Recurrent herpes outbreaks: causes and prevention

Once you get genital herpes, you have it for life. After the initial infection, symptoms go away but the virus remains dormant in your nervous system. In the future, it can reactivate and cause another outbreak. These recurrences are not new infections – they’re another flare-up of the same virus you first caught.

You may experience herpes outbreaks years after first contracting the virus. While some people have no further outbreaks, others may have a few, or even many in the following years. For most people, recurrent outbreaks become less severe and shorter in duration over time. Eventually, outbreaks may stop altogether.

You can spread herpes even without sores

Once you’ve caught herpes, you can transmit the virus to others even when you do not have visible sores or blisters (known as asymptomatic shedding) although the risk is quite low.

Because the virus can be transmitted even when no symptoms are present, it’s important to take appropriate precautions during sexual activity, such as using condoms and letting new partners know about the issue.

Daily antiviral tablets (suppressive therapy) can also reduce the chance of passing the virus on, but they do not remove the risk completely.

If you have had multiple genital herpes outbreaks and you are finding the symptoms painful or uncomfortable, you may be able to take treatment to help manage symptoms. This may also reduce how often outbreaks occur.

There are 3 antiviral medicines available to treat genital herpes: aciclovir, Valaciclovir and famciclovir.

To treat a genital herpes outbreak, these antiviral medicines are usually taken for between 1 and 5 days.

If you’ve had 6 or more genital herpes outbreaks in a year, you may be able to take antiviral medication for a longer time to help prevent future outbreaks – which is known as suppressive therapy. Fill in the Asda Online Doctor questionnaire and one of our doctors will advise if this is suitable for you.

Common triggers of herpes outbreaks

You may be able to recognise things that trigger an outbreak of genital herpes. Factors thought to be possible triggers of genital herpes outbreaks include:

• stress
• illness
• sex
• surgery
• hormonal changes, for example menstruation (having a period)
• sunlight or using sunbeds (UV light)
• having a weakened immune system (due to illness or medication)
• smoking
• drinking alcohol
• wearing tight clothing or non breathable fabrics, such as nylon

Not everyone has obvious triggers, and sometimes outbreaks may happen for no obvious reason. But it can still be helpful to notice patterns in your own outbreaks.

What is suppressive therapy?

Suppressive therapy is when you take antiviral medication every day to reduce how often genital herpes outbreaks happen. Instead of treating each episode as it appears, the medicine works continuously to keep the herpes simplex virus (HSV) under control.

Suppressive therapy has been shown to be effective. Research shows that taking daily antiviral medication can significantly reduce the number of symptomatic outbreaks.

A doctor may recommend suppressive therapy if you have frequent outbreaks (more than six a year), or if your outbreaks are severe or difficult to manage. If you think suppressive therapy might help you, speak to your GP or a sexual health clinic for personalised advice.

Simple self-care steps can make recurrent herpes outbreaks easier to cope with and may help sores heal. Ways to manage a recurring outbreak include:

• keeping the area clean by gently washing ulcers or blisters with warm salty water to help prevent infection
• soothing discomfort by applying a thin layer of petroleum jelly to any ulcers
• avoiding tight clothing to reduce irritation and allow the area to stay dry
• using pain relief if needed, such as paracetamol or ibuprofen
• applying an ice pack or cool compress wrapped in a clean cloth to ease pain and swelling
• avoiding touching sores, and wash your hands if you do, to prevent irritation, infection or spreading the virus to other areas of skin
• avoiding sex until sores have completely healed, as genital herpes is more easily passed on during an outbreak

Take medication for herpes outbreaks

Antiviral medication can help shorten an outbreak, ease symptoms, and sometimes prevent sores from fully developing. These medicines slow down the herpes simplex virus when it becomes active, so your body can clear the outbreak more quickly.

Asda Online Doctor offers three antiviral medications for genital herpes:

• aciclovir
• valaciclovir
• famciclovir

These antiviral medications are usually taken as tablets. They work best when you start them as soon as you notice symptoms, such as tingling, itching, or the first sign of blisters. A typical course lasts a few days, depending on which medicine you are prescribed and whether it is for a first outbreak or a recurrent one.

See a doctor the first time you experience symptoms of genital herpes, so the diagnosis can be confirmed and the right treatment offered.

For recurring outbreaks, speak with a doctor if your outbreaks are particularly painful or severe or they do not improve following treatment, you have more than 6 outbreaks in a year, or if you are pregnant and develop symptoms.

A first herpes outbreak typically lasts 2 to 4 weeks, though this can vary depending on factors such as your overall health, immune system and any treatment you may be receiving. During this time, symptoms such as blisters, ulcers, and flu-like symptoms may occur.

After your first genital herpes infection, recurrent outbreaks generally last 7 to 10 days. However, the duration and severity of these outbreaks can differ from person to person.

How often herpes outbreaks occur can vary significantly from person to person and the type of herpes you have (HSV-1 or HSV-2). This is influenced by factors such as individual health, stress levels, illness or fatigue.

Research suggests that about 89% of people with HSV‑2 experience at least one recurrence within the first year after infection. Many have multiple outbreaks: around 38% have six or more recurrences, and 20% have more than ten during that period. On average, patients experience roughly one recurrence every three months, with men tending to have slightly more frequent recurrences than women.

Over time, the frequency of outbreaks generally decreases for HSV-1 and HSV-2, although this can vary from person to person.