Genital herpes is caused by one of two types of herpes simplex virus: HSV-1 and HSV-2. Both viruses can infect the genitals and travel to other parts of the body, including the hands and the eyes. Usually, however, HSV-1 infects the mouth, causing small, painful blisters on the lips, while HSV-2 infects the genitals. If you have had one type of herpes infection, you can still get the other, although it is likely to be a less severe infection. Neither infection can be cured; they can only be controlled.
The symptoms of genital herpes usually appear within a week of infection in the form of itching, tingling, and soreness of a reddish patch on the skin in the groin area, which is followed shortly by small, red, painful blisters. In men these can occur on the penis, scrotum, buttocks, anus, or thighs. The blisters break, causing circular, open sores that develop a crust in a few days. During this time, walking may be painful and urination difﬁcult. The person may develop a fever and feel ill. Within a week to 10 days the sores will scab over and heal—until the next outbreak.
Despite these painful symptoms, genital herpes must be diagnosed by exam- ining (under the microscope) a sample taken from one of the sores. When the diagnosis is conﬁrmed, the physician will prescribe an antiviral medication. Such drugs have two effects: if taken early enough, they can shorten an outbreak; if taken over time, they can reduce the number of recurrences. Recurrences often start with a sick feeling (ﬂulike symptoms such as a cough, muscle pain, and headache) and a return of itching, tingling, or pain in the affected area.
Warning: If you have genital herpes, it is important to know that you can infect a sexual partner even between outbreaks, and even when you have no symptoms.
When herpes spreads, it can be life-threatening. It can infect the covering of the brain (the meninges) or the spinal cord. It can spread through the blood- stream to the liver, lungs, joints, or skin; babies and people with impaired immune systems are especially vulnerable. Even without spreading, the virus may affect the nerves in the pelvic area, causing pain, constipation, inability to urinate, and erectile dysfunction. However, these complications are rare.