Itching for information about genital herpes?

Posted 6 April 2018 in Men's Health, Sexual Health, Womens health

Taking a pillAffecting approximately 10% of UK people by the age of 25, herpes simplex type 2 (HSV-2), or genital herpes, is one of the most common sexually transmitted infections (STIs) in the country. Once a person is infected with HSV-2, their body will contain the virus for life. For some people, this may cause no further symptoms once the initial infection has cleared, but for others is it a nuisance as recurrent outbreaks can occur. Although there is no cure, HSV-2 symptoms can be managed with the right medication and self-care, allowing you to get on with your life. (1)

What is HSV-2?

HSV-2 is the main virus which causes genital herpes and is a strain of the herpes family of viruses. Other strains include HSV-1 which is responsible for cold sores but can also cause genital herpes, varicella-zoster virus which causes chickenpox and shingles, and Epstein Barr virus which is implicated in glandular fever.

Once it has found a way into the body and has caused an initial infection, HSV-2 remains within the body indefinitely. For most of this time it is in a dormant (inactivated) state within a nerve close to the initial point of infection, but outbreaks of genital herpes can occur and often have a trigger such as ill health, cuts or friction to the area, periods or UV light. (2)

What are the symptoms of genital herpes?

The earliest symptoms of genital herpes are usually a tingling or itching sensation in the genital area, followed by the formation of blisters on the area of the groin that was in contact with the infected area of the other person.

This may be the penis, vulva, anus, thighs or buttocks. These blisters burst, leaving sores which scab then heal. Under the foreskin of the penis and on the inside of the labia, ulcers will form as opposed to blisters.

As part of the initial infection there may be associated general malaise - aches and pains, fever and slightly swollen glands in the neck, armpits and groin. Discomfort when urinating and unusual discharge from the vagina are also possible symptoms. Symptoms of initial infection should clear within three weeks. (1, 2)

Subsequent outbreaks of genital herpes generally involve milder symptoms and clear up in a matter of days. (1)

How can I be tested?

If you have blisters in your genital area and think you may have genital herpes, you can attend a sexual health clinic to be tested. One of the blisters will be swabbed to obtain a sample to send off for testing. The sample can only be taken if there are blisters present. (2)

If your result comes back positive, anyone with whom you’ve been sexually active also needs to be tested. This is because symptoms of genital herpes can, in some cases, take years to appear after initial infection. If you don’t want to or can’t contact the partners yourself, the sexual health clinic may be able to contact them on your behalf. They will not reveal your identity while doing so. (2)

You can also test for genital herpes with our 7-in-1 test kit which tests for the 7 most common STI's.

How is genital herpes treated?

There is no cure for genital herpes, so the aim of treatment is to ease symptoms and sometimes shorten the duration of an outbreak.

Aciclovir, an antiviral drug, is the first line treatment. It is taken in tablet form three or five times a day, depending on the tablet strength, for five days.

The course may be extended if blisters appear after the course is started or if they have not healed sufficiently. Outbreaks can be treated with shorter courses if higher strength tablets are taken. An oral suspension and topical cream are also available. Alternative antivirals famciclovir and valaciclovir can be used orally in a similar way. (3)

For people who suffer from frequent outbreaks, antivirals can also be used for suppression to keep viral levels under control and prevent outbreaks from happening in the first place.

Instead of being taken as a course, they are taken every day for up to a year, after which treatment is halted to determine whether outbreaks return. If they do, treatment may be started again. If outbreaks keep happening despite taking suppressive treatment, your GP may consider referral to a specialist. (3)

Is there anything else I can do to ease the discomfort of an outbreak?

During an outbreak, you may benefit from the following self-care steps:

  • An ice pack covered with a flannel pressed against the area can help to ease the pain of the blisters. Do this for as long as is needed or comfortable.

  • You may want to try pouring water onto the groin as you urinate to reduce pain and discomfort.

  • Petroleum jelly or anaesthetic cream applied to the blisters may also help with discomfort during urination. Always make sure you wash your hands thoroughly before and after touching blisters.

  • Open sores are a potential site of a secondary bacterial infection. To avoid this, bathe regularly using plain or salt water.

  • Wear loose-fitting underwear and clothing to avoid rubbing of the area and therefore pain and potential bacterial infection. (2)

How can I reduce the spread of genital herpes?

The most effective way to prevent infection of partners is to abstain from any sexual contact while symptoms are present, from the tingling or itching until blisters and ulcers have completely healed. This includes sexual activity involving hands, as not only does this mean the virus can be transferred to a partner’s genitals, but it is possible for it to enter the body via the hands. (1, 2)

Additionally, always use condoms for vaginal or anal sex and dams for oral sex or vulval contact between partners, even when there is no outbreak. (2)

Avoid sharing sex toys. If you do, wash the toy thoroughly and cover with a fresh condom before each use. (1)

The antiviral drug valaciclovir can also be prescribed to help make HSV-2 less transmissible to partners. (3)

Is genital herpes a threat to other aspects of my health?

Fortunately, for healthy people, genital herpes is nothing more than an annoyance. It doesn’t predispose you to other diseases, affect fertility or alter your lifespan. Nevertheless, it can cause problems for people with HIV, so people with HIV who catch herpes will be managed by a specialist. If you need any further information or support, click here or consult your GP, pharmacist or sexual health clinic. (1, 2)

References

  1. Herpes Viruses Association. About herpes simplex virus [cited 16 March 2018]. Available at: https://herpes.org.uk/frequently-asked-questions/herpes-simplex-virus/
  2. NHS Choices. Genital herpes [cited 16 March 2018]. Available at: https://www.nhs.uk/conditions/Genital-herpes/
  3. British National Formulary (version 1.3.7) [Mobile application software]. Retrieved from: www.bnf.org

Author: Gabby Gallagher MPharm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 06/04/18


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