Genital herpes — managing symptoms and flare-ups
Reviewed by the My London Pharmacy clinical team, Zaynab Ali, Pharmacist Independent Prescriber
·29 July 2026
·5 min read
Quick answer
Genital herpes is a common viral infection caused by the herpes simplex virus. It can cause occasional outbreaks of blisters or sores, though many people have few or no symptoms. Antiviral tablets ease flare-ups and can reduce how often they happen, and most people manage the condition comfortably over time.
Understanding genital herpes
Genital herpes is caused by the herpes simplex virus (HSV), which comes in two closely related types, HSV-1 and HSV-2. Both can affect the genital area. HSV-1 is the type traditionally associated with cold sores around the mouth, but it increasingly causes genital infection too, often through oral sex. It is a very common infection, and many people carry the virus without ever realising, because symptoms can be mild, brief or absent.
Once you acquire the virus, it stays in the body and settles in nearby nerve cells, where it remains quietly for much of the time. It can reactivate from time to time, which is what causes an outbreak. This is completely normal and does not mean anything is wrong or that your immune system is failing. Certain things, such as being run down, stress, illness, friction or, for some people, their menstrual cycle, can make reactivation a little more likely.
Understanding how the virus behaves makes it much easier to manage, and most people find that outbreaks become less frequent and less intense as the years pass. A diagnosis of genital herpes is not a reflection of anything you have done wrong; it is simply a very common virus that a great many people live with comfortably.
What an outbreak feels like
A first episode is often the most noticeable. It may bring small blisters around the genitals, anus or thighs that burst to leave tender sores, along with itching, tingling, pain when passing urine, and sometimes flu-like feelings such as aches and a raised temperature.
Later outbreaks are usually milder and shorter. Many people notice a warning tingle or itch in the same area a day or two before sores appear, known as a prodrome. Recognising this early sign can help you start treatment promptly and manage the flare-up more comfortably.
How it is diagnosed
Genital herpes is usually diagnosed by a clinician examining the affected area and taking a swab from a blister or sore while symptoms are present. The swab confirms the virus and identifies which type it is, which can be helpful for understanding the likely pattern of future outbreaks.
A discreet consultation is the best first step if you notice sores or unusual discomfort. Testing is most accurate during an active outbreak, so it is worth seeking advice promptly rather than waiting for symptoms to settle.
Treating flare-ups
There is no treatment that removes the virus from the body, but antiviral medicines are very effective at controlling symptoms. They work by slowing the virus's ability to multiply, which shortens the outbreak and eases discomfort. Starting them early, ideally within the first day or two, or at the first warning tingle, gives the greatest benefit.
The most commonly used option is Aciclovir Tablets, typically taken several times a day for around five days. Valaciclovir 500mg Tablets is a related medicine that the body converts into aciclovir and is taken less often each day, which some people find more convenient. Famciclovir is a further alternative that works in a similar way. A clinician can advise which is most suitable based on your symptoms, how often outbreaks occur, and any other medicines you take.
Simple self-care also helps a flare-up settle. Keeping the area clean and dry, wearing loose cotton underwear, using plain water or a saltwater rinse to bathe the area, and taking ordinary pain relief such as paracetamol can all ease discomfort. Applying a little petroleum jelly can make passing urine less painful when sores are present, and some people find that passing urine while sitting in a warm bath helps.
Managing frequent outbreaks
Most people have only occasional flare-ups, but some experience them more often. If outbreaks are frequent or particularly disruptive, a clinician may suggest suppressive treatment, where a lower dose of an antiviral is taken every day over several months.
Suppressive treatment can greatly reduce how often outbreaks happen and can also lower the chance of passing the virus to a partner. It is usually reviewed periodically to see whether it is still needed, as outbreak patterns often ease naturally with time.
Herpes, relationships and partners
Being told you have genital herpes can feel worrying, but it is a manageable condition shared by a great many people. The virus is most likely to be passed on during an outbreak, so avoiding sexual contact when you have symptoms, from the first tingle until sores have fully healed, is an important step.
Using condoms and considering daily antiviral treatment can further reduce the risk between partners, though they do not remove it entirely because the virus can occasionally be present without symptoms. Honest conversation with a partner, at your own pace, is often reassuring, and a clinician can help you think through what to share.
Herpes and pregnancy
If you have genital herpes and are pregnant or planning a pregnancy, it is worth mentioning to your midwife or clinician, as there are simple steps to protect the baby. The main consideration is a first outbreak occurring for the first time late in pregnancy, which is managed with extra care because the virus is more likely to be passed on when the body has not yet built up antibodies.
For most people with established herpes from before pregnancy, the outlook is very reassuring and pregnancy is straightforward. Antiviral treatment towards the end of pregnancy may be recommended to reduce the chance of an outbreak around the time of birth, and a vaginal birth is usually possible when there is no active outbreak at the time. Personalised advice from your maternity team is the best guide here, and raising it early gives everyone time to plan calmly.
Whatever your situation, genital herpes is a manageable, common condition, and support is always available. A discreet, non-judgemental conversation with a clinician can help you understand your own pattern of outbreaks and the options that suit you best.
Frequently asked questions
Is genital herpes a lifelong condition?
The virus stays in the body permanently, but outbreaks tend to become milder and less frequent over time, and antiviral treatment manages symptoms effectively when they occur.
Can I pass herpes on when I have no symptoms?
It is possible, as the virus can occasionally be present without visible signs. Using condoms and, where advised, daily antiviral treatment reduces this risk.
How quickly should I start treatment?
Antivirals work best when started within the first day or two of an outbreak, so beginning at the first tingling or itching gives the greatest benefit.
Will herpes affect my sex life?
Most people continue to have healthy relationships. Avoiding sex during outbreaks and talking openly with partners, with support from a clinician, helps you manage it confidently.
Do I need to see someone in person?
A clinician can often assess your history and symptoms through a discreet online consultation and, where suitable, arrange antiviral treatment, though an examination and swab may be advised for a first outbreak.