Of all sexually transmitted infections, herpes is among the most feared.

Once contracted, the virus remains in the body and can lie dormant in nerve cells for months, years or even decades before becoming active. Some people experience tingling, itching or burning before small, painful blisters appear around the genitals, anus, thighs or bottom.

There is no cure for herpes, although antiviral medication can ease symptoms and shorten outbreaks. Recurrences can appear without warning, but common triggers include stress, illness, hormonal changes and friction around the affected area.

The latest figures from the UK Health Security Agency reveal that genital herpes diagnoses are rising in England, despite an overall fall in newly diagnosed STIs.

In 2025, 28,779 people were diagnosed with a first episode of genital herpes, an increase of just over three per cent compared with 2024.

However, the true number of infections is likely to be considerably higher, as many people have no symptoms and may not realise they carry the virus.

Genital herpes can be passed on through vaginal, anal and oral sex, including when an infected person has no visible sores. It can also be caused when the virus responsible for cold sores is transferred from the mouth to the genitals during oral sex.

Sarah Mulindwa, a practicing senior sexual health nurse, tells the Daily Mail that it's this asymptomatic nature of genital herpes that is partly responsible for its spread.

'Many people don't develop symptoms straight away following contact, and some may never develop noticeable symptoms at all,' she says. 

'Herpes can remain dormant in the body for months or even years before causing an outbreak, which means people often have no idea when or where they first acquired the virus.

'Viral shedding is when the herpes virus is active on the skin and can be passed to someone else, even though there are no visible symptoms.

'This is known as "asymptomatic shedding" and is one of the reasons herpes is so common, as many people pass it on without realising they have it.

'Shedding happens more often during the first year after infection and gradually becomes less frequent over time.

'If someone does develop symptoms after catching herpes, they usually appear between two and 12 days after exposure, with the average being around four to six days.' 

Distressingly for people infected, the first outbreak is usually the most severe - and can last between two and four weeks.

'When symptoms do occur, they may include painful blisters or ulcers around the genitals, anus or mouth, tingling or itching before sores appear, pain when passing urine, swollen glands and flu-like symptoms such as fever, headache and muscle aches during the first outbreak,' says Ms Mulindwa.

'Future outbreaks are typically much milder and often clear within seven to 10 days, especially if antiviral treatment is started early. 

However, not everyone will have multiple outbreaks. 

'There is no set pattern,' says Ms Mulindwa, who is also a sexual health expert at Lovehoney. 'Some people have one outbreak and never experience another, while others may have several each year.

'For some women, hormonal fluctuations around menstruation can trigger outbreaks, and some women also notice changes during perimenopause or menopause, although research is still limited.

'Stress, poor sleep, illness and friction during sex are also common triggers - for both men and women.

'It's important to remember that the impact of herpes isn't only physical. Many people experience anxiety or embarrassment after diagnosis because of the stigma surrounding herpes, despite it being an extremely common infection.' 

With that in mind, Ms Mulindwa answers some of the most commonly asked questions about genital herpes - and busts some damaging myths. 

How is herpes tested and diagnosed?

'If sores or blisters are present, the best test is a PCR swab taken directly from the affected area. This can confirm herpes and identify whether it is HSV-1 or HSV-2.

'Generally, HSV-2, which more commonly causes genital herpes, tends to recur more frequently than HSV-1, which is increasingly being passed to the genitals through oral sex. 

'Blood tests can detect antibodies to the virus, but they are not routinely used in UK sexual health clinics because they cannot reliably tell when or where the infection was acquired.' 

Can certain food or drinks trigger outbreaks or reduce them?

'There is very little strong evidence that specific foods directly cause outbreaks.

'Some people feel that alcohol, stress or foods such as chocolate or nuts can act as personal triggers, but this varies from person to person. Maintaining a healthy lifestyle, getting enough sleep and managing stress are likely to be more important than avoiding particular foods!.

'Some people choose to take lysine supplements, although the scientific evidence for their effectiveness remains mixed.'

What medications can help with herpes? 

'Antiviral medications such as aciclovir, valaciclovir and famciclovir can shorten outbreaks, reduce symptoms and lower the risk of passing the virus to a partner.

'For people with frequent recurrences, taking antiviral medication every day can significantly reduce both outbreaks and viral shedding.'

What are some scare stories about herpes people should ignore?

'One of the biggest myths is that herpes is rare or that only people with multiple sexual partners get it - in reality, it is one of the most common viral sexually transmitted infections

'Other myths include that you'll always know if you have it, you can only pass it on when you have visible sores and you can't have a normal relationship or sex life.

'None of these are true. Many people never develop symptoms, the virus can be spread even when there are no visible sores, and most people with herpes go on to have healthy relationships and families.'

How does herpes affect women compared with men?

'Women are biologically more likely to acquire genital herpes during vaginal sex because the genital lining provides a larger area for the virus to enter the body.

'In women, outbreaks may occur on the vulva, around the vagina, on the cervix, buttocks or around the anus.

'In men, sores most commonly appear on the penis, scrotum, buttocks or around the anus.'

What is the risk for pregnant women and herpes - if a baby is born during an outbreak can it become infected/unwell?

'Most women with herpes have completely healthy pregnancies and babies!

'The main concern is when someone catches herpes for the first time during the final few months of pregnancy, because they have not yet developed protective antibodies that can be passed to the baby.

'If active genital sores or early symptoms are present during labour, a caesarean section may be recommended to reduce the risk of transmission.

'Neonatal herpes is rare in the UK but can be very serious, which is why it's important for anyone with a history of herpes to tell their midwife or obstetric team early in pregnancy.'