What’s causing those tiny bumps?

One day, you’re going to the bathroom and notice small red bumps in your genital area. At first, you don’t think much about it until the next day when you start having pain and itching in the same place. You go to the doctor and find out that you have genital herpes. How did it happen? What can you do to treat it? Can you prevent it from coming back?


Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). It’s spread through skin-to-skin contact. There are two types: HSV-1 and HSV-2. HSV-1 most often causes cold sores or fever blisters around your mouth. It can be spread to the genital area during oral sex. HSV-2 is the type that is more likely to cause genital herpes because it’s very common and highly contagious. It can be transmitted even if you don’t have an open sore. It’s key to note that the virus doesn’t live outside the body very long, so it’s almost impossible to get infected through contact with toilets, towels, or other objects.

It can be challenging to know if you have herpes because most people don’t have any symptoms, or the symptoms are so mild, they go unnoticed. If you do have symptoms, they usually begin 2 – 12 days after exposure. Symptoms can include pain/itching in the genital area, small red bumps/tiny white blisters, ulcers (if blisters rupture and ooze/bleed), and scabs (ulcers that crust over). Typically, sores appear where the infection entered your body, such as the buttocks, thighs, anus, mouth, and urethra (the tube that connects your bladder to the outside). Women can also have sores in or on the vaginal area, external genitals, and cervix. For men, they can develop sores on the penis or scrotum. Some individuals have flu-like symptoms during the initial outbreak, like swollen lymph nodes in the groin, headache, muscle aches, and fever.

Herpes is different for each person. Symptoms typically recur, with some individuals experiencing numerous episodes each year. The good news is that in most cases, the outbreaks happen less frequently over time. Before a recurrence of the sores, you might feel burning, tingling, and itching where the infection first entered your body and have pain in your lower back, buttocks, and legs. Typically, recurrences are less painful and heal more quickly. Also, recurrences are less frequent with HSV-1 infections.

Certain factors can increase your chances of developing herpes. The first is being a woman because the virus is more easily transmitted from men to women than from women to men. The next is having multiple sexual partners because this elevates your potential exposure rate. Many complications can result from a herpes infection. It places you at a higher risk of developing other STIs. You can have bladder problems because herpes sores can cause inflammation around the urethra resulting in swelling that makes it too hard to urinate. Herpes can result in inflammation of the rectum lining, especially for men who have sex with men. In rare cases, herpes can lead to inflammation of the membranes and cerebrospinal fluid surrounding your brain and spinal cord resulting in meningitis. Newborns can be exposed to the virus during the birthing process, which can cause brain damage, blindness, or death for the newborn.


There isn’t a cure for genital herpes. However, there are medications that you can take to help sores heal sooner during an initial outbreak, lessen the severity and duration of symptoms in recurrent episodes, and reduce the frequency of recurrence. It can also help minimize the chance of transmitting the herpes virus to others. These medications are called antivirals and include acyclovir and valacyclovir. Your doctor will tell you to take the medication only when you have symptoms or daily (even if you don’t have an outbreak).

Another critical element of treatment is dealing with your emotions. Obviously, being diagnosed with herpes can be distressing. You might feel embarrassed, shame, and anger. Often, this anger can be directed at your partner because you might believe they infected you. It’s important to remember that herpes can lie dormant in your body for years, so it’s often difficult to know when you become infected. When talking to your partner, be open and honest about your feelings and believe what they’re telling you.


The best way to prevent a herpes infection is to abstain from sexual activity. The next best option is to limit sexual contact to only one person who is infection-free. Otherwise, you should be using a condom every time you have sex. If either you or your partner has an outbreak, you should avoid intercourse. If you’re pregnant and know you have genital herpes or think you might be sure to tell your doctor. They will have you tested to be sure. If positive, they’ll recommend you start taking antiviral medications late in your pregnancy to try to prevent an outbreak around the time of your delivery. If you do have an outbreak, your doctor might suggest a cesarean section to reduce the risk to your baby.

While it can be upsetting to find out that you have herpes, it can be managed so you can live a normal life. If you have any questions or concerns about genital herpes, please speak with your doctor. If you would like more information, please visit Medline Plus’s Genital Herpes page at https://medlineplus.gov/genitalherpes.html