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Herpes simplex - genital - Management
Basis for recommendation
CKS identified no national guidelines for assessing genital herpes in primary care. These recommendations are based on expert opinion [Sen and Barton, 2007], pragmatism, and good clinical practice.
- A thorough history and clinical examination is important to exclude other diagnoses in addition to genital herpes.
- Asking about the onset of symptoms and the use of self-care measures will help determine whether antiviral drugs should be used for treating this episode. Determining the frequency and severity of attacks will guide how future attacks need to be managed (episodic or suppressive treatment). See treatment of recurrent genital herpes.
- CKS could not identify any observational studies on trigger factors causing recurrences of genital herpes. However, if the person recognizes personal triggers, then it is pragmatic to avoid these in the future.
- Observational studies have shown that psychosocial morbidity can be more debilitating than the physical features of genital herpes [Mark et al, 2003]. Depression, fear of rejection, and feelings of isolation are commonly reported [Remington, 2004].
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