Anal Herpes: Symptoms, Treatment, and Prevention

Herpes is a contagious virus affecting more than half of all adults under the age of 50, and it has two subtypes that can affect the mouth, genitals, or anus. However, many people with herpes are not aware that they have it because they experience no symptoms, adding to how easily transmissible it is.

Anal herpes is a strain of the herpes simplex virus passed from person to person through anal sex. There is no cure for herpes, but several treatment options are available to reduce symptom severity and decrease the likelihood of passing herpes on to someone else.

Table of Contents

What Is Anal Herpes?

Herpes is a family of viruses that can cause infections around the mouth, vagina, penis, and anus.

As the name suggests, anal herpes is an infection due to the herpes virus that appears as sores or blisters around the anus.

The same virus that causes genital herpes can also cause lesions to appear around the anus or perianus. However, not everyone with genital herpes also has anal herpes.

Those who contract anal herpes will typically show symptoms within 2-10 days of transmission, and the first outbreak is often the most severe.

Anal Herpes Symptoms

Symptoms of anal herpes include:

  • white blisters or red bumps
  • ulcers that develop at the site of original blisters
  • itching and pain around the anus
  • changes in bowel habits
  • scabs covering ulcers that have bled or ruptured

The symptoms of anal herpes are not always obvious, and in some cases, you may not know that you have it. This makes it possible to spread the virus to others without knowing.

The first outbreak of anal herpes is often the most severe, and it may include symptoms of:

  • chills
  • fever
  • fatigue
  • nausea
  • muscle aches

While herpes is rarely a life-threatening condition, having it does make you more susceptible to HIV. Because of this, it is recommended to receive HIV testing if you test positive for herpes. 

What Does Anal Herpes Look Like?

Anal herpes manifests as white pus-filled blisters or red sores around the anus.

Anal herpes can be challenging to diagnose, though, because its symptoms are similar to syphilis and hemorrhoids, two other conditions that cause sores around or in the anus. 

How Is Anal Herpes Diagnosed?

To diagnose anal herpes, a doctor will likely want to start with a physical exam, and if the symptoms are obvious, this might be all the doctor needs to begin treatment.

However, in many cases, a doctor may not be sure that the symptoms you have are due to HSV since there are many sexually transmitted microorganisms that can cause anal symptoms. To further investigate the cause of your infection, your doctor may take a culture from the ulcers or blister, or they may choose to draw a blood sample. The sample collected will be sent to a lab, where they will perform tests to determine the cause behind your symptoms.

Is Anal Herpes Contagious?

Like other sexually transmitted diseases, anal herpes is contagious, and it is most likely to be spread to someone else when there are lesions on the skin in or around the anus. However, anal herpes can also be spread when the infected individual does not have any obvious symptoms.

How Does Anal Herpes Spread?

Anal herpes simplex virus (HSV) is a type of sexually transmitted infection, meaning it is passed from one person to another through sexual contact or intercourse.

There are two subsets of the herpes virus: HSV-1 and HSV-2. HSV-1 typically affects the mouth, although it can spread to the genitals or anus if someone infected with HSV-1 performs oral sex.

In comparison, HSV-2 typically infects the genitals. It can then spread to the anus because of close contact, or it can infect the mouth if someone performs oral sex on someone infected with HSV-2.

Essentially, herpes is spread through intimate, direct, and sexual contact with an infected person. This means that it can spread through anal, vaginal, or oral sex.

Anal Herpes Risk Factors

Since anal herpes is a sexually transmitted infection, its most significant risk factor is having sex. Additionally, having sex with multiple partners increases the risk of transmission.

Having sex, especially anal sex, without a condom also increases the risk of transmitting herpes.

How to Prevent Anal Herpes?

While the best way to prevent anal herpes is to abstain from sexual contact, you can also prevent its transmission by reducing your number of sexual partners or wearing a condom during every sexual encounter, including oral or anal sex.

For those who are sexually active, it is recommended to undergo regular STI screenings to ensure that any STIs are detected and treated early. It is also best practice to ensure your sexual partners are also undergoing regular screenings for STIs.

If you or your partner has anal herpes, it is essential to abstain from sexual activity during outbreaks since this is when the virus is more contagious.

How to Treat Anal Herpes?

Treatment for anal herpes helps to reduce the length of your outbreak and the severity of your symptoms. Additionally, treatment may help to reduce the risk of transmitting HSV to your sexual partner.

Since HSV is a virus, the primary form of treatment is antiviral therapy. Those with HSV are often given antiviral medications to take until the herpes outbreak ends. 

However, a doctor may also prescribe an antiviral medication to take regularly, even once the outbreak has ended. This is called suppressive therapy and may help to reduce the risk of transmitting HSV to a sexual partner.

If anal herpes is severe, a doctor may treat it with intravenous antiviral therapy, which injects the medication directly into the bloodstream.

The first outbreak of herpes typically lasts 2 to 4 weeks, but it is common to have repeat outbreaks during your first year with herpes. 

Can Anal Herpes Be Cured?

Anal herpes cannot be cured, and HSV infections are considered lifelong conditions. This is because the herpes simplex virus moves into your nerve cells after your first outbreak, and it then stays with the nerve cells for the remainder of your life.

However, even though the virus cannot be cured, it does often remain inactive or dormant for long periods of time. For many people with HSV, outbreaks are triggered by external factors such as illness, stress, pregnancy, or sun exposure.

Even though there is no cure for HSV, symptoms can be managed easily with antiviral medications. Additionally, even though the virus is lifelong, the number of outbreaks typically reduces over time, and recurrences are typically shorter and less severe than the initial outbreak.

When to See a Doctor?

If you are experiencing any symptoms of anal herpes, it is crucial to see a doctor immediately. While time is not of the essence in terms of curing the infection, starting antiviral medication can help to lessen the severity of the outbreak.

Seeing a doctor early can also increase your chances of being tested for and diagnosed with other STDs, which can ensure that you receive treatment for them as well.

Get Help From an Online Doctor!

Online doctors can be very helpful for those with a previous herpes diagnosis. If you have had a herpes outbreak before, and are currently experiencing a recurrence, you can meet with a DrHouse doctor in just 15 minutes to receive a prescription for an antiviral treatment. If you are not currently experiencing an outbreak but would like to prevent future outbreaks and the risk of passing herpes to a sexual partner, your doctor can discuss a daily preventative treatment.

Key Takeaways

Herpes is a very common sexually transmitted disease because many people with it do not have any symptoms, making it difficult to detect and easy to pass on. There are two strains of the herpes virus, HSV-1 and HSV-2, which can infect the mouth, genitals, or anus.

For those who experience symptoms, anal herpes typically appears as red sores or white pus-filled blisters around the anus. It is usually spread through anal sex, although it can also spread from the genitals due to their close proximity.

There is no cure for anal herpes, but antiviral treatment is able to reduce symptom severity and lessen the risk of passing herpes to someone else. Despite the herpes virus remaining in your nerve cells for life, it often goes dormant for long periods of time, and each subsequent outbreak is typically less severe.

If you have been diagnosed with anal herpes in the past and are experiencing an outbreak or would like to discuss daily preventative treatment, DrHouse allows you to meet with a doctor in just 15 minutes to discuss treatment options.


Content on the DrHouse website is written by our medical content team and reviewed by qualified MDs, PhDs, NPs, and PharmDs. We follow strict content creation guidelines to ensure accurate medical information. However, this content is for informational purposes only and not a substitute for professional medical advice, diagnosis, or treatment. For more information read our medical disclaimer.

Always consult with your physician or other qualified health providers about medical concerns. Never disregard professional medical advice or delay seeking it based on what you read on this website.

If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.



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