Patient Basics: Genital Herpes

Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus. It can cause painful blisters and sores in the genital area that come and go over time, though many people who carry the virus never notice any symptoms. There’s no cure yet. Antiviral medicines shorten outbreaks, prevent many of them, and lower the chance of passing the virus to a partner.

Key points

• Two types of the virus cause genital herpes. HSV-2 is the usual cause, and HSV-1, the type behind most cold sores, causes a growing share through oral sex.
• Herpes spreads through skin contact during sex, even when no sores are showing.
• The first outbreak is usually the worst. Later ones tend to be milder and shorter.
• Daily antiviral medicine can prevent most outbreaks and cuts the risk of spreading it.
• If you’re pregnant, tell your care team if you or a partner have ever had herpes.

How genital herpes spreads

Herpes passes through direct contact with skin or moist lining in the genital area, anus or mouth during vaginal, anal or oral sex. Someone can pass it on when they have sores, but also on days when their skin looks normal. Most new infections happen this way, often from a partner who doesn’t know they have the virus.

You can’t catch genital herpes from toilet seats, towels, swimming pools or sharing cups.

After the first infection, the virus stays quietly in nerve cells near the base of the spine. From time to time it can travel back along the nerve to the skin and cause a new outbreak.

Genital herpes symptoms

The first outbreak

If symptoms appear, they usually start about 2 to 12 days after contact. They can include:

• Tingling, itching or burning in the genital area
• Small, painful blisters that break open into shallow sores, then crust over
• Pain when passing urine, if urine touches the sores
• Fever, body aches, headache and swollen glands in the groin

Sores can appear on the penis, scrotum, vulva, vagina, cervix, anus, buttocks or inner thighs. A first outbreak can take 2 to 4 weeks to heal fully.

Later outbreaks

Many people have repeat outbreaks, especially with HSV-2. They’re usually milder, heal within about a week, and often come with warning signs such as tingling or shooting pains in the legs, hips or buttocks a few hours to a day before sores appear. Over the years, outbreaks usually become less frequent. Stress, illness, friction and menstrual periods can trigger them in some people.

Some people never have an obvious outbreak, or mistake mild symptoms for an ingrown hair, a pimple or a yeast infection.

How it’s diagnosed

• Swab of a sore. If you have a blister or sore, a provider can swab it and test it for the virus. This is the most accurate test. It works best in the first few days, so try to be seen while sores are fresh.
• Blood test. This looks for antibodies that show past infection, and can tell HSV-1 from HSV-2. It can’t show where on the body the infection is, and false results can happen. It isn’t recommended as a routine test for people without symptoms, but it can help in some situations, such as when a partner has herpes.

Your provider may also suggest tests for other sexually transmitted infections, including HIV and syphilis, which can also cause genital sores.

Treatment

Three antiviral medicines are used: acyclovir, valacyclovir and famciclovir. They’re taken by mouth. Creams and ointments don’t work well for genital herpes.

• First outbreak. A course of 7 to 10 days helps sores heal faster and eases pain.
• Treating outbreaks as they come. Keep medicine on hand and start it at the first tingle or sore. A short course of one to a few days can shorten the outbreak.
• Daily suppressive treatment. Taking an antiviral every day can prevent most outbreaks. It’s a good choice for people with frequent or upsetting outbreaks, or with a partner who doesn’t have herpes.

Comfort during an outbreak

• Take acetaminophen or ibuprofen for pain.
• Soak in a warm, shallow bath. If it stings to pee, try passing urine in the bath or pouring warm water over the area as you go.
• Keep the area clean and dry, and wear loose cotton underwear.
• Wash your hands after touching sores, so you don’t spread the virus to your eyes or other places.

Lowering the chance of passing it on

• Tell sexual partners before you have sex. It’s a hard talk for many people, and practicing what you’ll say can help.
• Avoid sex, including oral sex, from the first warning signs until sores have fully healed.
• Use condoms or dental dams every time. They lower the risk but don’t cover all the skin that can shed the virus.
• Consider daily antiviral medicine. Combined with condoms and avoiding sex during outbreaks, it greatly lowers the risk to a partner.

Herpes sores also make it easier to catch or pass on HIV.

Pregnancy

Herpes can pass to a baby during birth and cause a serious infection in the newborn. The risk is highest when a person catches herpes for the first time late in pregnancy. If you’ve had herpes before, your provider will usually suggest an antiviral from about 36 weeks to lower the chance of an outbreak at delivery. If sores or warning signs are present when labor starts, a cesarean birth is usually advised. If you’re pregnant and don’t have herpes, avoid sex with a partner who does during the last three months, or talk with your provider about ways to lower the risk.

Living with herpes

A herpes diagnosis can feel upsetting, but the infection is very common and usually mild. Most people go on to have healthy sex lives and relationships. Talking with your provider, a counselor or a support group can help.

When to see a doctor

• New blisters, sores or bumps in the genital area
• Outbreaks that are frequent, severe or slow to heal
• A sore near your eye, which needs prompt care
• Pain, discharge or bleeding from the anus (proctitis), which herpes can cause after anal sex
• Herpes if you are pregnant or have a weakened immune system

Get emergency care for a severe headache with a stiff neck, confusion or fever, or if you can’t pass urine. In a newborn, get care right away for fever, poor feeding, unusual sleepiness or blisters on the skin.

Common questions about genital herpes

What does genital herpes look like?

Usually a small cluster of fluid-filled blisters on red skin. They break into shallow, round, painful sores, then crust over and heal without a scar. Later outbreaks may be only a few small sores, a crack in the skin or a red patch, which is easy to mistake for an ingrown hair or a pimple.

Does genital herpes itch?

Yes, often. Itching, tingling or burning is a common early sign that starts hours to a day before sores appear, and sores can itch as they heal. Itching with no bumps or sores has many other causes, such as a yeast infection or irritation from soap.

Can you be born with herpes?

Rarely. A baby can catch herpes during birth if the virus is active in the birth canal, and very rarely before birth. Newborn herpes is serious and shows up in the first weeks of life. Most people with herpes caught it later, through skin contact.

Is a positive HSV-1 IgG test dangerous?

No. It means you’ve had HSV-1 at some point, as about half of US adults have, often from cold sores in childhood. The test can’t show whether the infection is in the mouth or the genitals, and it needs no treatment unless you have symptoms.

Questions to ask your doctor

• Which type of herpes do I have?
• Should I treat outbreaks as they come, or take medicine every day?
• How can I lower the risk of passing it to my partner?
• Should my partner be tested?
• What should I do if I become pregnant?

Learn more

• About genital herpes (Centers for Disease Control and Prevention)
• Genital herpes (MedlinePlus, U.S. National Library of Medicine)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.