Complications of Genital Herpes
The complications of genital herpes are rare but can be serious when they do occur. Genital herpes, when properly managed, is a relatively mild condition for most people. However, if left untreated or if the immune system is compromised, the virus can lead to additional health issues — both physical and emotional.
Understanding potential complications reinforces the importance of early diagnosis, appropriate treatment, and ongoing self-care.
Secondary Infections
Open sores from herpes are vulnerable to bacterial infections, particularly in individuals with poor hygiene or a weakened immune system. These secondary infections may cause:
Increased pain and swelling
Delayed healing
Pus or discharge from sores
Fever or red streaks near the affected area
Mild bacterial infections can usually be treated with topical or oral antibiotics. In rare cases, they may require further medical attention.
Urinary Retention
In severe outbreaks — especially during the primary infection — some individuals may experience urinary retention due to swelling, pain, or lesions near the urethra. This is more common in women and can lead to:
Incomplete emptying of the bladder
Painful urination
A need for catheterisation if the bladder becomes overly distended
Prompt medical support is crucial to prevent further complications such as bladder infections.
Proctitis and Rectal Inflammation
Individuals who engage in receptive anal intercourse may experience inflammation of the rectum, known as herpetic proctitis. Symptoms include:
Rectal pain or itching
Mucus discharge
Bleeding during bowel movements
A sensation of fullness or pressure
This complication is more commonly associated with HSV-2 and may occur without external genital sores. Antiviral medication helps resolve symptoms quickly.
Neonatal Herpes
One of the most serious complications is neonatal herpes, a rare but potentially life-threatening condition that occurs when a baby is exposed to HSV during childbirth. Risk factors include:
A first-time genital herpes infection in the third trimester
Active sores at the time of labour
Prolonged rupture of membranes
Neonatal herpes can affect the baby’s skin, eyes, brain, or other organs. To prevent this:
Pregnant individuals with known herpes may take suppressive antivirals from 36 weeks onward
If active lesions are present during labour, a C-section is often recommended
With proper antenatal care, the risk of neonatal herpes is extremely low.
Psychological and Social Impact
The emotional toll of herpes can be long-lasting if not addressed. People may experience:
Chronic anxiety about future outbreaks or disclosure
Depression or feelings of worthlessness
Avoidance of intimacy or dating
Social withdrawal due to perceived stigma
This emotional burden can affect mental health, work performance, and personal relationships. Access to counselling, education, and peer support groups can help individuals rebuild confidence and self-image.
Increased Risk of HIV
Research shows that people with genital herpes are at higher risk of contracting HIV if exposed. This is due to:
Open sores or micro-tears, which make it easier for HIV to enter the bloodstream
The presence of inflammatory cells that attract HIV
Increased viral shedding during outbreaks
This underscores the importance of consistent condom use, STI testing, and suppressive therapy in managing sexual health.
Herpetic Whitlow and Eye Infections
In rare cases, herpes can spread from the genitals to other parts of the body through direct contact. These complications include:
Herpetic whitlow – a painful finger infection caused by autoinoculation (touching a sore and then touching a broken area on the finger)
Herpes keratitis – an infection of the eye, potentially leading to vision problems if not treated early
Good hygiene, especially handwashing after touching sores, reduces the risk of these secondary issues.
Long-Term Outlook
For most individuals, genital herpes becomes less disruptive over time. Outbreaks may decrease in frequency, and the emotional distress associated with the condition tends to improve as people gain knowledge and confidence in managing it.
Suppressive therapy, lifestyle changes, and emotional support allow people with herpes to:
Maintain healthy sexual relationships
Have children safely
Live full, empowered lives
Complications of Genital Herpes
Recognising and addressing the complications of genital herpes enables early intervention, prevents escalation, and encourages a compassionate, stigma-free approach to sexual health.
