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Genital Herpes

A very common, lifelong skin infection caused by the herpes simplex virus. Most people have no symptoms or mild ones. There is no cure, but antiviral medicine controls outbreaks and lowers the chance of passing it on — and a newborn who seems unwell needs care right away.

What is genital herpes?

Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus (HSV) (MedlinePlus). It is lifelong, but it can be treated and managed, and outbreaks often become less frequent over time (CDC). Having it says nothing about your worth as a person — and, as the numbers below show, it is very common.

For sores on or around the mouth, see our Cold Sores guide.

How common is it?

A U.S. national survey found antibodies to HSV-2 in 11.9% of people aged 14 to 49 in 2015–2016 — more often in women than men (15.9% vs 8.2%, adjusted for age) — down from 18.0% in 1999–2000 (age-adjusted) (CDC National Center for Health Statistics). CDC estimates there were 572,000 new genital herpes infections among people aged 14 to 49 in the U.S. in 2018 (CDC). Worldwide, about 520 million people aged 15 to 49 (13%) have HSV-2 (WHO).

How does it spread?

Through vaginal, anal or oral sex — contact with a herpes sore, genital skin or fluids, or, for HSV-1, the saliva or mouth area of a partner with oral herpes (CDC). Shared sex toys can also pass it on (NHS).

Symptoms and outbreaks

Most people have no symptoms or mild ones mistaken for a pimple or ingrown hair, so most don’t know they have herpes (CDC). When symptoms appear, they may include tingling, itching or burning before sores form (WHO); blisters on or around the genitals, rectum or mouth that break into painful sores and may take a week or more to heal (CDC), sometimes on the buttocks or thighs (MedlinePlus); pain when peeing or unusual discharge (NHS); and, with a first outbreak, fever, body aches or swollen glands (CDC).

Symptoms may not appear for weeks or even years after infection. The virus stays in a nearby nerve and can flare in the same area (NHS). Repeat outbreaks are common in the first year, but they tend to become milder and less frequent (MedlinePlus), and some people never have another (NHS). See a provider about any unusual sore, discharge or burning when you pee (CDC); these can have other causes too. For women, see also our Female Problems guide.

Testing

Find confidential, free or low-cost testing with CDC’s GetTested.

Lowering the chance of passing it on

Herpes and HIV

Herpes sores give HIV a way into the body, and even without sores herpes increases the immune cells in the genital lining that HIV targets (CDC). HSV-2 raises the risk of getting HIV about two- to three-fold (CDC STI Treatment Guidelines, WHO), and people with both are more likely to pass HIV on (WHO). Everyone with genital herpes should be tested for HIV (CDC STI Treatment Guidelines). Herpes testing or treatment doesn’t lower HIV risk (CDC). See our HIV & AIDS guide for testing and PrEP.

Eyes, and shingles

Touching sores can carry the virus to the eyes, so don’t touch them, and wash your hands right away if you do (CDC). Herpes eye infection is rare and is treated with antiviral medicine prescribed by a doctor (WHO, CDC); see our Eyes and Cold Sores guides. Shingles (herpes zoster) is a different virus: the chickenpox virus waking up again (CDC). MBHA plans a separate Shingles guide.

Get medical care right away if:

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Swab testing of sores; prescription antivirals (acyclovir, valacyclovir, famciclovir) taken for each outbreak or every day as suppressive therapy; late-pregnancy antivirals and a C-section if sores are present at delivery. Cost estimate being researched (antivirals, visits and tests). Free or low-cost STI testing is available at many clinics. Antivirals shorten and ease outbreaks, and daily therapy cuts recurrences by 70–80% in people with frequent outbreaks and lowers the chance of passing HSV-2 to a partner. There is no cure.
Chiropractic No role in treating herpes, which is a viral infection. Not applicable. Spinal care does not act on the herpes virus. Rely on medical care for outbreaks and prevention.
Acupuncture No established role. We found little research on acupuncture for genital herpes. Cost estimate being researched. No good evidence it prevents or shortens outbreaks. Never place needles on or near sores.
Herbal medicine Propolis ointment, topical zinc, lemon balm and lysine supplements have been tried. None cures herpes or replaces antiviral medicine. Cost estimate being researched. Small, older studies of propolis and topical zinc look promising but are weak; lemon balm is studied mainly in cold sores; evidence for lysine is mixed and weak. Check interactions and allergies first.
Massage therapy No role in treating herpes. If you have massage for other reasons, keep well away from any sores. Cost estimate being researched. Does not affect the virus. Avoid any contact with sores; reschedule during an outbreak in the area to be massaged.
MBHA Wellness Coach Learning your triggers, sleep and stress care, condoms and dental dams, preparing to talk with partners, and support for stigma, anxiety and low mood. Cost estimate being researched. Helps you feel more in control, may mean fewer outbreaks from avoidable triggers, and supports safer, more confident relationships — alongside, never instead of, medical care.

Approach 1 of 6

Conventional medicine (AMA)

There is no cure, but medicine can prevent or shorten outbreaks and make it less likely you pass herpes on (CDC). We don’t list doses — your clinician will choose the medicine and schedule for you.

1. The antiviral medicines

Three antivirals are approved for genital herpes: acyclovir, valacyclovir and famciclovir. Antiviral creams offer little benefit for genital herpes and are discouraged. The tablets control symptoms but don’t clear the virus or change how often outbreaks happen after you stop them; allergic and other reactions are rare (CDC STI Treatment Guidelines). They don’t cure herpes (MedlinePlus). Everyone with a first episode should get antiviral treatment, because a new infection can cause a long, painful illness (CDC STI Treatment Guidelines).

2. Episodic or suppressive therapy?

  • Episodic: a short course at the first sign of each outbreak. It works best started during the warning tingle or within a day of sores appearing, so providers often give a prescription to keep on hand (CDC STI Treatment Guidelines). It may shorten an outbreak by a day or two (NHS).
  • Suppressive: an antiviral every day. It cuts recurrences by 70–80% in people with frequent outbreaks; many report none at all. Long-term safety is well documented, and quality of life improves for many people. Because outbreaks lessen over time, review it with your provider each year (CDC STI Treatment Guidelines). For genital HSV-1, daily therapy is usually kept for frequent outbreaks, and it can be considered for anyone in real distress about the diagnosis (CDC STI Treatment Guidelines).

3. Protecting partners

Where one partner has a history of genital HSV-2, daily valacyclovir lowered transmission, and CDC encourages such couples to consider suppressive therapy alongside condoms and avoiding sex during outbreaks. Limits: it hasn’t been studied in people whose HSV-2 was found only by a blood test, or for genital HSV-1, and in people with HIV it did not reduce transmission of HSV-2 or HIV. A partner without herpes should not take antivirals to try to prevent it (CDC STI Treatment Guidelines). Spread is still possible on treatment (MedlinePlus).

4. In pregnancy

Acyclovir is believed safe in pregnancy and breastfeeding. For recurrent genital herpes, daily antivirals from 36 weeks reduce outbreaks at term and the need for a cesarean, though they may not prevent every newborn infection. People with herpes sores at the start of labor should have a cesarean, which lowers but doesn’t remove the baby’s risk (CDC STI Treatment Guidelines). See Herpes and pregnancy.

5. Easing an outbreak

Keep the area clean with plain or salt water, use a wrapped ice pack (never ice straight on skin), and avoid tight clothing (NHS). A warm bath without soap, loose clothes and over-the-counter pain relievers can help (WHO). Petroleum jelly, or pouring water over the area while you pee, can ease painful peeing (NHS). Wash your hands after touching sores (CDC).

Who to see

Your primary care provider or a sexual health clinic (NHS). Sores that keep returning despite treatment may be drug-resistant and are managed with an infectious disease specialist (CDC STI Treatment Guidelines).

What it costs

Antivirals, visits and tests: cost estimate being researched. For free or low-cost testing, search CDC’s GetTested.

How well it works — what to expect

Expect shorter, milder outbreaks with treatment, fewer outbreaks with daily therapy for many people, and a lower risk to partners. Antivirals control herpes; they don’t cure it. It is manageable with medicine (CDC).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has no role in treating genital herpes, which is a viral infection. Spinal care does not act on the virus, and we found little research on chiropractic for herpes. For outbreaks and protecting partners, see Conventional medicine.

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

We found little research on acupuncture for genital herpes, and nothing showing it prevents or shortens outbreaks. It should never replace antiviral medicine.

What it costs

Cost estimate being researched.

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Read this first. No herb or supplement cures herpes or replaces antiviral medicine; online herpes “cures” made from natural products are unproven (narrative review, Viruses). If you are pregnant, have a weakened immune system or a first outbreak, see a clinician rather than self-treating. We don’t list strengths or doses.

Propolis

Propolis is a resin-like material made by bees (narrative review, Viruses). In a 2000 study of 90 people with recurrent genital HSV-2, more people using propolis ointment had healed by day 10 (24 of 30) than with acyclovir ointment (14 of 30) or a dummy ointment (12 of 30); the study was small and only single-blind (trial, Phytomedicine). A 2026 analysis of 7 studies of lip and genital herpes found propolis and/or honey healed faster than acyclovir cream (meta-analysis, International Journal of STD and AIDS), but another review called the evidence inconclusive because of low quality and small samples (systematic review, Evidence-Based Complementary and Alternative Medicine). The head-to-head comparisons were with acyclovir cream or ointment, which CDC discourages for genital herpes in favor of tablets (CDC STI Treatment Guidelines). Propolis is a known contact allergen; people allergic to bee stings, honey, ragweed or chrysanthemums should not use it (Memorial Sloan Kettering).

Topical zinc

In one small 2013 study in India, fewer people who applied zinc sulfate solutions had a recurrence over 6 months than in a 10-person water group, with no serious side effects. Herpes was diagnosed with a smear test (study, Indian Journal of Sexually Transmitted Diseases and AIDS) that CDC says should not be relied on (CDC STI Treatment Guidelines). That is too little to go on.

Lemon balm (Melissa)

Lemon balm extract blocked HSV-2 in cell studies, and its human trials have been in cold sores (narrative review, Viruses). We found little research on it for genital herpes, though it is a popular self-help choice among UK support group members (survey, International Journal of STD and AIDS). See our Cold Sores guide for the trials.

Lysine

The evidence for this amino acid supplement is mixed and weak. A 1985 trial was titled “Failure of lysine in frequently recurrent herpes simplex infection” (trial, Archives of Dermatology). A 2017 review found it ineffective at lower intakes, with only better self-reported experience at higher ones; it called for longer controlled studies and warned people with heart or gallbladder disease of theoretical risks (review, Integrative Medicine). A more hopeful 2023 review has an author who works with a biotech company (narrative review, Viruses).

Interactions

Tell your doctor and pharmacist about every herb or supplement you use, because some interact with medicines (NCCIH). Use them alongside your antiviral plan, never instead of it.

What it costs

Cost estimate being researched.

Approach 5 of 6

Massage therapy

Massage has no role in treating herpes; it doesn’t affect the virus. If you enjoy massage for relaxation, the risk of harm from massage generally appears low (NCCIH).

MBHA caution: avoid any contact with sores. During an outbreak in or near an area to be massaged, reschedule; therapists should not work over blisters or broken skin. Herpes isn’t spread by towels or bedding, but it does spread through contact with a sore (CDC).

What it costs

Cost estimate being researched.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you live comfortably and confidently with herpes, alongside — never instead of — your doctor or clinic.

Learn your triggers

Things that can set off outbreaks include friction from sex or tight clothing (lubricant may help), sun or sunbeds on the area, smoking, alcohol, being unwell, stress, your period, and surgery in the area (NHS), as well as fever and injury (WHO). Some can’t be avoided (NHS). A simple diary of what came before each outbreak helps you and your provider choose between episodic and daily treatment.

Sleep and stress

Most adults need 7 or more hours of sleep; enough sleep helps you get sick less often and ease stress. Regular sleep times, a cool, quiet room and no screens before bed help (CDC). A review of prospective studies found suggestive evidence that chronic stress or depression comes before more frequent outbreaks, and recommended combining medicine with psychological support (review, International Journal of STD and AIDS). Your coach can help you build a stress routine you’ll keep.

Condoms and dental dams

Use a new condom for the whole of every act of vaginal, anal or oral sex (CDC), and a new latex or polyurethane dental dam each time for oral sex on the vagina or anus, with water- or silicone-based lubricant, never oil-based products (CDC). Neither removes the risk completely (MedlinePlus).

Stigma and mental health

Genital herpes can be stigmatizing and affect relationships (WHO). A review of 30 studies found people may feel depression, anxiety, isolation, stigma and lower self-esteem, and that counseling, psychosocial support and treatment helped some of these, though which approach works best is still unclear (systematic review, JBI Evidence Synthesis). One review describes a cycle in which distress and frequent outbreaks feed each other (review, Journal of Health Psychology). If worry or low mood weighs on you, tell your provider, and see our Anxiety and Depression guides.

Support

CDC points people with herpes and their partners to the American Sexual Health Association (CDC STI Treatment Guidelines): ashasexualhealth.org. Support groups can ease the stigma many people feel (survey, International Journal of STD and AIDS).

Another approach

Herpes and pregnancy

People who had genital herpes before pregnancy can usually expect a healthy baby (NHS). What matters most is that your prenatal care team knows, and avoiding a new infection late in pregnancy. MBHA plans a separate Pregnancy guide.

Neonatal herpes

Herpes passes to a baby most often during delivery and can be deadly in a newborn (CDC). Many mothers of affected babies never knew they had herpes (CDC STI Treatment Guidelines). After birth, a baby can catch it from a cold sore kiss or a herpes blister on a breast or finger; everyone should wash their hands before handling the baby, and anyone with a sore should not kiss the baby (NHS). Watch for the warning signs at the top of this page.

Another approach

Talking with partners

CDC encourages telling current partners, and telling new partners before a sexual relationship begins (CDC STI Treatment Guidelines). Disclosure is often stressful (systematic review, JBI Evidence Synthesis), but it often goes better than people fear: in a UK support group survey, 83% of members who told a partner were not rejected (survey, International Journal of STD and AIDS).

An MBHA Wellness Coach can help you rehearse the conversation.

Member stories

Living with Genital Herpes? Share your experience

Real experiences help others choose. Tell us what you tried — conventional medicine, chiropractic, acupuncture, herbs, massage or coaching — what it cost and what changed.

No stories have been published for this condition yet. Yours could be the first.

Which approaches have you tried?

What did you try, what did it cost, and what changed for you? Please leave out anything you’d rather keep private.

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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