Sexual HealthPending review

Genital herpes

Genital herpes is a lifelong infection in which herpes simplex virus establishes latency in sacral sensory ganglia after primary infection, so the virus (not just the initial outbreak) remains present for life and can reactivate as recurrent lesions.

In a nutshell

HSV infects epithelium, then travels along sensory nerves to establish permanent latency in sacral ganglia. This latency, not the initial rash, is what makes herpes lifelong: periodic reactivation sends the virus back down the same nerve to cause recurrent, usually milder, lesions.

Classic presentation

Painful, grouped genital vesicles and ulcers with dysuria and tender inguinal nodes on first presentation; a shorter, milder, unilateral recurrence at the same site thereafter, sometimes preceded by tingling.

Key points

  • Latency in the sacral dorsal root ganglia, not persistent skin infection, is why herpes cannot be cured and why recurrences occur at the same site.

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Educational content pending clinical review. Not medical advice.