Last updated 15 December 2021
Herpes is one of the most common virally transmitted STIs. There were 32,000 new diagnoses in 2013 (HPA, 2013); this is an 89% increase from 2003. Many people can carry the virus and it will not cause any problems, however some people still suffer great emotional distress when diagnosed due to the generally very negative view of herpes.
If you say ‘cold sore’ people won’t care but herpes and cold sores are in fact both caused by the same virus! There are two types of herpes, one that can affect the face and one that can affect the genital area. Both types can be found at either site.
Causes and symptoms
The virus normally enters the body through a skin abrasion (tiny skin cuts), and once under the skin it starts to multiply and cause damage to the surrounding skin before infecting nerves in the surrounding area. By now you’ll start to experience some tenderness around the infected area and small blisters or spots will start to appear. Often people burst these spots – thinking it’s just a normal spot – but try not to. The pus within them also contains more of the herpes virus, thus meaning you could spread the virus further.
The next stage is often the most painful: the spots then form ulcers. The ulcers are usually painful and accompanied by raised glands in the groin. Patients can experience pain on passing urine and sometimes they feel as if they have the flu. These symptoms can last for two weeks, but start to improve after a week if no treatment is given.
Diagnosis and treatment
If you have any of the above symptoms it’s a good idea to visit your local sexual health clinic, where they can normal diagnose herpes simply by looking at the spots or ulcers.
Just a quick note: many sexual health clinics have appointments, but if it is your first outbreak of symptoms then you should attend as an emergency. The sexual health clinic will normally prescribe an antiviral medication, called acyclovir. The dose and frequency will depend on the clinic, however once you commence the antiviral medication you shouldn’t see any future spots or ulcers, so if new ones do develop then pop back to your sexual health clinic as they may need to alter your prescription slightly.
Further outbreaks
Once the first outbreak of herpes has got better you should still avoid sex for several days – this is because the ulcer may have healed but the herpes virus can still be present on your skin, so there is a risk of you infecting others. The virus now retracts away from the skin but still remains dormant in the nerves surrounding the affected area. If the body becomes stressed in the future then the virus can wake up and cause a new outbreak of herpes. Subsequent episodes of herpes are normally not as painful as the first episode; however you still need to avoid sex during an outbreak and you can take a course of acyclovir to help reduce the duration of the symptoms. If you keep getting outbreaks then you should visit your sexual health department, as medication can be given to help control the virus.
Informing sexual partners
Some people may have heard of a recent criminal prosecution for deliberately passing on the herpes virus to a sexual partner. Many feel this was a very harsh verdict, however the basis of the case was the deliberate infection of another individual.
Future sexual partners should be informed of a herpes infection, even if it’s not currently in ‘outbreak’ stage, so that they can make an informed decision about sexual activity. This is probably done best before any sex. Even though you may not have any symptoms there is still the potential to pass the virus on to a sexual partner.
Further reading about Herpes: Herpes Viruses Association
One of the biggest complaints about condoms – and the primary reason men are reluctant to use them – is that they affect the sensation of intercourse and diminish the sexual pleasure.
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Essentially you should check the regulations for the destination country and also any countries you stay in during transit (ie: you leave the transit/departure area of the airport) with the relevant embassy (see 
