What are the complications of herpes?
In healthy adults, herpes seldom leads to complications. Recurrent outbreaks are common, and sometimes these are painful. In someone with a weakened immune system, herpes outbreak can be frequent and severe.
HSV occasionally infects the eyes. If untreated, this can cause damage and, potentially, loss of vision. Ocular herpes most often happens when an oral HSV-1 infection becomes active and travels a nerve pathway to an eye (typically, only one eye is affected).
While very uncommon, pregnant women sometimes pass herpes to their babies. This is more likely to happen when a woman contracts herpes while pregnant, so it's especially important for pregnant women to be cautious. If a pregnant woman or her partner has genital herpes, she and her healthcare provider should talk about ways to protect her and the baby. Most women with genital herpes deliver vaginally and have healthy babies. If a woman shows signs of a genital herpes outbreak at delivery, she will most likely have a caesarean section.
Genital herpes makes a person more likely to contract HIV, if exposed. This is primarily due to the open sores and blisters HSV causes. Also, HIV may be more infectious and likely to be transmitted in someone who has both HIV and HSV.
Reduce your risk
There are several things that can lower the risk of herpes:
- Avoid sex during outbreaks, or if you experience symptoms in the genital area such as itching or tingling.
- Take a prescription HSV medication everyday (talk to your healthcare provider about this).
- Use condoms or other latex barrier (such as a dental dam) for each sex act (oral, anal, and vaginal). A barrier should be put on before any sexual contact takes place.
- Have sex with only one partner (who only has sex with you)
- Talk with your healthcare provider to see what STD tests might be recommended for you.
- Talk to your partner
When one partner has genital herpes, it may be a good idea for the other partner to be tested, too. Keep in mind that symptoms of genital herpes are often overlooked, and most people with genital herpes are not aware that they have the infection.
Herpes can be managed in a relationship, but communication and education are important. See the resources section below for more information on all aspects of HSV, including relationships.
There is no cure for herpes, but medications can treat symptoms and control outbreaks (not everyone with herpes requires treatment). There are antiviral medications approved to treat genital herpes.
They are approved for treatment during an outbreak, as well as to reduce or eliminate outbreaks. Daily, or suppressive therapy, may reduce the risk of transmitting genital HSV to a partner.
Healthcare providers sometimes diagnose herpes by looking at the sores. Since symptoms of herpes can vary widely from person to person, some cases are difficult to diagnose this way.
A viral culture (taking a swab from a herpes sore or blister) is another way to diagnose herpes. A major advantage of this test is the reliability of a positive result, which can also be typed to determine if HSV-1 or HSV-2 is present. Type-specific blood tests for herpes can also be done, and are the test of choice when no symptoms are present. These tests can accurately determine if a person has antibodies (substances in the bloodstream the body produces in response to herpes) to HSV-1 or HSV-2.
What are the symptoms?
Most people with genital herpes aren't aware they have the infection, as symptoms can be mild or mistaken for another condition.
A first or primary outbreak of herpes can be pronounced and painful, though. Symptoms can develop within a few weeks after contracting genital HSV and might include:
- One or more small, fluid-filled blisters or sores around the genitals, anus, thighs, and buttocks. Sometimes the sores develop inside the vagina. The sores usually scab like a cut and heal in two to four weeks, and more blisters can occur during this time. Painful urination is common during a first outbreak.
- During a primary outbreak of genital herpes, a person also can have flu-like symptoms that include headaches, fevers, and swollen glands (especially near the groin).