Genital Herpes ICD-10: A60.0

Sexually transmitted infection / Viral skin condition

Often searched as: genital sores, blisters on genitals, painful ulcers down there, STI with blisters, cold sore on genitals, herpes symptoms, herpes outbreak, genital herpes treatment…

Clinical urgency level

lowmediumhigh

Systems Affected

skingenital mucosaperipheral nervous systemneonatal (in pregnancy complications)

Severity Levels

mild

Recurrent episodes with few small blisters or ulcers, mild discomfort, resolving within 5–10 days — managed with episodic antiviral therapy.

moderate

Frequent recurrences (6+ per year), significant pain, emotional impact, or risk of transmission to partner — benefits from daily suppressive antiviral therapy.

severe

Primary genital herpes with widespread painful ulcers, urinary retention, fever and systemic symptoms; or neonatal herpes in pregnancy; or disseminated HSV in immunocompromised — requires urgent hospitalization.

Red Flags

First outbreak with widespread painful genital ulcers, fever, or difficulty urinating
Genital herpes diagnosed late in pregnancy (third trimester) — neonatal transmission risk
Disseminated herpes in an immunocompromised person (spreading blisters beyond genitals)
Herpes encephalitis symptoms: severe headache, confusion, neck stiffness alongside genital outbreak
Urinary retention from severe genital lesions — requires urgent care
New genital ulcer that doesn't look like typical herpes — rule out syphilis or other STIs

Clinical Presentation

Genital herpes — grouped vesicles and ulcers (clinical reference)

View gallery on DermNet NZ (image gallery reference)

HSV-2 ulceration pattern — educational clinical image

Source: Wikimedia Commons (CC BY-SA 3.0 )

When to See a Doctor

See a doctor for any first-time genital sore, blister, or ulcer — even if mild. A prompt diagnosis allows antiviral treatment that reduces severity and duration. If you're pregnant and have or suspect genital herpes, inform your OB immediately. Partner notification and regular STI screening are important parts of management.

Differential Diagnosis

Syphilis (painless primary chancre — vs painful herpes ulcers)
Chancroid (painful ulcer — Haemophilus ducreyi)
Lymphogranuloma venereum
Contact dermatitis (genital — from condoms, products)
Fixed drug eruption
Behcet's disease (recurrent oral and genital ulcers)
Erosive lichen planus (genital)

Comorbidities

HIV (HSV-2 significantly increases HIV acquisition and transmission risk)
Other STIs (co-infection common — always screen broadly)
Depression and anxiety (significant psychological burden of chronic STI diagnosis)
Neonatal herpes (life-threatening complication in newborns of infected mothers)
Aseptic meningitis (rare complication of primary HSV-2 infection)

Prognosis

Genital herpes is a lifelong infection — the virus cannot be eliminated from the body. However, recurrences typically become less frequent and severe over time. Daily suppressive therapy with valacyclovir or acyclovir reduces recurrence by 70–80% and significantly lowers transmission risk to partners. Most people with genital herpes live normal lives with minimal impact once they understand and manage their condition. The main psychological burden — stigma and disclosure — is often harder than the physical symptoms.

Detailed Overview

Causes, Symptoms, and When to Take Action Genital herpes is one of the most common sexually transmitted infections worldwide. It is caused by herpes simplex virus (HSV), usually HSV-1 or HSV-2, and leads to recurring genital lesions and potential complications. How It Looks Texture: Ulcers, vesicles or blisters, often preceded by tingling or burning (prodromal symptoms) Color: Red or inflamed base with clear or fluid-filled vesicles Shape: Clusters of small blisters that may ulcerate or crust over Location: Genital area; may also involve nearby skin, perianal region, or mucous membranes Why Does It Appear? Primary infection occurs when HSV enters through skin or mucous membranes during contact. After the first episode, the virus remains latent in nerve ganglia and can reactivate, causing recurrent outbreaks. Triggers for recurrence include stress, menstruation, other illnesses, immunosuppression, and possibly friction or trauma of genital skin. Should You Be Concerned? Yes, for several reasons: The first episode tends to be more severe and may include systemic symptoms like fever or painful urination. Recurrent episodes, although often less severe, can impact quality of life. In pregnancy, there is risk to the newborn, especially if the mother acquires genital herpes late in pregnancy. Possible complications include painful urination, psychological distress, and risk of transmission to partners or infants. Can You Prevent It? While HSV infection cannot be completely prevented after exposure, measures may reduce outbreaks and transmission: Avoid contact with active lesions, especially during prodromal phase Use protective practices with partners Inform sexual partners and consider precaution during pregnancy Monitor for early symptoms to minimize severity 👉 How Piel AI Can Help Piel AI supports tracking of outbreak frequency, lesion appearance, and healing by capturing images over time. While not diagnostic, this helps you notice patterns, detect changes earlier, and share info with healthcare providers. Summary Genital herpes is a recurring viral infection caused by HSV-1 or HSV-2. It presents with blisters/ulcers, often painful, with possibility of prodrome. Recurrent outbreaks can affect quality of life; risk elevated during pregnancy for newborn. Preventive awareness, early detection, and communication are key.

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