Definitive Guide

Herpes simplex symptoms and treatment

Herpes affects more than 3.7 billion people under the age of 50 worldwide. It is estimated that roughly one in six people aged between 14 and 49 suffer from genital herpes.

However, despite this, herpes sufferers are often still unsure about treatment and transmission. Although there is no cure for herpes, there are steps you can take towards reducing symptoms and preventing passing it on.

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Fast facts

What is herpes?

Herpes is a long-term condition caused by the herpes simplex virus (HSV). The infection can affect the male and female genitalia, anal region, mucosal surfaces, and skin across the body. There is no cure for herpes, but symptoms can be treated with medications and home remedies.

What does herpes look like?

The most familiar symptoms of herpes are ulcers, sores and blisters. The small blisters eventually crust over and scab. Other symptoms of genital herpes include pain when urinating and unusual vaginal discharge. However, many people who carry the virus won’t show any symptoms at all.

Types of herpes

For most people, the term herpes is commonly associated with genital herpes and cold sores. However, there are actually eight main types of the herpes virus that can affect humans. The symptoms of each type vary.

While there is currently no cure for herpes, there are medicines that can help prevent or shorten outbreaks, as well as reducing the risk of transmitting the disease.

If you want to know the types of herpes, we can help with:

  • How do you get herpes?
  • How many people have herpes?

This chapter covers

  • Genital herpes
  • Cold sores
  • Chickenpox and shingles
  • The Epstein-Barr Virus
  • Cytomegalovirus
  • Roseola
  • Kaposi’s sarcoma-associated herpesvirus

Genital herpes

Genital herpes can be caused by both herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). These viruses are highly contagious, with roughly two-thirds of the population under the age of 50 believed to carry HSV-1 and an estimated 417 million people under the age of 50 infected with HSV-2.

Many people with HSV-1 and HSV-2 never show symptoms. However, other people infected with genital herpes may experience small blisters on their genitals, anus, thighs or bottom. Other symptoms include a burning sensation around your genitals, pain when going to the toilet and unusual vaginal discharge.


HSV-1 and HSV-2 have no known cure. However, antiviral medications such as aciclovir can help treat the symptoms.

Cold sores

Oral herpes is predominantly caused by HSV-1, with rare cases being caused by HSV-2. HSV-1 can cause painful sores on your lips, tongue, gums, nose, inside your cheeks, on the roof of your mouth and occasionally your eyes. Oral herpes is commonly referred to as cold sores.

Oral herpes is transmitted through direct contact, most commonly through kissing and oral sex. There is no known cure but it can be treated using antiviral medications.

Chickenpox and shingles

Chickenpox and shingles are caused by varicella zoster virus (VZV), which is also known as human herpesvirus 3. VZV typically affects people during childhood as chickenpox. Chickenpox causes itchy and painful lesions to form across the body.

VZV can also reoccur as shingles (herpes zoster), causing itchy lesions to develop in band-like patterns across the body. A complication of shingles is that it can cause long term pain that lasts over several months.


If you are over the age of 70, you may be eligible to receive a shingles vaccine on the NHS to reduce your risk of getting shingles. Consult your GP for more information.

The Epstein-Barr Virus

The Epstein-Barr Virus (EBV) is otherwise known as human herpesvirus 4 or HHV-4. EBV is most commonly known for causing glandular fever (also known as mono or infectious mononucleosis), a virus that spreads through saliva and is often regarded as the “kissing virus”.

EBV symptoms typically pass without treatment after two to three weeks. However, if your symptoms are severe or you develop complications then your GP may recommend a course of treatment.


The Cytomegalovirus (CMV), otherwise known as human herpesvirus 5 (HHV-5), can affect people of all sexes and ages. According to the CDC, over 50% of people in the United States are infected with CMV.

Sufferers of CMV may experience no physical effects. However, they may also experience flu-like symptoms. People with weakened immune systems can become more unwell with this infection. CMV can also cause complications during pregnancy, and pregnant women can pass an ‘active’ CMV infection on to their unborn baby, which is known as congenital CMV.


Roseola can be caused by both human herpesvirus 6 (HHV-6) or human herpesvirus 7 (HHV-7). While many people infected with HHV-6 or HHV-7 show no symptoms, roseola patients may experience diarrhoea, vomiting, fever and flu-like symptoms followed by a widespread rash.

Both HHV-6 and HHV-7 are extremely common. A variant of HHV-6, HHV-6B, infects almost 100% of human beings, usually before the age of three. Similarly, studies show that the majority of children under the age of 6 will become infected with HHV-7.

As with other types of herpes, there are no known treatments for HHV-6 or HHV-7.

Kaposi’s sarcoma-associated herpesvirus

Human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpes virus, is the most recently discovered form of herpes. The virus was identified in Kaposi sarcoma tumours, cancer that results in lesions on the skin, lymph nodes and internal organs mostly of AIDS patients.

HHV-8 predominantly affects people with HIV/AIDS, with between 30 and 35% of AIDS sufferers believed to be infected. Human herpesvirus 8 can also be found in recipients of organ transplants and those with a weakened immune system.

While there is no cure for HHV-8, the virus is treatable through highly active antiretroviral therapy (HAART). This involves a combination of antiretroviral drugs which improve immune system function and help to prevent opportunistic infections from spreading.

Herpes signs and symptoms

While herpes often causes painful lesions and blisters, you may experience no symptoms at all. You may not have herpes symptoms that you can see or feel, or they may be so mild that you hardly notice them. Some symptoms of herpes can also be easily confused with other illnesses, such as the flu, and because of this, many people don’t know that they carry the herpes virus. This increases the likelihood of accidentally transmitting the virus to somebody else. If you want to know the signs and symptoms of herpes, we can help with:

  • What does herpes look like?
  • How do you know if you have herpes?

This chapter covers

  • Do I have herpes?
  • What are the symptoms of genital herpes?
  • What are the symptoms of oral herpes?
  • What are the symptoms of chickenpox?
  • What are the symptoms of shingles?
  • What are the symptoms of mono?
  • What are the symptoms of roseola?

Do I have herpes?

It is often difficult to know if you have herpes because the virus may be asymptomatic. This means that you show no signs of infection. Herpes symptoms can also occur up to a year or two following the initial transmission of the virus.

There is currently no cure for herpes. Once infected, the virus stays in your body for life. Just because the symptoms or an outbreak has passed, doesn’t mean that the infection has passed or that you can’t spread the virus.

What are the symptoms of genital herpes?

The most frequent symptoms of genital herpes are itchy or painful blisters and ulcers forming on your penis, vagina, vulva, cervix, anus, buttocks or the inside of your thighs. These blisters then break and turn into painful sores.

Other symptoms may include:

  • A burning sensation when you pass urine
  • Trouble passing urine
  • Pain around your genitals
  • Itching
  • Swollen glands
  • Fever
  • Headache
  • Aches and tiredness

What are the symptoms of oral herpes?

While you may not experience any symptoms when you first become infected with oral herpes, an outbreak of cold sores may happen later on.

Cold sores often start with a tingling or burning sensation around your mouth. The virus then causes small fluid-filled sores to form on your lips or inside and around your mouth.

If you have frequent recurrent infections, these cold sores may grow in size and often develop in the same place every time. They can also ooze before crusting or scabbing over.


Most cold sores disappear without treatment within 7 to 10 days. If cold sores are causing you a lot of trouble, you can suppress them by taking antiviral tablets called aciclovir daily.

What are the symptoms of chickenpox?

Chickenpox is easily diagnosed. Sufferers experience the following symptoms:

  • Red spots will first appear anywhere on the body
  • These spots will then fill with fluid and become blisters
  • The blisters may burst or spread further on the body
  • The spots scab over. More blisters may appear while others scab

Other symptoms include:

  • A high temperature
  • Aches, pains and a general feeling of being unwell
  • A generalised itch
  • Lack of appetite

What are the symptoms of shingles?

Otherwise known as herpes zoster, shingles causes a painful rash. You may first feel a tingling or painful feeling in an area of skin or a headache and feeling of illness. A rash will appear a few days afterwards.

Shingles patients may experience the following symptoms:

  • A rash appears as red blotches on your skin. It should only appear on one side of your body
  • The rash becomes itchy or painful blisters that ooze. After a few days, these blisters dry out and begin to scab over
  • The rash can form a cluster. The skin remains painful until after the rash has passed and can persist longer
  • Your eye may become red and sore, or you may have issues with your sight
  • It may become difficult to move one side of your face with hearing loss on that side

What are the symptoms of mono?

If you’ve never been infected with infectious mononucleosis (mono) before, symptoms may develop within 4 to 7 weeks. The symptoms of mononucleosis include:

  • Extreme fatigue or tiredness
  • Fever
  • Headache
  • Aches and pains
  • Sore throat
  • Swollen glands in the neck or underarms
  • A rash

What are the symptoms of roseola?

Roseola most often shows up as a fever followed by a skin rash. The fever typically lasts up to a week, while the rash should develop up to a day after the fever fades.

A roseola rash is pink and usually starts on the abdomen before spreading to the face, arms and legs. Other symptoms of roseola include:

  • Irritability
  • Ear pain
  • Low appetite
  • Swollen glands
  • Sore throat
  • Mild cough
  • Diarrhoea

Herpes treatment

While there is no cure for herpes, there are treatment options available depending on what type of herpes you have.

Most forms of herpes, such as chickenpox or roseola, fade on their own without treatment. However, in cases with painful outbreaks, there are over-the-counter treatments and natural remedies which may help relieve the pain.

If you are unsure which treatment is best for you, we can help with:

  • Are there any home remedies for herpes?
  • What herpes medication is available?

This chapter covers

  • How to test for herpes
  • Is herpes curable?
  • Preventing the spread of herpes
  • Why you should go to a sexual health clinic
  • Can herpes be cured naturally?

How to test for herpes

A diagnosis of herpes will depend on what type of herpes you have. Your GP will usually be able to diagnose you based on a physical exam and possibly with the results of certain laboratory tests. If you have any symptoms, these will help you narrow down what your diagnosis might be.

Is herpes curable?

Unfortunately, there is no known cure for herpes. However, herpes is a very common virus that shouldn’t dramatically impact your day-to-day life.

Many people with herpes show no symptoms at all, but if you do there are medicines that can help prevent or shorten these outbreaks.

Preventing the spread of herpes

If you have genital or oral herpes, you should try and follow these simple steps to reduce the risk of transmitting the virus:

  • Always use condoms and dental dams during oral, anal or vaginal sex
  • Always tell your sexual partners that you have herpes before you have sex
  • Never have sex during a herpes outbreak
  • Talk with your GP about daily herpes medications which can lower the risk of spreading herpes
  • Learn how to identify when an outbreak is coming. You may feel a burning or itching sensation beforehand
  • Avoid touching your herpes sores. If you do touch them, wash your hands with soap and water immediately

Why you should go to a sexual health clinic

If your GP thinks that you have genital herpes they are likely to refer you to a sexual health clinic. Sexual health clinics specialise in treatments for problems with the genitals and urine system.

Sexual health clinics often get test results quicker than GP practices and do not charge a prescription fee for treatment. They also offer a walk-in service where you don’t require an appointment.

Can herpes be cured naturally?

While there is no cure for herpes, you may be able to reduce its symptoms through natural remedies and lifestyle changes. However, you should always consult your GP before attempting any alternative treatments.

Some people suggest that an extract of the echinacea plant, an ointment containing propolis, the herb Prunella vulgaris or the gypsy mushroom can all help reduce the symptoms of genital herpes. However, research is mixed on the results of these treatment options.

Oral Herpes

One of the most common types of herpes is oral herpes, otherwise known as cold sores. Oral herpes is caused by strains of the herpes simplex virus called HSV-1 and HSV-2.

Oral herpes can cause painful sores to appear on the upper and lower lips, the roof of the mouth, tongue, gums, cheeks, nose or chin. Because the virus is highly contagious it is important to understand how best to treat it and how to prevent transmission. If you’re looking for information on oral herpes, we can help with:

  • What is oral herpes?
  • Are cold sores herpes?

This chapter covers

  • What are cold sores?
  • How long are cold sores contagious?
  • Treatments for cold sores
  • Cold sores: do’s and don’ts
  • Why do cold sores come back?
  • When to visit your GP?

What are cold sores?

Cold sores are usually caused by a strain of the herpes simplex virus called HSV-1 and occasionally HSV-2. This virus is highly contagious and can be transmitted through direct contact. Transmission is much more likely if there is contact is with an open sore. The virus remains asymptomatic most of the time.

When the virus is triggered, the result is an outbreak of cold sores. Triggers can vary from person to person but include fatigue, stress or injuries to the affected area. The frequency of outbreaks can vary from person to person, ranging from a few times each year to never at all.

How long are cold sores contagious?

Cold sores are contagious from the first feelings of a tingling sensation or other early symptoms until the cold sore has completely healed. If you are unsure whether your cold sore has disappeared, it is best to wait a few extra days.

Treatments for cold sores

Cold sores will usually heal on their own within 14 days. However, there are antiviral creams available over the counter which can help ease the symptoms and speed up the healing process.

It is recommended that you use antiviral cream immediately when the first signs of a cold sore appear. This will usually be a tingling or burning sensation around your mouth. By doing this you will decrease the amount of time you have symptoms for. There are also cold sore patches available which contain hydrocolloid gel.

Cold sores: do’s and don’ts

Cold sores are very contagious and take a short time to heal. Until then, make sure to follow these do’s and don’ts:


  • Eat soft foods at a cool temperature if eating is painful
  • Wash your hands with soap and water before and after applying antiviral cream to the sore
  • Use SPF lip balm if sunshine triggers your sores
  • Take paracetamol or ibuprofen to ease any pain or swelling
  • Drink plenty of fluids


  • Kiss anyone while you have a sore
  • Share cutlery, lipstick or anything that comes into contact with your sores
  • Have oral sex until the sore completely heals
  • Touch your sore
  • Rub cream into the sore (dab it instead)
  • Eat acidic or salty foods
  • Kiss your child

Never kiss your baby while you have a cold sore. This can cause neonatal herpes, a very dangerous illness to newborn babies.

Why do cold sores come back?

Once you have the herpes simplex virus, it stays in your body for the rest of your life. This means that after your first outbreak, cold sores can come back at any time.

Most people are exposed to the herpes virus when they’re young. While it may be asymptomatic for a long time, symptoms usually appear when you’re older. You won’t know if the herpes virus is in your body until you get symptoms.

When to visit your GP?

You should see your GP in any of the following scenarios:

  • Your cold sore has not started healing after 10 days
  • You’re worried your cold sore might be something else
  • The cold sore is very painful and large
  • You have frequent cold sores (more than 6 episodes in a year)
  • You or your child also have swollen gums and sores in your mouth
  • You are pregnant
  • You have a weakened immune system

Genital herpes

Genital herpes is caused by the herpes simplex virus. Many people don’t show any visible signs or symptoms. However, during outbreaks, the infection affects the genitalia, inner thighs and anal area.

Painful fluid-filled blisters can appear anywhere in the genital or anal area, buttocks or the tops of the thighs. The virus may also cause pain or stinging when passing urine and unusual vaginal or urethral discharge. If you are looking for information on genital herpes, we can help with:

  • Does genital herpes go away?
  • How long does it take for herpes to show up?

This chapter covers

  • What is genital herpes?
  • What causes genital herpes?
  • Diagnosing genital herpes
  • How is genital herpes spread?
  • Genital herpes treatment
  • Genital herpes and pregnancy

What is genital herpes?

Genital herpes is a viral infection which causes painful blisters and ulcers to form on the genitals that can break open and ooze fluid. These blisters can also affect the inner thighs and anal region. As genital herpes can be transmitted through sexual contact, it’s often referred to as an STI.

What causes genital herpes?

Genital herpes is most often caused by a strain of the herpes simplex virus known as HSV-2, but can also be caused by HSV-1. It is highly contagious and can be transmitted through sexual contact.

Many people may have genital herpes but show no symptoms, and therefore increase the risk of passing on the virus. Outbreaks are caused by certain triggers such as hormonal changes, sunlight, or the common cold.

Diagnosing genital herpes

Blisters forming on your genitalia is known as an outbreak. It is likely that your first outbreak will occur between two and twenty days after you contract the virus. Other symptoms include an itching or tingling sensation on the affected areas, swollen lymph glands and headaches.

Your GP will typically be able to diagnose genital herpes by a visual examination. They may also take laboratory tests if needed. If you think you might have genital herpes or are experiencing an outbreak, visit your GP or local sexual health clinic.

How is genital herpes spread?

Genital herpes is highly contagious and can be spread by direct contact, usually during sexual intimacy with an infected person. This includes kissing, oral sex and direct contact with the vagina, penis or anus. It is very unlikely that you can catch genital herpes from toilet seats or sharing cups and towels because the virus doesn’t survive on surfaces long enough.

Genital herpes treatment

There are three main drugs that are commonly used to treat genital herpes. These are aciclovir, valaciclovir and famciclovir. Each of these is available as oral medications that you can take throughout the day.

There is also a range of lifestyle changes and home care options that you can consider to help reduce the risk of an outbreak. Consult your GP for more information.

Genital herpes and pregnancy

It’s understandable to be worried about your baby if you have genital herpes. Because genital herpes can be transmitted to your baby during delivery if you have an outbreak, it’s very important that you inform your GP of your condition as soon as you know you’re pregnant.

Your GP will help you to understand available treatments to ensure healthy delivery of your baby and the options available to you.

Genital herpes advice

Being diagnosed with genital herpes can come as a surprise, and may affect your mental health and wellbeing. However, herpes is a very common virus, with some people showing symptoms and some people not.

It is important to be practical and keep calm about your diagnosis. Having herpes is quite normal, and so it is useful to hear the facts. If you’re looking for advice following a herpes diagnosis, we can help with:

  • Can I have sex with herpes?
  • How do I tell my partner I have herpes?

This chapter covers

  • Coping with a herpes diagnosis
  • Caring for herpes at home
  • Herpes and your sex life
  • Staying healthy with herpes
  • When your partner has herpes

Coping with a herpes diagnosis

Finding out that you have genital herpes can be a shock. However, remember that it is a very common condition across the world. Don’t blame the person who gave it to you, they probably didn’t mean to put you at risk, and rather focus on what you can do now.

While there is no cure, your first outbreak will most likely be the worst you have. Tell your partner about it, ask your doctor how to avoid spreading it, and get support. Having herpes won’t stop you from living your life.

Caring for herpes at home

Self-care is often enough to relieve the discomfort caused by genital herpes. Over-the-counter medicines such as aspirin, paracetamol or ibuprofen can help ease the pain of herpes symptoms.

Doctors recommend that lesions should be kept dry. Try to avoid wearing tight clothing and wear cotton underwear if possible as cotton absorbs moisture better than synthetic fabrics.


If using a towel to dry after a bath or shower is uncomfortable, try using a hairdryer on a cool setting.

Herpes and your sex life

People with genital herpes can still have normal sex lives, even if it may be more complicated than before your diagnosis. Be careful what you do and when you do it.

When you have sores on your genitals or suspect a herpes outbreak is on its way, avoid vaginal sex, anal sex and oral sex. Between outbreaks, it’s okay to have sex but make sure that your partner understands and accepts the risks involved.

Staying healthy with herpes

Outbreaks of genital herpes can be triggered by stress. Managing your stress levels is important in reducing the risk of symptoms flaring up and maintaining a healthy lifestyle. There are five steps you can take to help manage your stress:

  • Get enough sleep. Most people need eight hours of sleep to function properly. Try not to get too much or too little sleep and find the right balance for you
  • Balance your diet. Try to cut down on sugary and processed foods, caffeine and alcohol while eating plenty of fruit and veg
  • Exercise. Physical activity can help sustain a healthy body and mind
  • Reach out. Don’t be afraid to talk to friends, family, your partner or attend support groups if you find you’re struggling with your diagnosis
  • Relax. Try to find time to do things you most enjoy, whether that’s listening to music, watching TV or just taking a quiet moment

When your partner has herpes

Finding out that your partner has genital herpes can cause a lot of questions about the condition, your own risk, and how it might affect your relationship. The first step is to be honest and open with each other and not to place blame or judgement. The Herpes Virus Association has helpful advice on how to talk to a partner.

It is not guaranteed that you will have herpes if your partner does. The likelihood depends on several factors, including whether you always use a condom and how long you’ve been sexually active. If you are concerned, see your GP to get tested.

If you don’t have herpes, while there is no 100% effective way to prevent transmission, using condoms and avoiding sexual intimacy when symptoms flare up are advised. Contrary to common belief, it is very rare that you can get herpes from a toilet seat, or from objects such as soap or towels.

GRAPHIC: herpes pictures

The following images show what the different types of herpes look like. This includes pictures of herpes outbreaks, genital herpes and oral herpes.

It is recommended that you see a GP who will accurately diagnose your herpes instead of attempting self-diagnosis. If you are looking for information on what herpes looks like, we can help with:

  • What does a herpes outbreak look like?
  • What is the difference between mouth herpes and herpes on the lip?

This chapter covers

  • Genital herpes pictures
  • Oral herpes pictures
  • Chickenpox pictures
  • Shingles pictures
  • Mononucleosis pictures
  • Roseola pictures

Genital herpes pictures

Itchy or painful blisters form on the genitalia, anus or the inside of the thighs. These blisters later break and turn into painful sores.


Oral herpes pictures

Small fluid-filled sores form on the lips, or inside and around the mouth.


Chickenpox pictures

Red spots and blisters appear across the body.

Shingles pictures

A small band of red blotches and blisters appears on a concentrated area of the skin.

Mononucleosis pictures

Mono can cause enlarged lymph nodes in the neck and armpit, as well as a throat infection or tonsillitis.

Roseola pictures

A pink rash starts on the abdomen before spreading to the face, arms and legs.


Private STI test

You can buy comprehensive STI tests which often test for 12 of the most common STIs in the UK, including herpes type I and II.

This chapter covers

  • Complete STI tests

Complete STI tests

You can get tested for:

  • HIV
  • Chlamydia
  • Gonorrhoea
  • Syphilis
  • Hepatitis B
  • Hepatitis C
  • Herpes Simplex I
  • Herpes Simplex II
  • Mycoplasma Genitalium
  • Ureaplasma
  • Trichomonas Vaginalis

About the authors


This chapter covers

  • Dr Sufian Ali
  • Dr Sarah Welsh
  • Dr Abby Hyams
  • Disclaimer

Dr Sufian Ali

Dr Sufian Ali is a Medicspot GP based in the West of Scotland, having attended Aberdeen Medical School and completed his GP training in Glasgow. He has enjoyed working in a number of specialties including paediatrics, psychiatry and emergency medicine; while also working in a variety of settings.

Dr Sarah Welsh

Dr Sarah Welsh is co-founder of HANX and a gynaecology doctor. She graduated from Newcastle Medical School and has worked in Obstetrics & Gynaecology and sexual health in London since 2015. She has a diploma in Sexual and Reproductive Healthcare and is currently focused on building HANX, a considered sexual wellness brand that puts people first.

Dr Abby Hyams

Dr Abby Hyams grew up in Manchester and did her medical training in Bristol. She has been a GP for over ten years, many of them as a partner in an NHS practice in Hemel Hempstead. Dr Hyams loves being a GP because of the wide spectrum of people she encounters every day.


This article is for general information only and should not be used for the diagnosis or treatment of medical conditions. Medic Spot Limited has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. In the event of an emergency, please call 999 for immediate assistance.

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