Herpes infections are caused by the Herpes Simplex Viruses (HSV) types 1 and 2.

It is important to remember that herpes simplex is a localised skin problem and generally doesn’t have serious consequences other than recurrence.

Approximately 1 in 8 sexually active Australians has genital herpes.

While previously thought that HSV1 was cold sores and HSV2 was genital, its now found that more than 50% of initial genital episodes are caused by HSV1.

Symptoms and presentation

Often is it asymptomatic and you can have HSV1 or 2 without ever knowing it.

However the initial episode can be severe, and if it is, prompt treatment is recommended.

  • Initial episodes with severe extensive ulcers, and a feeling of being unwell
  • Recurrent ano-genital ulcers or blisters
  • Recurrent skin splits – which may be painful or sore
  • Redness with itching/tingling
  • Urethritis in men (painful or difficult urination)
  • Cervicitis in women (irritable cervix which can be painful, bleeds easily, or causes discharge)

How is it diagnosed?

An examination often is obvious as to the cause, however confirmatory testing with swabs will let us know if it is indeed HSV1, HSV2 or sometimes varicella (which is not herpes but shingles/chickenpox).

The only time blood tests are helpful for herpes, are when they will provide meaningful information we can act on, ie during pregnancy.
Testing people with no symptoms is not recommended as it is not a definitive diagnosis, and there’s really nothing we can do unless you have an active infection.

Please read the fantastic herpes NZ website on all the facts.


What do I do if I have herpes?

If it’s your first episode, try to get in to see our doctor as soon as possible as the earlier we commence treatment the more successful it is at reducing your symptoms.

For initial episodes we treat with antiviral medication for 5 days.

If you have a recurrent episode, then we can treat with medication from 1-3 days.

If you get frequent recurrences, then we can use daily suppressive therapy for 6 months, then review and see if you get another recurrence. We avoid ongoing suppression without reviewing as each episode will get less severe and less frequent.

If you’re having a particularly bad episode then the following can be helpful;

  • Simple analgesia like paracetamol or ibuprofen
  • Salt water baths (⅓ cup of salt in a tub of warm water, and sitting in this)
  • Topical anaesthetic creams from the pharmacy or your doctor
  • Urinating whilst in the bath or shower helps relieve the pain from the skin sensation
  • Use condoms with ongoing partners
  • Herpes is not a notifiable condition

What next?

Your symptoms should begin to resolve quite quickly following commencement of treatment.

Sometimes your doctor will give you a standby prescription in the event you get a recurrent episode so you can get started on treatment straight away. Just remember to let the doctor know you needed to use it so they can monitor how you’re doing.

Discussing herpes with your partner can be an uncomfortable conversation to have. It’s important to realise that having cold sores, is medically the same condition. So the stigma really shouldn’t be there.

Have a read of Herpes and Relationships again from the wonderful NZ herpes foundation (those Kiwi’s sure make some great medical websites), for ways to approach the topic with your partner.

If you’re interested in doing an STI screen, or are worried you might have symptoms book in with our doctors for an STI check. If you want to know how often you should get tested, have a look at our page on how often should I have a sexual health check for more information.

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