Herpes infection can be passed from you to your unborn child before birth but is more commonly passed to your infant during delivery. This can lead to a potentially deadly infection in your baby (called neonatal herpes). It is important that you avoid getting herpes during pregnancy. If you are pregnant and have genital herpes, you may be offered anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes at the time of delivery. At the time of delivery, your doctor should carefully examine you for herpes sores. If you have herpes symptoms at delivery, a ‘C-section’ is usually performed.
Herpes infection of the genital tract is a sexually transmitted infection (sexually transmitted disease or STD). Like in the mouth area, herpes symptoms and signs include a painful, blistering rash around or on the genital or rectal areas. These lesions open and result in painful sores that can take two to four weeks to heal. The sores can sometimes cause painful urination. Recurrent outbreaks are typical, and the time between outbreaks varies among affected people and even within the same individual. Prior to an outbreak, a tingling, burning, or itching sensation may be present on the area of involved skin.
There’s quite a variety, in short. And while genital herpes certainly can and does cause these signs of infection literally on the genitals (the penis or the vulva) it also can produce signs of infection nearby. Herpes sores on or between the buttocks are common (and sometimes slow to heal), as are lesions on the thigh. Herpes can bring about what feels like a tiny fissure around the anus, something easily confused with hemorrhoids. So remember: recurring signs and symptoms in the genital or anal area could well be herpes lesions.
Genital herpes is passed on by skin-to-skin contact during vaginal, oral or anal sex, or by sharing sex toys. You can get genital herpes even if there are no visible sores or blisters, and once you have the virus, there is no cure. 'Herpes is more likely to be passed on just before, during or straight after an outbreak, as herpes blisters and sores are highly infectious,' says O’Sullivan.

You should stop having sexual contact as soon as you feel warning signs of an outbreak. Warning signs may include a burning, itching, or tingling feeling on the genitals or around the mouth. Do not have vaginal, anal, or oral sex — even with a condom — until seven days after the warning signs stop or the sore heals. The virus can spread from sores not covered by the condom. It can also spread in sweat or vaginal fluids to places the condom doesn't cover.
Some people have recurrent outbreaks with the so-called “classic” blister-like herpes lesions that crust over, or with painful sores. In recurrent herpes, however, this process usually takes about half the time it does in first episodes. In addition, many people have very subtle forms of recurrent herpes that heal up in a matter of days. And lastly, herpes is capable of reactivating without producing any visible lesions (asymptomatic reactivation).
Herpesviral encephalitis and herpesviral meningitis Herpes simplex encephalitis (HSE) is a rare life-threatening condition that is thought to be caused by the transmission of HSV-1 either from the nasal cavity to the brain's temporal lobe or from a peripheral site on the face, along the trigeminal nerve axon, to the brainstem.[16][17][18][19] Despite its low incidence, HSE is the most common sporadic fatal encephalitis worldwide. HSV-2 is the most common cause of Mollaret's meningitis, a type of recurrent viral meningitis.
Pain, itching and the appearance of sores called lesions are common symptoms of genital herpes. Lesions may appear inside or outside the vagina, and on or around the penis. In both women and men, these sores may appear in and around the anus.6 Lesions typically appear from two days to two weeks after you first get infected with the virus, and will take seven to 14 days or more to heal.7
Herpes infection of the genital tract is a sexually transmitted infection (sexually transmitted disease or STD). Like in the mouth area, herpes symptoms and signs include a painful, blistering rash around or on the genital or rectal areas. These lesions open and result in painful sores that can take two to four weeks to heal. The sores can sometimes cause painful urination. Recurrent outbreaks are typical, and the time between outbreaks varies among affected people and even within the same individual. Prior to an outbreak, a tingling, burning, or itching sensation may be present on the area of involved skin.
People who have had HSV-1 are less likely to contract HSV-2 than those who have not. Previous exposure to HSV-1 also decreases the severity of an HSV-2 outbreak. Reoccurrence of the virus is common, and the virus can be active yet asymptomatic. These infections are more likely to be contracted since the person isn’t aware the virus is active. Studies have shown that 50 percent of the cases of sexual transmission of the virus occurred during asymptomatic infections.
In all cases, HSV is never removed from the body by the immune system. Following a primary infection, the virus enters the nerves at the site of primary infection, migrates to the cell body of the neuron, and becomes latent in the ganglion.[14] As a result of primary infection, the body produces antibodies to the particular type of HSV involved, preventing a subsequent infection of that type at a different site. In HSV-1-infected individuals, seroconversion after an oral infection prevents additional HSV-1 infections such as whitlow, genital herpes, and herpes of the eye. Prior HSV-1 seroconversion seems to reduce the symptoms of a later HSV-2 infection, although HSV-2 can still be contracted.
Avoid touching any sores you have. If you do, wash your hands with soap and water. You should avoid sex while you have sores, and use a male or female condom or dental dam with your partner if sex occurs despite intentions to not have sex. Herpes is most contagious during an outbreak, but it’s also possible to spread herpes when no symptoms are present.
'Using condoms or dams can help to protect against STIs, but herpes can also be passed on by skin-to-skin contact with the affected area, so it’s strongly recommended that you don’t have sex during this time,' she adds. 'This includes direct genital contact or skin-to-skin contact with the affected area, and doesn’t have to be penetrative sex,' says O’Sullivan.
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