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Herpes - What it is and how to deal with it

Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

What is herpes?

Herpes is the name of a group of viruses. In this group is the herpes simplex virus type 1 and type 2.

Herpes simplex viruses cause painful blisters and sores. The herpes simplex virus type 1 is found mostly in places above the waist. It causes cold sores around the mouth. The herpes simplex virus type 2 is found mostly in places below the waist. It causes genital herpes (herpes around the sexual organs). Sometimes type 1 causes genital herpes and type 2 causes herpes around the mouth.

How is genital herpes spread?

Genital herpes is spread easily. The virus from an infected person can enter your body by passing through a break in your skin or through the tender skin of your mouth, penis or vagina, urinary tract opening, cervix, or anus. Herpes is most easily spread when blisters or sores can be seen. But it can be spread at anytime, even when there aren't any symptoms.

Genital herpes is usually spread from one person to another by having sex. This includes oral sex, when it can be passed from the mouth to the genitals or from the genitals to the mouth. Herpes can also be spread from one place on your body to another, such as from your genitals to your fingers, then to your eyes or to other parts of your body. So try not to touch your sores. If you do touch them, wash your hands well. Herpes can also be spread from a mother to her baby when she gives birth if the baby passes through an infected birth canal.

What happens once someone is infected?

Once you have the virus, you'll go through different stages of infection. Herpes infections are never cured but can be treated with medication.

Primary stage. This stage usually starts two to eight days after you're infected, but it can take much longer to begin. During this stage, the virus attacks healthy cells. Usually, the infection causes one or more groups of small, painful blisters to form. The fluid in the blisters may be clear or cloudy. The area under the blisters will be red. The blisters break open so easily that they quickly become open sores. So you may not ever notice the blisters. Besides having tender blisters or sores in your genital area, it may hurt to urinate (pee). Your glands may be swollen, and you may run a fever and have other flu-like symptoms.

Herpes can be spread very easily when there are blisters or sores. While most people have a painful primary stage of infection, some don't have any symptoms at all, and may not even know they're infected.

Latent stage. During this stage, there are no blisters, sores or other symptoms. At this time, the virus is travelling from your skin into the nerves near your spine, where it rests until something makes it start attacking healthy cells again and cause more symptoms.

Shedding stage. The virus sometimes starts multiplying in the nerves. It can then get into body fluids, such as saliva, semen or vaginal fluids. This is called shedding. There are no symptoms during the shedding stage, but the herpes virus can be spread during this time.

Recurrences. Many people have blisters and sores that come back after the first herpes attack goes away. This is called a recurrence. Usually, the symptoms aren't as bad as they were during the first attack. Stress, or being sick or tired may start a recurrence. Being in the sun or having your menstrual period may also cause a recurrence. You may know when a recurrence is about to happen because you may feel itching, tingling or pain in the place where you were first infected. Herpes can be spread during recurrences.

Tips to soothe the pain

	Take ASA (some examples are aspirin, Entrophen), acetaminophen (some examples are Excedrin, Panadol, Tylenol) or ibuprofen (some examples are Advil, Medipren, Motrin IB).
	Place lukewarm or cool cloths on the sore place.
	Take lukewarm baths. (you may urinate in the tub at the end of the bath if you're having pain urinating - this helps water - down your urine do it doesn't burn the sores so badly.)
	Keep the area dry and clean.
	Don't wear nylon underwear. Wear cotton briefs.
	Don't wear tight-fitting clothes.

Is there a cure for herpes?

No. But antiviral medications such as acyclovir (an example is Zovirax) and valacyclovir (an example is Valtrex) can be very helpful. These drugs speed up healing and can lessen the pain of herpes for many people. Antiviral pills can be used to treat primary or recurrent herpes. The pills can also be used to stop or lessen the number of recurrences. It's important to see your doctor as soon as you think you may have herpes. Herpes is easier to diagnose when there are sores, so go to your doctor right away. This way, you can start treatment sooner and perhaps have less pain with the infection.

Is there a safe time to have sex and not spread herpes?

No time is completely safe because it's hard to know for sure when you or your partner can spread herpes. Some people may not even know they have herpes because they don't have symptoms or don't know that their symptoms are caused by herpes. Try to talk openly with your sex partner about herpes.
You can help protect others and yourself by avoiding sex if you have any sores of if your partner has sores and by using condoms all of the time. Herpes can spread from one person to another very easily when sores are present. Another reason to avoid sex when sores are present is that sores make it easier to catch the AIDS virus.

Condoms can only help reduce the risk of spreading herpes if they cover all the infected skin. Using a spermicidal (sperm-killer) cream or jelly in the vagina, such as those that contain nonoxynol-9, along with condoms may also help prevent the spread of herpes.

Will herpes cause problems with being pregnant?

Herpes doesn't lessen your chances of getting pregnant. The main concern with pregnancy is that the baby may be born while you have sores or are shedding the herpes virus, which could spread the infection to the baby. If a baby catches herpes, it could be serious. The baby is usually safe in the uterus. Tell your doctor if you have genital herpes or have ever had sex with someone who did. You may have to have a cesarean section if you have an outbreak at the time you go into labor, so the baby won't have to go through your birth canal.

What about how I feel about having herpes?

It's common to feel guilty or ashamed when you hear you have herpes. You may feel that your sex life is ruined and that someone you thought you could trust has hurt you. You may feel down. Keep in mind that you are one of millions of people with herpes. Herpes may get less severe as time goes by, and you can help protect your sex partners by not having sex during outbreaks and using condoms at other times. Talk to your family doctor about how you're feeling.

Tips on dealing with herpes

	Talk to your doctor if you think you may have herpes.
	Remember that you're not alone. Millions of people have herpes.
	Keep yourself healthy and limit your stress.
	Don't touch your sores.
	Talk to your sex partner about your concerns.

PDF Version

Revised 2007
The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor.

This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada:

The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages.

This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians.

Support for this program has been provided by an educational grant to the Research and Education Foundation by Scotiabank.