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Herpes simplex - genital - Management
How should I assess a person with recurrent genital herpes?
- Ask how the diagnosis of genital herpes was confirmed and when this was carried out. Ideally, the person should have seen a specialist in genito-urinary medicine and had a viral culture or polymerase chain reaction (PCR) to identify the herpes simplex virus.
- Ask about symptoms, including ulcers, urethral discharge, and dysuria; discuss whether lesions are still forming, their onset (determine if started within 5 days), and whether the person experiences prodromal sensations (tingling or burning).
- Ask about previous attacks (within the last year), their frequency and severity (usually decreasing with time), and management (self-care and/or antiviral medication).
- Ask whether the person has identified personal trigger factors (e.g. sexual intercourse, sunlight, physical illness, excess alcohol, stress).
- Carry out an external examination of the genitalia and surrounding skin (lesions are usually unilateral and localized to the same area in each attack).
- Determine the person's understanding of genital herpes (prognosis, risk of transmission) and enquire (if appropriate) about the affect on self-esteem, mood, and relationships. See advice on genital herpes.
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