Herpes is a common infection generally transmitted through skin-to-skin contact. There are several strains of the herpes virus, two of these strains commonly cause genital herpes. You can have oral herpes (on the lips, most often 'cold sores'), genital herpes (on the genitals) or non-genital herpes (herpes on other parts of the body; most often 'shingles'). Shingles is not sexually transmitted. It is a secondary event long after the initial infection with common 'chicken pox'. Shingles is usually a one-off occurrence.

Strains of the virus

There are two types of the herpes simplex virus, HSV-1 and HSV-2. HSV-1 is the virus that most commonly causes cold sores on the lips or face. It is often transmitted in childhood through kissing, but can be transmitted at any age. HSV-1 can also be transmitted to the genitals through direct skin-to-skin contact, often via oral sex. About 80% of adults have HSV-1 by the time they are 25. A much smaller proportion will show obvious symptoms, such as cold sores.

HSV-2 is the virus responsible for most genital herpes and is most commonly transmitted through sexual contact. Approximately 1 in 8 sexually active Australians has genital herpes. Of these, 20 per cent are aware that they have the virus, 60 per cent are unaware that they have it, but have symptoms, while another 20 per cent have no symptoms.

Controlling the first outbreak

Most people with genital herpes have no noticeable symptoms and do not realise they have come into contact with the virus. They may only notice symptoms at a later date. For others, the first symptoms of genital herpes may show up 2 to 21 days after coming into contact with the virus. This first episode of herpes is often the most severe. When you first come into contact with the virus your immune system has not had time to develop protective antibodies. This means the virus can multiply rapidly, causing significant symptoms.

If you are experiencing a severe first episode of genital herpes, you may notice that your lymph nodes (the glands in your groin, neck and armpit) are swollen, or that you have flu-like symptoms such as sore muscles, tiredness, headaches, fever and chills. You may notice swelling, pain or itching around the genitals, possibly followed by painful red spots that can form small blisters. These blisters may burst to form open sores or ulcers, which crust over and heal. You may also experience pain when urinating due to the tenderness in your genital area.

Herpes of the anus or rectum may also result in rectal and lower back pain, an urgent need to pass faeces, bloody or mucus discharge, constipation and blisters on the skin area around the anus.

Usually symptoms will heal within 2 to 4 weeks and cause no long-term damage. If you experience significant pain with any outbreak you should ask your doctor about antiviral medications which can significantly reduce the length and severity of the outbreak.

Will I get genital herpes again?

After a first outbreak of herpes, the virus stays in the body for life. Some people do not have any further episodes or symptoms of herpes. This is called inactive infection, when the virus is hidden in the body and not infectious.

However, the symptoms of genital herpes do recur in some people. These outbreaks tend to be milder and heal faster than the first outbreak. This is called an active infection.

The active period may be obvious, with symptoms, or it may not. It is possible that symptoms are not obvious, or not present at all, but skin cells are shedding the virus during an active phase. This "viral shedding" may be potentially infectious to others if sexual contact occurs.

What causes the virus to reactivate?

Researchers are uncertain about what causes the virus to reactivate. Some common triggers are menstruation, being run-down or anything that causes skin irritation, such as friction during prolonged sexual intercourse. Triggers are different for different people and can even be different for the same person over time. Keep a record of your outbreaks and try to identify any possible triggers. This will allow you to adjust your lifestyle to best manage genital herpes.

Can I Control the Symptoms?

There are some homeopathic preparations available thatv are effective in controlling Herpes symptoms.