Treatment:

Genital herpes cannot be cured. However, antiviral treatment can relieve the symptoms. Medication can quickly relieve the pain and discomfort during an outbreak, and can shorten healing time. Medications have been shown to speed healing and relieve symptoms in first attacks more than in recurrent episodes of genital HSV-1 and HSV-2 infections.

If necessary, patients can use daily suppressive therapy, which may reduce the frequency of recurrence in patients with frequent genital herpes outbreaks.

For maximum benefit during recurrences, start therapy as soon as the tingling, burning, or itching begins, or as soon as you notice blisters.

Possible side effects from herpes medications include:

• Fatigue
• Headache
• Nausea and vomiting
• Rash
• Seizures
• Tremor

Some people need medication through a vein (intravenous) for severe herpes infections that can involve the brain, eyes, and lungs. These complications sometimes develop in people with a compromised immune system.

Warm baths may relieve the pain of genital lesions. Gentle cleansing with soap and water is recommended. If you develop a secondary infection of the skin lesions by bacteria, you can use a topical or oral antibiotic.

Support Groups:

See: Herpes genital - support group

Expectations (prognosis):

Once you are infected, the virus stays in your body for the rest of your life. Some people never have another episode, and others have frequent recurrences. In most recurrences, no obvious trigger is identified. Many people, however, find that attacks of genital herpes occur with the following conditions:

• Fatigue
• General illness (from mild illnesses to serious conditions, such as operations, heart attacks, and pneumonia)
• Immunosuppression due to AIDS or medication such as chemotherapy or steroids
• Menstruation
• Physical or emotional stress
• Trauma to the affected area, including sexual activity

In people with a normal immune system, genital herpes remains a localized and bothersome infection, but is rarely life-threatening.

Complications:

Various complications are associated with herpes infection. The herpes virus is of special significance to women because research has found that it can cause cancer of the cervix. The risk increases when HSV is present in combination with human papilloma virus (HPV), the virus responsible for genital warts (condyloma).

For pregnant women, HSV-1 or HSV-2 on the outside of the genitals or in the birth canal is a threat to the infant. Infection of the newborn can lead to herpetic meningitis, herpetic viremia, chronic skin infection, and even death.

Herpes infection also poses a serious problem for people who have a weakened immune system because they have AIDS, are undergoing chemotherapy or radiation therapy, or take high doses of cortisone. These people may develop infections of various organs, including:

• Encephalitis (rare)
• Herpetic esophagitis (herpes infection of the esophagus)
• Herpetic keratitis (herpes infection of the eye)
• Herpetic hepatitis (herpes infection of the liver)
• Incontinence
• Persistent infection of the mucous membranes and skin of the nose, mouth, and throat
• Pneumonitis (herpes infection of the lung)
• Recurrent disease
• Spread of the virus to other organs of the body
• Transverse myelopathy (damage that extends across the spinal cord)

Calling your health care provider:

Call for an appointment with your health care provider if you have any symptoms of genital herpes, or if you develop fever, headache, vomiting, or widespread symptoms during or after an outbreak of herpes.