Overview
Genital herpes is one of the most common sexually transmitted infections. It is caused by herpes simplex viruses, usually type 2 and increasingly also type 1. After the first infection, the viruses remain in nerve cells for life and can become active again at intervals. An outbreak often begins with tingling or burning, followed by painful blisters that burst and crust over. Symptoms usually heal within one to three weeks, and typically faster during recurrences. Many affected people experience recurring outbreaks, which often become less frequent over the years. According to current knowledge, a cure is not possible, but the condition can be well controlled: following a medical assessment, antiviral agents can shorten an acute outbreak, and daily suppressive therapy may be considered for frequent recurrences. In the video consultation, your symptoms are assessed based on your medical history and photographs; if suitable, a private prescription can be issued.
Common causes
Transmission occurs mainly through direct skin and mucous membrane contact during vaginal, anal or oral intercourse. Viruses can be shed and passed on even without visible blisters; a large proportion of infections occur during symptom-free phases. Herpes simplex virus type 1, the classic cause of cold sores, can also cause genital herpes through oral sex. After the first infection, the viruses lie dormant in nerve ganglia. Certain triggers can promote recurrences, including feverish infections, psychological stress, lack of sleep, intense UV exposure, mechanical irritation of the skin, hormonal fluctuations such as during menstruation, and a weakened immune system. Individual triggers vary from person to person; keeping a symptom diary can help you recognise your own patterns and discuss them with your doctor.
When to see a doctor
Medical evaluation is advisable if blisters or ulcers appear in the genital area for the first time, if outbreaks recur frequently, or if symptoms do not improve within a few days despite treatment. You should also seek medical advice promptly in the case of severe pain, extensive skin changes, purulent discharge or accompanying fever. Pregnant women with suspected genital herpes should inform their gynaecologist immediately, as transmission to the child during birth is possible. People with a weakened immune system also require close medical supervision. Warning signs of an emergency are high fever with severe malaise, neck stiffness, confusion, seizures, or the inability to pass urine. If such signs occur, do not hesitate: call emergency services 112 or go to an emergency department immediately.