and you might never show any symptoms. The blood test is not recommended to screen people who don’t have any symptoms of herpes. For more information about the blood test, speak to your doctor.

How is herpes treated?

While herpes can’t be cured, treatments are available to help manage symptoms.

Treatments can reduce how long the symptoms last and how severe they are. Most herpes episodes last 3-10 days.

There are tablets (antiviral medication) which are available with a prescription from a doctor. The tablets are most effective when started as soon as possible before or after blisters appear, ideally within 3 days. After you have a prescription from your doctor, you can start the medication yourself at the first sign of symptoms coming back.

Other treatments at home may also help symptoms.

These include:

• taking simple pain relief (e.g. paracetamol, ibuprofen)
• salt baths – this may help if your genital area is painful (1 tsp to 2 cups water)
• acyclovir creams (e.g. Zovirax), which can be used on the sores on the mouth as soon as they appear. There are also tablets available over-the-counter at the pharmacy for sores on the mouth.
• topical anaesthetic such as lignocaine (available at a pharmacy), patted gently onto the affected area
• weeing in a warm bath or shower if urinating (weeing) is painful
• keeping the area as cool and dry as possible
• wearing loose non-restrictive clothing
• drinking plenty of water so the urine is diluted and doesn’t sting as much
• resting to help recovery.

Can symptoms come back?

Herpes symptoms can come back, usually in the same place. But when they do, they’re often not as bad as the first time and happen less often or stop completely as time goes on.

Most people will have at least one recurrence of symptoms in their lifetime. Some people might never have another episode.

Some people can feel herpes symptoms coming on with a tingling or stinging feeling in the area. When you feel this, taking antiviral medicine early might help stop the episode from becoming worse.

It’s not possible to predict how or when a herpes episode will happen. However, certain triggers can cause symptoms to come back. These include: illness or fever, your menstrual cycle/period, injury, emotional stress, sunburn or surgery.

If you have frequent, severe or troublesome symptoms, there are treatments available to help. Treatment can be given when someone has a recurrent episode (episodic treatment) or can be taken for a 6-month period continuously to help reduce how often and how long symptoms happen (suppressive treatment). It’s a good idea to speak with a doctor or nurse about your options.

If I have herpes, how can I protect myself and others?

There are ways to reduce the chance of spreading herpes:

• Avoid sex if you feel an episode of herpes coming on (e.g. tingling on the mouth, genitals or anus) and avoid sex for 1 week after the symptoms/sores have gone.
• Don’t touch your herpes sores and, if you do, wash your hands well with soap and water immediately after.
• Use condoms or dental dams for vaginal, anal and oral sex. Condoms are an effective barrier to prevent infection but only if they cover the infected area.
• Don’t share items that have touched saliva (oral herpes).
• Daily antiviral medication (suppressive treatment) may also reduce the risk of passing herpes on to a regular partner/s.
• Consider telling your partner/s if you have genital herpes so you can avoid passing it on. Many people don’t realise how common herpes is and most people appreciate and respect honesty.

While it’s unlikely, it’s possible to pass on the infection even if there are no obvious blisters, sores or other symptoms.

Remember, herpes symptoms are more common when you are unwell or stressed. Keeping healthy, getting enough sleep and reducing the stresses in your life may make herpes outbreaks shorter, less severe and happen less often.

It is also important to have regular testing for other sexually transmitted infections (STIs).

Does herpes affect fertility or pregnancy?

Herpes does not affect fertility (ability to get pregnant).

Pregnant people with a history of herpes can have a safe pregnancy and vaginal birth. However, if you have a genital herpes outbreak when you give birth, you could pass the virus to your baby during delivery. Herpes can cause serious problems for babies, so it’s important to tell your doctor or midwife if you or your partner have been diagnosed with herpes.

Where can I get help or more information?

If you have any concerns about herpes, it’s a good idea to see a doctor or a sexual health clinic. Generally, herpes is a very manageable condition and there are effective treatments. There is a lot of inaccurate information out there about herpes, so it’s important to get the right information about how it will affect you.

You can contact SHINE SA’s Sexual Healthline or make an appointment at SHINE SA for further information, treatment and sexual health counselling.

You can also:

• Make an appointment with your local doctor, health care provider or Aboriginal Health Service.
• You can also contact Adelaide Sexual Health Centre:
  260 Currie Street, Adelaide Tel: 71117 2800
  www.sahealth.sa.gov.au/adelaidesexualhealthcentre

More information

Herpes NZ: www.herpes.org.nz/herpes-patient-info/herpes-patient-info-key-facts

Reviewed March 2025