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What Is Anal Herpes?

Anal herpes is an infection of the herpes simplex virus (HSV) that occurs in or around the anus. It is spread through anal sex and can cause painful sores to develop. Although there is no cure for anal herpes, there are treatments available which may help to alleviate symptoms and reduce the frequency of breakouts. Using condoms during sex and avoiding sex during herpes outbreaks can help to reduce the risk of transmission.

Types of Herpes

Herpes is an infection that can result when someone is exposed to the herpes simplex virus (HSV). One type of herpes, called HSV-1, usually causes oral herpes. This type of herpes infection occurs in the mouth and leads to the development of cold sores. Although less common, genital herpes may be caused by HSV-1.

There’s a second type of herpes, HSV-2, which typically causes genital herpes. It affects the area on or around the genitals or anus. In general, anal herpes is considered to be a type of genital herpes. Oral herpes may be caused by HSV-2, though this is less common.

How Does Anal Herpes Spread?

Anal herpes can spread in a few ways:

  • Receiving anal sex from someone who has genital herpes.
  • Receiving oral-anal sex (mouth-to-anus contact) from someone who has oral herpes.
  • Coming into direct contact with sores.
  • Virus spreading from one part of the body to another (like herpes on the genitals spreading to the anal area).

Sexual contact is the most common way for anal herpes to spread. While it’s more likely to be transmitted when direct contact with sores occurs, herpes can also be spread when no sores are present.

Anal Herpes Symptoms

When someone first gets anal herpes, symptoms usually appear with two to 10 days after the virus enters the body. The first outbreak is typically the most severe. Symptoms that usually occur only with the initial infection include:

  • Fever.
  • Chills.
  • Nausea.
  • Fatigue.
  • Muscle aches.

The main symptom of an anal herpes outbreak is the development of blisters on or around the anal area, These blisters eventually turn into painful sores. This symptom develops over a series of phases from when they first appear to when they heal:

  1. A tingling or itching sensation is felt in the affected area where the blisters will eventually appear.
  2. About 12 to 24 hours later, the blisters begin to appear and fill with liquid.
  3. The blisters eventually open and turn into sores.
  4. The sores slowly scab over before healing.

While the first outbreak of anal herpes can last for two to four weeks, outbreaks that occur after that are usually much shorter. Typically, sores in recurrent outbreaks heal within three to seven days and are less painful than with the first outbreak.

Anal Herpes Risk Factors

There are two things which put you at an increased risk for getting anal herpes:

  • Having unprotected vaginal, anal, or oral sex.
  • Having sex with a partner who has tested positive for herpes.

Practicing safe sex and having open lines of communication with your partners can help to reduce your risk of infection.

Anal Herpes Diagnosis

The most common way to test for anal herpes is to take a fluid sample from a sore that has developed on the anal area. That sample is tested to find out if it contains the virus and, if so, which type of HSV is present.

If you think you may have anal herpes but you do not have an active outbreak, a medical provider can use a blood test to check for herpes. The test results will show whether your blood contains antibodies that the body naturally creates to fight the virus when an infection is present. It can also determine which type of HSV you have.

Anal Herpes Treatment

There is no cure for anal herpes. Once you have herpes, you have it for life and there will always be a risk that you could pass it to a sexual partner. However, the outbreaks usually lessen in frequency and severity over time.

The best treatment for anal herpes is an antiviral medication, such as acyclovir, valacyclovir, or famciclovir. You’ll need to get this medication through a prescription from your doctor or Nurx™ medical provider. To request herpes treatment from Nurx, get started here.

There are two ways you can take it:

  1. Episodic therapy: This method involves taking antiviral medication at the first signs of an outbreak and continuing to take it daily to speed up healing so symptoms are experienced for a shorter period of time.
  2. Suppressive therapy: With this method, you take the antiviral medication daily to help reduce the risk of frequency and severity of symptom flare-ups.

Keeping your immune system strong is another way you can reduce the frequency of outbreaks and help sores heal faster. The stronger your immune system, the better your body is able to fight the virus. Use these tips to boost your immunity naturally:

  • Eat a diet rich in fruits and vegetables.
  • Exercise regularly.
  • Maintain a healthy weight.
  • Get adequate sleep.
  • Minimize stress.
  • Drink in moderation
  • Avoid smoking.

Anal Herpes Prevention

There are several steps you can take to help prevent an anal herpes infection:

  • Always use condoms or other barrier methods when having sex. For preventing anal herpes, that means having partners wear a condom on their penis when you receive anal sex or use a dental dam or DIY barrier method (like cutting a latex condom to lay it flat or using household plastic wrap) when you receive oral-anal sex.
  • Avoid having vaginal, anal, or oral sex if a partner has an active herpes outbreak. When symptoms are present, the virus spreads easily.
  • Ask infected partners if they take herpes medication. While it’s their choice whether or not medication is right for them, taking the medication daily lowers the risk of the infection being transmitted during sex.

While condoms are one of the most recommended prevention methods for herpes, it’s important to note that they do not provide 100% protection against the virus. This is because some herpes sores can occur in areas that aren’t covered by the condom. It’s still possible to get anal herpes even when using condoms during anal sex.

Further Reading

Genital Herpes – CDC Fact Sheet, Centers for Disease Control and Prevention, August 2017

How to boost your immune system, Harvard Health Publishing, July 2018

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