Genital herpes - self-care

One type of herpes virus stays in the body by hiding within nerve cells. It can remain "asleep" (dormant) for a long time. The virus can "wake up" (reactivate) at any time. This can be triggered by:

• Fatigue
• Genital irritation
• Menstruation
• Physical or emotional stress
• Injury

The pattern of outbreaks varies widely in people with herpes. Some people carry the virus even though they've never had symptoms. Others may have only one outbreak or outbreaks that occur rarely. Some people have regular outbreaks that occur every 1 to 4 weeks.

To ease symptoms:

• Take acetaminophen, ibuprofen, or aspirin to relieve pain.
• Apply cool compresses to sores several times a day to relieve pain and itching.
• Women with sores on the vaginal lips (labia) can try urinating in a tub of water to avoid pain.

Doing the following may help sores heal:

• Wash sores gently with soap and water. Then pat dry.
• Do not bandage sores. Air speeds healing.
• Do not pick at sores. They can get infected, which slows healing.
• Do not use ointment or lotion on sores unless your provider prescribes it.

Wear loose-fitting cotton underwear. Do not wear nylon or other synthetic pantyhose or underwear. Also, do not wear tight-fitting pants.

Genital herpes cannot be cured. Antiviral medicine (acyclovir and related drugs) may relieve pain and discomfort and help the outbreak go away faster. It may also reduce the number of outbreaks. Follow your provider's instructions about how to take this medicine if it has been prescribed. There are two ways to take it:

• One way is to take it for about 7 to 10 days only when symptoms occur. This typically shortens the time it takes for symptoms to clear up.
• The other is to take it daily to prevent outbreaks.

Generally, there are very few if any side effects from this medicine. If they occur, side effects may include:

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

Consider taking antiviral medicine daily to keep outbreaks from developing.

Taking steps to keep yourself healthy can also minimize the risk for future outbreaks. Things you can do include:

• Get plenty of sleep. This helps keep your immune system strong.
• Eat healthy foods. Good nutrition also helps your immune system stay strong.
• Keep stress low. Constant stress can weaken your immune system.
• Protect yourself from the sun, wind, and extreme cold and heat. Use sunscreen, especially on your lips. On windy, cold, or hot days, stay indoors or take steps to guard against the weather.

Even when you do not have sores, you can pass (shed) the virus to someone during sexual or other close contact. To protect others:

• Let any sexual partner know that you have herpes before having sex. Allow them to decide what to do.
• Use latex or polyurethane condoms, and avoid sex during symptomatic outbreaks.
• Do not have vaginal, anal, or oral sex when you have sores on or near the genitals, anus, or mouth.
• Do not kiss or have oral sex when you have a sore on the lips or inside the mouth.
• Do not share your towels, toothbrush, or lipstick. Make sure dishes and utensils you use are washed well with detergent before others use them.
• Wash your hands well with soap and water after touching a sore.
• Consider using daily antiviral medicine to limit viral shedding and reduce the risk of passing the virus to your partner.
• You may also want to consider getting your partner tested even if they have never had an outbreak. If you both have the herpes virus, there is no risk for transmission.

Contact your provider if you have any of the following:

• Symptoms of an outbreak that worsen despite medicine and self-care
• Symptoms that include severe pain and sores that do not heal
• Frequent outbreaks
• Outbreaks during pregnancy

Herpes - genital - self-care; Herpes simplex - genital - self-care; Herpesvirus 2 - self-care; HSV-2 - self-care

Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 23.

Whitley RJ, Gnann JW. Herpes simplex virus infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 350.

Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. PMID: 34292926 pubmed.ncbi.nlm.nih.gov/34292926/.

Updated by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.