Herpes

Herpes simplex virus, commonly known as herpes, is a virus that commonly causes cold sores and genital sores. It is very common, and 80% of the adult UK population have it.

How is herpes acquired

It can be passed on by skin to skin contact, including kissing, oral sex, vaginal or anal sex. There are 2 strains of herpes – type 1 and type 2. Both types can affect the genital skin.

Symptoms

The majority of people with herpes simplex infection have no symptoms and are unaware that they have the infection. Some people experience genital sores that last for a few days, and go away without any treatment. The sores might appear soon after the infection has been acquired, but can also appear months or years after acquisition.

Tests and diagnosis

Testing for herpes is a swab test carried out when visible lesions are present. Testing for other STIs will usually be recommended as well.

Treatment

Treatment for herpes may be recommended before test results are available if you have symptoms and the nurse or doctor thinks that herpes is the likely cause.

Treatment recommended for a first episode of herpes may include

·         5 day course of Aciclovir 400mg tablets 3 times daily

·         Lidocaine 5% ointment to help with symptoms

·         Simple analgesia such as paracetamol may help

·         Keep well hydrated so your urine is diluted, which will mean it stings less when urinating.

·         If you have any difficulties passing urine please seek urgent medical attention.

Recurrent episodes

Sometimes people can experience frequent recurrences of herpes. Recurrences can be more frequent if you are going through a stressful time, but often there is no clear reason. If the recurrences are frequent or severe you may benefit from daily suppressive treatment, or episodic treatment started when you notice the first signs of a recurrent episode.

Episodic treatment

Aciclovir 800mg 3 times daily for 2 days

If this treatment is recommended, we would suggest making sure you have 1-2 courses of treatment at home, so you can start it as soon as you notice the first symptoms. This will stop or significantly shorten the episode.

Daily suppressive treatment

Aciclovir 400mg twice daily

If this course of treatment is recommended, it is usually continued for 3-6 months.

How long to continue daily suppressive treatment

After 3-6 months it is recommend having a trial of stopping daily treatment. It is common for an episode to come on within a few days or weeks of stopping the daily treatment, so keep a small supply of aciclovir so that you can start a short course of “episodic treatment”(see above) when this occurs.  Once the 2 day course is complete, stop the acyclovir again an see how long the gap is between the first episode and the second episode. If the gap is less than 2 months, you may want to consider re-starting the daily treatment. If the recurrences are less often, you may wish to switch to episodic treatment (see above).

Support

Further information and support can be found here, or by speaking to a nurse or doctor at your nearest sexual health department