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Genital Herpes: What It Looks Like, How Long It Lasts, How It Spreads, and the Antivirals Used in Practice, Explained by a Dermatologist

3 days ago
20 min read

Genital herpes is an infection with the herpes simplex virus (HSV) of the skin and mucous membranes of the genitals, groin, buttocks, or around the anus. It causes clusters of clear 1–3 mm blisters on a red base that break into painful shallow sores, then crust over and heal on their own in 2–4 weeks for a first episode and 5–10 days for a recurrence.

The main cause is HSV type 2 (HSV-2), but over the past decade HSV type 1 (HSV-1), the same virus that causes cold sores on the mouth, has become a much more common cause of genital herpes, especially in young people, because it spreads through oral sex.

Herpes is very common. The World Health Organization estimates that about 1 in 8 people aged 15–49 worldwide carry HSV-2, and most people who carry the virus never know it. Having herpes says nothing about a person's behavior or worth, and it does not mean your partner was unfaithful, because the virus can stay in the body for years before the first outbreak. This article answers the questions patients actually ask in the clinic: is this sore herpes, what medicine do I need, how many days until it heals, and how do I avoid passing it to my partner. For an overview of herpes at every site, read our main article on herpes and what causes it.

What causes genital herpes and how does it spread?

Genital herpes spreads through direct contact with the skin or mucous membranes of an infected person. The virus enters through tiny breaks in the skin that cannot be seen, or through thin mucosal tissue, then travels along nerves and settles for life in the nerve cluster near the tailbone (sacral ganglia). When triggered, the virus travels back down to the skin at the same spot or nearby, which is why sores recur in the same place.

Ways it can really spread

  • Vaginal or anal sex with someone who has genital HSV-2 or HSV-1.

  • Oral sex with someone who has cold sores or who carries HSV-1 in their saliva without symptoms. This is why a person whose partner has never had genital sores can still get genital herpes.

  • Skin-to-skin contact in areas a condom does not cover, such as the scrotum, pubic area, groin, and buttocks.

  • Mother to baby during childbirth, which is uncommon but serious (see the pregnancy section below).

Ways it almost never spreads: The herpes virus survives only briefly outside the body, so catching it from a toilet seat, swimming pool, or a dry towel is so unlikely that it is not worth worrying about.

Incubation period: Symptoms begin 2–12 days after exposure, about 4 days on average. Many people are infected without symptoms or with symptoms so mild they go unnoticed, and have their first outbreak months or years later.

What does early genital herpes look like?

A first infection usually follows a fairly clear sequence. Knowing it helps you see a doctor during the window when antivirals work best.

  1. Days 1–2, warning stage (prodrome): burning, itching, or tingling on the skin of the genitals, buttocks, or thighs. Some people have pain shooting down the leg. Nothing is visible on the skin yet.

  2. Days 2–4, red bumps and blisters: small red bumps turn into clusters of clear 1–3 mm blisters. In a first episode there are often several clusters on both sides.

  3. Days 4–7, blisters break into shallow sores: the blisters break and merge into shallow sores with red edges. They are very painful, especially when urinating. The lymph nodes in the groin become swollen and tender.

  4. Whole-body symptoms: in a first episode, about half of patients have fever, headache, and body aches, like a flu, especially women.

  5. Days 8–14, crusting: sores on dry skin dry out and crust over, while sores on moist mucous membranes do not crust but gradually become shallower.

  6. Days 15–28, fully healed: the sores close, usually without scarring. Some redness or darker discoloration may remain and fades over a few weeks.

Without treatment, a first episode lasts about 3 weeks on average and the virus is shed from the sores for about 12 days. Starting an antiviral early can shorten the whole episode by several days and make symptoms clearly milder.

What does genital herpes look like in women?

  • What it looks like: blisters and shallow sores on the outer lips, inner lips, vaginal opening, around the urethra, and perineum, which may spread to the buttocks, inner thighs, or around the anus. Some women see only cracks or tiny sores that look like scratch marks, along with increased vaginal discharge when the virus involves the cervix. Urination burns so much that some women hold their urine.

  • Cause: HSV-2 or HSV-1. Women catch the infection from a partner more easily than men because the vaginal lining has a larger area of contact, and a first episode is usually more severe in women than in men. In some women, recurrences are linked to the days before a period.

  • Severity and urgency: most episodes heal on their own, but women are more likely than men to develop urinary retention from pain and inflammation of the nerves near the tailbone, and mild meningitis is also seen more often. Herpes does not cause cervical cancer (HPV does), but herpes sores make it easier to catch HIV.

  • When to see a doctor: if you have blisters or sores on the genitals for the first time, come within 72 hours so you can start medicine and have a sample taken. Come right away if you cannot urinate for more than 6–8 hours, have a severe headache or stiff neck, or are pregnant. Itching and discharge without sores are usually a different problem; see intertrigo in women and vaginal yeast infection.

What does genital herpes look like in men?

  • What it looks like: clusters of clear blisters on the foreskin, the groove under the head of the penis, the shaft, scrotum, pubic area, or thighs. On dry skin the blisters are easy to see and then crust, while under the moist foreskin you are more likely to see several shallow red sores. Some men have a clear discharge from the urethra and burning when urinating.

  • Cause: HSV-2 or HSV-1, spread through vaginal, anal, or oral sex. Men who have sex with men may also have sores around the anus.

  • Severity and urgency: a first episode is usually milder in men than in women but can still be very painful. Sores under the foreskin can make it swell so that it cannot be pulled back, which needs medical care.

  • When to see a doctor: if you have a sore on the penis for the first time, see a doctor to confirm it is really herpes, because a painless sore on the penis is often primary syphilis, which is treated differently. Come right away if the foreskin swells and cannot be pulled back, or if you cannot urinate.

Herpes on the buttocks and around the anus

  • What it looks like: clusters of blisters or shallow sores on the buttock cheeks, the cleft between them, or around the anus. Herpes on the buttocks is usually a recurrence of HSV-2 and appears in the same spot each time. If the infection involves the inside of the anus, it causes straining, painful bowel movements, and mucus or blood, called herpes proctitis.

  • Cause: the virus hiding in the nerve cluster at the tailbone also supplies the skin of the buttocks, so it can come out there even when the first infection was on the genitals. Proctitis comes from anal sex.

  • Severity and urgency: sores on the buttocks are often mistaken for a boil, pimple, folliculitis, or insect bite, because the skin there is thick and the blisters break quickly. A helpful clue is that they appear in the same spot again and again, with burning 1–2 days beforehand.

  • When to see a doctor: if bumps on the buttocks appear in the same place more than twice, get a PCR test while the bumps are present to confirm. If you have painful bowel movements with blood or mucus, you should also be tested for other sexually transmitted infections.

Why is the first episode the worst?

  • What it looks like: several clusters on both sides, severe pain, fever, body aches, and swollen groin lymph nodes, lasting 2–4 weeks. The first episode with symptoms (first clinical episode) comes in two types: true first infection (primary), when the body has never met HSV before and which is the most severe, and first symptomatic episode of an older infection (non-primary), which is milder and shorter.

  • Cause: the body has no immunity to the virus yet, so the virus multiplies a great deal before the immune system catches up. People who have had cold sores from HSV-1 before usually have milder symptoms when they get HSV-2 on the genitals.

  • Severity and urgency: this is when complications are most common, including urinary retention, mild meningitis, and spread to other sites when a hand touches a sore and then the eye.

  • When to see a doctor: everyone with a first episode should get an antiviral, even if they come after 72 hours, as long as new blisters are still appearing or the pain is still severe, because the first episode is when the medicine helps the most.

Recurrent herpes: how often and what triggers it

  • What it looks like: a single cluster of blisters on one side, in the same place or close to it, usually preceded by burning, itching, or tingling 6–48 hours earlier. No fever. It heals in 5–10 days.

  • Cause: the virus hiding in the nerve cluster is triggered to come out. Common triggers are lack of sleep, stress, illness with fever, the days before a period, friction from sex, strong sunlight, and a weakened immune system.

  • Severity and urgency: how often it recurs depends on the virus type. Genital HSV-2 recurs about 4 times in the first year on average, while genital HSV-1 recurs far less, about once in the first year on average, and both tend to space out over time. Knowing which type you have therefore helps predict the future.

  • When to see a doctor: if you have 6 or more recurrences a year, or each one disrupts your life, talk to your doctor about long-term suppressive medicine. If you also often have cold sores, or blisters that follow a line along a nerve with severe burning pain, it may be shingles, which also needs prompt treatment.

Infected with herpes but no symptoms: can you still spread it?

  • What it looks like: no blisters, no sores, and no idea you are infected, or only some redness, tiny cracks, or mild itching that you assume is friction. Most people whose blood tests show antibodies to HSV-2 never knew they had herpes.

  • Cause: the virus comes to the skin from time to time without causing sores, called asymptomatic shedding. Studies that collected samples every day found that people with HSV-2 shed virus on about 10–20% of days in the first years, decreasing over time.

  • Severity and urgency: it is not harmful to you, but most genital herpes infections are passed on by a partner who has no symptoms that day. This is why avoiding sex only when sores are present lowers the risk but does not bring it to zero.

  • When to see a doctor: blood screening for herpes is not recommended in people with no symptoms at all, but talk to your doctor if your partner has herpes and you want to know whether you carry it, or if you are pregnant and your partner has a history of herpes.

Genital herpes during pregnancy

  • What it looks like: the same symptoms as in other people, but a pregnant woman who is infected for the first time may have more severe symptoms.

  • Cause: the risk to the baby comes from contact with the virus in the birth canal during delivery, not through the placenta. The risk differs greatly depending on when the infection was acquired. If the mother is infected for the first time in the third trimester, the baby has roughly a 30–50% chance of infection, because the mother has no antibodies to pass on. If the mother had herpes before pregnancy and has a recurrence, the risk is below 1%.

  • Severity and urgency: herpes in a newborn is serious, so a plan must be made together with the obstetrician. The standard approach is to give suppressive antiviral medicine from 36 weeks of pregnancy until delivery for mothers with a history of herpes, and to consider a cesarean delivery if there are sores or warning symptoms when labor begins.

  • When to see a doctor: if you are pregnant and have sores or blisters on the genitals, see a doctor right away and tell your obstetrician. If you have never had herpes but your partner has a history of genital or oral herpes, avoid both vaginal and oral sex in the third trimester.

Herpes in people with weakened immunity

  • What it looks like: large, deep, widespread sores that take longer than 4 weeks to heal, or recur very often. Sometimes there are no visible blisters, only a chronic sore at the edge of the anus.

  • Cause: people with HIV and a low immune count, people on chemotherapy, organ transplant recipients, and people who take immunosuppressants or high-dose steroids for a long time. The immune system cannot fully control the virus.

  • Severity and urgency: they are more likely than other people to develop resistance to acyclovir and often need higher doses or longer courses. On the other hand, genital herpes sores make it about 2–3 times easier to catch HIV, so an HIV test should always be done alongside.

  • When to see a doctor: sores on the genitals or buttocks that do not heal within 2 weeks even with medicine, or if you have an illness or take a medicine that weakens immunity, see a doctor to have a sample tested and to consider adjusting treatment. For more on rashes seen in people with HIV, read what AIDS-related skin bumps look like.

How can you tell it is herpes and not something else?

Bumps or sores on the genitals have many possible causes, and many need different treatment. Features that point to herpes are small blisters in clusters, breaking into several shallow, burning sores, preceded by warning symptoms, and appearing in the same place again and again. The conditions most often confused with it are:

  • Primary syphilis: a single sore with a raised, firm edge and a clean, smooth base that is painless, with swollen lymph nodes that are not tender. Untreated, it progresses to a secondary syphilis rash over the whole body including the palms and soles.

  • Chancroid: a deep sore with ragged edges and pus that is very painful, with groin lymph nodes that can swell and burst. It is now rarely seen in Thailand.

  • Folliculitis or ingrown hairs from shaving: red bumps or pustules with a hair in the center, in hair-bearing skin, not clustered shallow sores. See also folliculitis.

  • Candida yeast infection: a moist red patch with small bumps around the edge, itchier than it is painful. Women have a curd-like white discharge.

  • Fixed drug eruption: a dark red or blistered patch on the penis or lips that appears in the same place each time after taking the same medicine, such as certain painkillers or antibiotics, and leaves a dark mark.

  • Behcet disease: frequent recurrent mouth ulcers together with deep genital sores and eye inflammation. See also Behcet disease.

  • Genital warts: raised fleshy growths, not blisters or sores, painless, caused by HPV rather than HSV. See also genital warts.

  • Friction sores: appear right after sex or scratching, with no blisters beforehand, and heal in 2–3 days.

Judging by sight alone is often wrong, even for doctors. Current guidelines therefore recommend confirming with a laboratory test whenever possible, especially for a first episode.

How is genital herpes confirmed?

  • PCR test from the sore (best): a cotton swab is rubbed at the base of a fresh blister or sore. The result shows whether it is herpes and whether it is HSV-1 or HSV-2, and it is clearly more sensitive than culture. It should be collected within the first 48–72 hours, because once the sore has crusted, false negatives are common.

  • Blood test for type-specific antibodies (type-specific IgG): used when there is no sore to test. It shows whether you have ever been infected with HSV-2. Antibodies take about 3–12 weeks to appear after infection, so the test can be falsely negative early on. A positive HSV-1 blood test cannot tell whether the virus is in the mouth or the genitals.

  • IgM testing should not be used: it cannot tell a new infection from an old one and often gives false positives.

  • Test for other sexually transmitted infections as well: everyone with genital sores should be tested for HIV and syphilis, and testing for gonorrhea and chlamydia should be considered according to risk, because these infections can occur together and many have no symptoms.

How is genital herpes treated? Antivirals for a first episode

The main treatment is oral antiviral medicine, using three drugs with equally good evidence: acyclovir, valacyclovir, and famciclovir. None of them kills the virus hiding in the nerve cluster, but they stop the virus that has come out to the skin from multiplying, so sores heal faster, hurt less, and shed virus for a shorter time. The doses in international guidelines for a first episode in an adult with normal kidney function are:

  • Acyclovir: 400 mg three times a day for 7–10 days. It is the cheapest but has to be taken often.

  • Valacyclovir: 1 g twice a day for 7–10 days. It is absorbed better and is taken less often.

  • Famciclovir: 250 mg three times a day for 7–10 days.

Signs the medicine is working: within 2–3 days of starting, no new blisters should appear, pain should clearly ease, and sores should begin to become shallow and dry within 5–7 days. If the sores have not fully healed after 10 days, the doctor may extend treatment. If the sores have not improved at all in 5–7 days, consider a wrong diagnosis, a secondary bacterial infection, or a resistant virus in someone with weakened immunity.

Precautions: all three drugs are cleared by the kidneys. People with kidney disease, older adults, or those who drink little water need a dose adjustment and enough fluids. Side effects that can occur are headache and nausea, which are usually mild. The choice of drug, dose, and duration must be assessed and prescribed by a doctor for each person.

Treating recurrences: taking medicine only when symptoms appear (episodic therapy)

For people who recur infrequently, a supply of medicine is kept at home as prescribed by the doctor, and you start it immediately at the first warning symptom or within 24 hours of seeing blisters. The earlier you start, the better it works. If you start after the blisters have already broken into sores, the benefit is much smaller. Commonly used regimens are:

  • Acyclovir: 800 mg twice a day for 5 days, or 800 mg three times a day for 2 days.

  • Valacyclovir: 500 mg twice a day for 3 days, or 1 g once a day for 5 days.

  • Famciclovir: 1 g twice a day for just 1 day, or 125 mg twice a day for 5 days.

Signs it is working: blisters that were about to appear sometimes stop altogether without turning into sores, or if they do appear, they heal about 1–2 days faster than without medicine. If you use this approach and still recur so often that it disrupts your life, you should switch to long-term suppressive medicine.

Long-term suppressive therapy: who should use it

Suppressive therapy means taking a low dose of antiviral medicine every day, continuously, without waiting for symptoms. It suits

  • people who recur 6 or more times a year, or whose episodes are very painful, or who are so worried that it affects daily life and relationships,

  • people who have a partner who is not infected and want to lower the chance of passing the virus on,

  • pregnant women with a history of herpes from 36 weeks of pregnancy until delivery, at the obstetrician's discretion,

  • people with weakened immunity who recur often.

Commonly used doses: acyclovir 400 mg twice a day, or valacyclovir 500 mg once a day (people who recur more than 10 times a year may need 1 g once a day), or famciclovir 250 mg twice a day.

How well it works: it reduces the number of recurrences by about 70–80%, and many people have no outbreaks at all while taking it. In a study of couples in which one partner carried HSV-2, having the infected partner take valacyclovir 500 mg every day reduced symptomatic infection in the partner by about 75% and reduced all HSV-2 transmission by about half. These drugs can be used safely for years in people with normal kidneys. Doctors usually schedule a review every 6–12 months to check whether continuing is still necessary, because the frequency of outbreaks often falls on its own over time.

Can I use a cream, and caring for the sores at home

Antiviral creams are not recommended for genital herpes. Over-the-counter acyclovir cream offers very little benefit compared with tablets, because not enough medicine reaches the virus multiplying under the skin, and repeatedly applying cream to a painful sore risks irritation. Standard guidelines therefore recommend oral medicine as the mainstay. Sore care that helps you feel better and lowers the chance of a secondary infection includes:

  1. Rinse gently with clean water or saline twice a day, then pat dry. Do not scrub or pick at the crusts.

  2. Sit in warm water for 10–15 minutes to ease pain. People who find urinating very painful can urinate while sitting in warm water or pour water over the area while urinating.

  3. Common painkillers such as paracetamol at the dose on the label, or a topical numbing gel prescribed by your doctor for severe pain.

  4. Wear loose cotton underwear to reduce friction and moisture.

  5. Wash your hands every time after touching a sore, especially before touching your eyes or contact lenses.

  6. Avoid sex of every kind from the first warning symptom until the sores are completely healed and the skin is smooth.

  7. Do not put steroid creams, medicated balms, or herbal remedies on the sores, as they can make the sores spread or become infected.

How many days does genital herpes take to heal, and how can it heal faster?

The duration depends on whether it is a first episode or a recurrence and how quickly you get medicine.

  • First episode, no medicine: about 2–4 weeks, about 3 weeks on average.

  • First episode, antiviral within 72 hours: pain eases in 2–3 days and most sores heal within 7–10 days.

  • Recurrence, no medicine: about 5–10 days.

  • Recurrence, medicine started at the warning stage: usually heals in 3–5 days, and sometimes no sore forms at all.

What really helps you heal faster: only one thing has clear evidence, which is to start an oral antiviral as early as possible. Keeping the sores clean and dry, getting enough sleep, and not scratching or picking help prevent a secondary bacterial infection that slows healing. Popular remedies that do not help you heal faster include applying toothpaste, alcohol, or lime juice, which only increase burning and irritation.

Does genital herpes go away on its own, and is it curable?

The sores heal on their own even without medicine, because the immune system controls the virus on the skin within a few weeks. But the virus remains hidden in the nerve cluster. There is currently no medicine or vaccine that removes the virus from the body, so any product claiming to cure herpes permanently has no evidence behind it.

The good news is that for most people, herpes recurs less and less often and more and more mildly over time, especially herpes caused by HSV-1, which many people have only once and then almost never again. And for people who recur often, suppressive medicine lets them live and have relationships normally.

Is genital herpes dangerous? Complications to know about

For a healthy adult, genital herpes is not life-threatening and does not cause infertility. Most of the difficulty is the pain and the emotional impact, but there are complications you should know about.

  • Urinary retention: seen in about 10–15% of women with a first episode, from pain and inflammation of the tailbone nerves. Some people also have constipation.

  • Mild meningitis: severe headache, stiff neck, and sensitivity to light, seen in a first episode. Most people recover fully, but need to be under a doctor's care.

  • Spread to other sites: rubbing the eyes with a hand that touched a sore can cause herpes keratitis of the cornea, or spread to the fingers.

  • Secondary bacterial infection: a sore that becomes swollen, red, and spreading, with throbbing pain and pus.

  • Higher chance of HIV: herpes sores make it easier to catch and pass on HIV.

  • Newborn infection: in women infected for the first time near delivery, as explained above.

Signs that need a doctor right away: being unable to urinate, a severe headache with a stiff neck or drowsiness, a red, painful eye or blurred vision, widespread sores with a high fever, pregnancy with genital sores, or weakened immunity with sores that will not heal.

Preventing spread to your partner, and telling your partner

  • Avoid sex of every kind during symptoms, from the first burning or itching until the sores are completely healed, including oral sex.

  • Use a condom every time, even without symptoms. It lowers the risk of catching HSV-2 by about 30%. It does not protect fully because it does not cover all the skin where the virus can appear.

  • Daily suppressive medicine in the person who carries the virus lowers transmission to the partner by about half again. Using a condom together with suppressive medicine therefore gives the best protection available today.

  • People with cold sores should avoid putting their mouth on a partner's genitals while the mouth sores are present.

  • Tell your partner before you start having sex. It is hard, but it lets your partner decide about protection, and partners who have been together a long time often already carry the same virus without knowing. A blood test for your partner helps show how careful you need to be.

  • There is no approved herpes vaccine for use in people. The shingles vaccine does not protect against herpes.

Quick summary

  • Genital herpes is caused by HSV-2 or HSV-1. It shows as small clear blisters in clusters that break into shallow, burning sores, preceded by warning symptoms, and appearing in the same place again and again.

  • The first episode is the worst and heals in 2–4 weeks. Recurrences are milder, heal in 5–10 days, and space out over time.

  • A painless, single genital sore with a firm edge should make you think of syphilis, which is treated differently.

  • The main treatment is an oral antiviral: acyclovir, valacyclovir, or famciclovir. 7–10 days for a first episode, 1–5 days for a recurrence. Creams are not recommended.

  • For 6 or more recurrences a year, or a partner who is not infected, daily suppressive medicine reduces recurrences by 70–80% and lowers transmission to the partner by about half.

  • What to do right away with a first sore: see a doctor within 72 hours for medicine and a PCR test, and get tested for HIV and syphilis.

Frequently asked questions about genital herpes

How can I tell if it is herpes?

The features that point most strongly to herpes are burning, itching, or tingling 1–2 days beforehand, then clear 1–3 mm blisters in clusters on a red base that break into several painful shallow sores, and, in a recurrence, appearing in the same place or close to it. However, judging by sight alone is often wrong. The most accurate confirmation is a PCR test from a fresh sore within the first 48–72 hours, which also tells you whether it is HSV-1 or HSV-2, and you should be tested for HIV and syphilis at the same time, because some genital sores look similar but are treated differently.

How many days does genital herpes in women take to heal?

For a first episode with no medicine, sores in women usually heal in 2–4 weeks, about 3 weeks on average, and women often have more severe symptoms than men, including very painful urination and fever. If an oral antiviral is started within 72 hours, pain eases in 2–3 days and most sores heal within 7–10 days. Recurrences are much milder and heal in 5–10 days even without medicine, and faster if medicine is started at the warning stage. If the sores have not healed after more than 4 weeks, return to the doctor to look for other causes.

How do I make herpes heal faster?

The only way with clear evidence that herpes heals faster is to start an oral antiviral as early as possible. For a first episode, start within 72 hours. For a recurrence, start at the first burning or itching or within 24 hours of seeing blisters. People who recur often should therefore ask their doctor to prescribe medicine to keep at home. Gently rinsing the sores dry, sitting in warm water, wearing loose cotton underwear, and not picking the crusts help ease pain and prevent secondary infection. Applying toothpaste, alcohol, or medicated balm does not help you heal faster and causes more irritation.

What are the treatments for genital herpes?

There are 3 forms of treatment depending on the situation. The first is treatment of a first episode: acyclovir 400 mg three times a day, or valacyclovir 1 g twice a day, or famciclovir 250 mg three times a day, for 7–10 days. The second is taking medicine only when a recurrence occurs, for 1–5 days, started at the warning stage. The third is daily suppressive medicine for people who recur 6 or more times a year or want to lower the chance of passing it to a partner. Antiviral creams are not recommended because the benefit is small. Doses must be adjusted by a doctor according to kidney function and other health conditions.

Does genital herpes go away on its own?

The sores of herpes heal on their own because the immune system controls the virus on the skin. A first episode takes about 2–4 weeks and a recurrence about 5–10 days. But the virus stays hidden in the nerve cluster near the tailbone, and there is currently no medicine or vaccine that removes it, so it can recur when you are short of sleep, stressed, or ill. The good news is that most people recur less often and more mildly over time, especially with HSV-1. Even though the sores heal on their own, you should see a doctor for a first episode to get medicine and confirm the diagnosis, because medicine helps you heal faster and greatly reduces complications.

Is genital herpes in women dangerous?

For a healthy woman, genital herpes is not life-threatening, does not cause infertility, and is not a cause of cervical cancer. The complications to watch for are urinary retention in a first episode, seen in about 10–15%, and mild meningitis. The most important issue is pregnancy. If infected for the first time in the third trimester, the baby has as high as a 30–50% chance of infection during delivery, while for a woman who had herpes before pregnancy the risk is below 1%. A woman with a history of herpes should therefore tell her obstetrician from the first antenatal visit.

The information in this article is general knowledge to help you decide to see a doctor. It is not a diagnosis or a prescription for any individual. The choice of drug, dose, and duration of treatment must always be assessed by a doctor. If you are pregnant, have kidney disease, or have weakened immunity, tell your doctor before starting medicine.

To read about other skin conditions written by our dermatologists, visit the skin condition article hub.

Written by Dr. Patara Voravutinon, Dermatologist · Last reviewed September 24, 2026

 
 
 

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