Extremely common, entirely manageable, and far less consequential than its reputation.
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Genital herpes is caused by herpes simplex virus — either type 1 or type 2. It is one of the most common sexually transmitted infections in the UK, and the great majority of people who carry it have no idea they do, because most infections cause either no symptoms or symptoms mild enough to be mistaken for thrush, a cut or an ingrown hair.
Two things are worth saying before anything else, because they change how people feel about a diagnosis considerably.
This is far more common than the stigma suggests. A large share of first episodes are now caused by type 1 — the cold sore virus — transmitted through oral sex, frequently from someone with no visible cold sore at the time. Nobody did anything unusual.
Genital herpes does not affect fertility, does not cause cancer, and does not shorten your life. The cancer association people worry about belongs to HPV, which is a different virus entirely. For most people this is a recurring nuisance that becomes less frequent over the years, not a serious illness.
The one situation where it genuinely matters medically is a first episode late in pregnancy, covered properly below.
Usually the worst, and occasionally severe:
A first episode typically lasts two to three weeks.
Milder, shorter and progressively less frequent — typically:
Recurrences usually become less frequent over time. Many people find they stop almost entirely after the first couple of years.
Asymptomatic shedding — the virus is intermittently present on the skin without any sore, and can be passed on then. This is why partners are so often infected without anyone having noticed anything, and why nobody should be blamed for transmission.
Because the virus sheds without symptoms and most carriers are unaware, a new diagnosis says nothing reliable about when or from whom it was acquired — it can lie dormant for years before a first episode. Relationships have been damaged by assumptions that the timing simply does not support.
A swab taken directly from an ulcer or blister, tested by PCR. This is the definitive test, and it must be done while a lesion is present — ideally in the first 48 hours, before it starts healing. Once things have healed, the opportunity has gone until the next episode.
The swab also identifies whether it is type 1 or type 2, which is genuinely useful: type 1 recurs less often, and knowing which you have helps predict what to expect.
Blood tests for herpes antibodies are not routinely recommended in the UK, and it is worth understanding why. They show past exposure to the virus but cannot tell you where on the body it is, cannot tell you when you acquired it, and are positive in a large proportion of the population from childhood oral infection. A positive result in someone with no symptoms generates a great deal of anxiety and almost no useful information.
If a service is offering you a herpes blood test as part of a general screen, that is worth questioning.
NHS sexual health clinics are free, expert in this, and do not require a GP referral. They will swab, type the virus, screen for other infections and offer partner notification support. For a first episode with lesions present, that is genuinely the best route, and we will say so.
Thrush; folliculitis or an ingrown hair; eczema or contact dermatitis; syphilis, which classically causes a painless ulcer; and aphthous ulceration. Painful clustered blisters point to herpes; a single painless ulcer needs syphilis excluded.
Aciclovir or valaciclovir, taken as a short course. Start at the first tingle — as with cold sores, treatment begun during the warning phase can prevent the outbreak developing, while treatment started once ulcers have formed shortens things only modestly.
For anyone with recurrent episodes, we can provide a supply to keep at home so treatment starts within minutes rather than after an appointment. That single arrangement changes the experience of the condition more than anything else.
A daily antiviral taken continuously. Worth considering with six or more recurrences a year, or where outbreaks are severe or badly affecting your life.
It reduces recurrences substantially, and — importantly — reduces the risk of transmitting the virus to a partner, which for many people is the main reason to take it. It is well tolerated and safe long-term. Treatment is usually reviewed after a year, since recurrences often decline naturally in the meantime.
Tell your midwife or obstetrician if you have genital herpes, or if you develop it while pregnant. The distinction is important and frequently misunderstood:
We cannot examine you or take a swab. A first episode with visible lesions is best seen at a sexual health clinic, where it can be swabbed, typed and screened alongside other infections — free, and without a referral. What we can do well is treat recurrences quickly, arrange suppressive treatment, and provide standby supplies.
Seek urgent same-day care if:
Contact your maternity unit rather than us if you are pregnant and: you develop a first episode at any stage, you have an outbreak near your due date, or your waters break with active lesions.
Book a consultation for:
This is often the hardest part, and it is worth approaching practically. Some things that genuinely help:
The emotional impact of a herpes diagnosis is consistently out of proportion to its medical significance, and that is a function of stigma rather than of the condition. It does not affect fertility, does not cause cancer, does not shorten life, and becomes less troublesome over time. If the diagnosis is affecting your mood or your relationships, that is worth raising — it is a common and legitimate reason to seek support.
NHS sexual health clinics are free, expert, confidential and often walk-in, and for genital herpes they are the better service — they can swab lesions, which is what confirms the diagnosis, and they provide ongoing support.
Aciclovir is a very cheap generic and treatment is free on the NHS.
The most valuable thing about herpes is not the prescription — it is accurate information, because the stigma causes more distress than the virus does. Genital herpes is extremely common, most people who carry it have no idea, and it is not a reflection of anyone's behaviour. Many people acquire it from a partner with no symptoms at all.
Two clinical points genuinely change things. First, antiviral treatment works best started within 72 hours of symptoms beginning — so having a supply at home for recurrences is worth more than a prescription obtained on day four. Second, suppressive treatment taken daily is highly effective for frequent recurrences, substantially reduces transmission to a partner, and is under-offered.
Where we will not go: blood tests for herpes are not recommended for routine diagnosis or screening in the UK. They cannot reliably distinguish site of infection, cause considerable anxiety, and BASHH advises against them. We will not arrange one.
Herpes in pregnancy, particularly a first episode in the third trimester, needs urgent obstetric input — that is genuinely time-critical.
BASHH UK national guideline for the management of anogenital herpes is the principal reference. It recommends diagnosis by PCR from a lesion swab, and treatment with oral aciclovir, valaciclovir or famciclovir started as early as possible.
BASHH recommends suppressive antiviral therapy for people with six or more recurrences a year, or for whom recurrences are distressing, and notes it reduces asymptomatic shedding and transmission risk.
BASHH advises against type-specific serological testing for routine screening, given interpretive difficulties and the anxiety generated — the basis for the position above.
BASHH and RCOG joint guidance on genital herpes in pregnancy covers management of first and recurrent episodes, the role of suppressive treatment from 36 weeks, and the indications for caesarean section where a first episode occurs in the third trimester.
BASHH also addresses partner notification and psychological support, recognising the disproportionate distress associated with the diagnosis.
Frequently impossible to say, and this matters for relationships. The virus can lie dormant for years before producing a first episode, and most people who carry it never had recognisable symptoms. A new diagnosis is not evidence about when or from whom it was acquired, and assumptions to the contrary have caused a great deal of unnecessary damage.
Generally no. Herpes antibody blood tests show past exposure but cannot tell you where on the body the virus is, cannot date the infection, and are positive in much of the population from childhood oral infection. They generate anxiety without useful information. The meaningful test is a swab of an actual lesion, taken while it is there.
Yes. Genital herpes does not affect fertility in men or women. What matters is telling your midwife, because the management of a first episode late in pregnancy differs considerably from that of recurrent herpes — which is usually low risk and compatible with a normal vaginal birth.
No. That association belongs to HPV, a completely different virus, and the confusion between the two causes needless fear. Herpes does not cause cervical or any other cancer.
The virus stays, but outbreaks typically become less frequent and milder over time, and many people find they largely stop after the first couple of years. Type 1 genital herpes recurs less often than type 2, which is why typing the virus is worth doing.
Yes — asymptomatic shedding is how most transmission happens, and it is the reason nobody should be blamed. What reduces the risk meaningfully is avoiding sex during outbreaks, using condoms, and taking daily suppressive antiviral treatment, which lowers transmission substantially.
There is no legal requirement. Most people find it easier to be honest, and the conversation is generally less difficult than anticipated once the facts are on the table — it is common, most carriers are unaware, and transmission risk can be considerably reduced. Sexual health clinics can help you think it through.
No. The virus does not survive on surfaces, and it is not transmitted by toilet seats, towels, swimming pools or shared baths. It requires direct skin-to-skin contact.
August 23, 2026
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
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Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
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Usually
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Same day
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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