Genital Herpes in Men – Symptoms, Stages, Treatment & More

Genital herpes symptoms in men

The prodrome, or initial stage of a genital herpes outbreak is commonly associated with tingling, irritation, or burning in and around the affected area. 

HSV-1 symptoms in men typically affect the mouth, and can occur anywhere from 30 minutes to a few days after experiencing the burning sensation around the mouth.

HSV-2 symptoms may also present sensations of shooting pain, aches or numbness in the lower back, buttocks or thighs. These early signs of herpes in men can often be mistaken for other ailments or injuries, particularly in the case of back pain. Fever, soreness, headaches and swollen lymph nodes are also indicators that the prodrome stage is occurring, although these residual effects tend to reduce in severity with subsequent flare-ups. 

Anal herpes is also a form of HSV-2. It is commonly mistaken with haemorrhoids or piles. As they can all cause similar pain around the anal cavity. Any sensitivity or tingling in the genital area should be observed if concerns about HSV-2 exist due to recent sexual encounters.

During this stage of genital herpes in men, the virus is travelling to the surface of the skin. As the virus progresses through stages, the effects on the genitals themselves will become pronounced in the form of sores.

Penis

Genital herpes on the penis typically appears during the blister stage, although it is important to note that they can also affect the urethra, making urination painful. Sores can also affect the penis tip or head, shaft, or trunk, as well as surrounding areas. Some men will only experience one or two blisters, while others will have many, often emerging in a cluster, honey-comb like grouping. 

Sores and bumps on the penis are usually painful and can cause irritation. The rash will eventually fill with liquid and finally burst. Once they’ve burst, bumps will leave behind open wounds, which eventually scab over before healing. 

Scrotum

Herpes on the scrotum does not only affect the skin on the sheath of the scrotum, but the entirety of the seven layers that envelop them. Herpes outbreaks can cause painful ulcers on the scrotum, representing the fourth stage of infection. Similar to how anal herpes can be mistaken for other conditions, herpes on the skin of the scrotum is often confused with other sexually transmitted infections (STIs) that cause ulcers, such as chancroid and syphilis. 

Testicles

Chafing or irritation can often disguise the onset of genital herpes on the testicles, particularly during the prodrome phase. Despite concerns some men raise regarding herpes proximity to testicles, the HSV-2 infection isn’t associated with causing infertility in men. Some research links herpes to a reduction in sperm count however, which could make pregnancy difficult for infected individuals trying to conceive. A genital herpes flare-up on the testicles could contribute to making sexual activity uncomfortable, due to the irritation and pain commonly experienced at this time.

Under the foreskin

Herpes sores can form under the foreskin. Lesions in this area can take longer to heal than exposed areas, as less oxygen is available to assist in the scabbing process following a blister burst. Blisters are likely to take even longer to heal where foreskin is uncut.

Herpes-induced irritation and sensitivity in the area between the glans and foreskin can lead to a condition called balanitis, which causes symptoms such as a strong odour or chunky discharge. The Cleveland Clinic describes balanitis as a treatable condition most commonly found in uncircumcised men.

Men experiencing irritation under the foreskin are encouraged to frequently examine the area for the appearance of lesions, bumps or blisters attributable to an HSV-2 outbreak. This inspection is recommended due to the ability for the redness to disguise itself beneath the foreskin, hindering the relief associated with early detection and treatment.

Genital herpes treatment for men

Left unchecked, male herpes symptoms can be painful and – in the case of individuals with suppressed immune systems – potentially severe. Men experiencing an outbreak should not touch their sores or the fluids that they emit, as this could cause further irritation and pain.
It is recommended that a man washes his hands immediately after touching a herpes lesion. Regarding treatments for genital herpes, there are two medications recommended as part of a symptom-containing protocol. 

• Aciclovir, commonly known as Zovirax, is a popular medication taken to combat the frequency and duration of male herpes outbreaks. Aciclovir tablets work by changing the DNA of the herpes simplex virus, preventing the strain from multiplying and infecting more cells. Aciclovir is available in 200mg, 400mg, and 800mg tablets and can be utilised as part of a suppression protocol.

• Valaciclovir, better known by the brand name Valtrex, is the prodrug of aciclovir and is also taken to suppress male herpes. By inhibiting the viral replication of the HSV-2 virus, Valaciclovir reduces the severity and length of an outbreak. It also reduces the pain and irritation associated with the formation of blisters as they progress to liquid-filled ulcers. As Valaciclovir remains active in the body longer than aciclovir, the frequency of dosage is reduced in comparison. Available in 500mg tablets, Valaciclovir is also an effective suppression agent when taken as a preventative treatment.

Combined with home remedies designed to ease the discomfort associated with a herpes outbreak, medication utilised effectively can aid in healing herpes sores faster. There is no difference in treatment for herpes in women and men. 

You won’t always get symptoms

Signs of herpes in men aren’t always readily apparent or detectable. In fact, many men with genital herpes may not even be aware they’ve contracted the virus. Although a male herpes rash is commonly associated with an outbreak, it is important to note that the virus remains contagious even when no visible signs of flare-up are showing. Due to the nature and structure of the neural pathways the virus travels upon, recurrences of herpes may not appear in the same area of the body as previous outbreaks.

Reactivation of the virus can be asymptomatic, so males should take caution when engaging in sexual activity if infected with the HSV-2 virus.

How can males test for herpes?

Symptoms of herpes in men can be difficult to put down to herpes. This is because signs of herpes can often overlap with other STIs. Consideration should be taken if irritation or redness begins to develop in the genital areas. One should ask a healthcare provider for an examination in the event of symptoms or after coming into contact with someone infected with an STI. 

It is likely that your healthcare provider will ask you to carry out a genital herpes test, which involves taking a swab from an open sore. The accuracy of results is determined by the quality of the sample. Symptoms of herpes in men must be prevalent in order to ascertain a positive test result, as asymptomatic individuals will not have blisters from which a sample can be taken. The male herpes test does not differ from methods utilised by women in determining HSV-2 infection.

If you are not able to get a quick appointment with your doctor, you may wish to take a picture of your herpes sores. If you are waiting a few weeks for an appointment, there is a good chance that the outbreak will have healed by then; so pictures are a good way to help your doctor to make an accurate diagnosis.

How to avoid catching genital herpes

In order to reduce the chances of catching genital herpes, men could take the following precautions:

• A long-term mutually monogamous relationship with a partner who does not have herpes 
• Practising safe sex by utilising condoms during sexual activity. While condoms do not completely stop the spread of herpes, they are effective at diminishing chances of transmission
• If engaging in sexual contact with someone who has herpes, ask them if they are taking an anti-herpes medicine daily. The presence of a preventative protocol will also reduce chances of transmission, although it is still possible to contract genital herpes from someone undergoing suppressive therapy.
• Avoid having oral, vaginal or anal sex if a partner is experiencing a herpes outbreak

How to prevent outbreaks

Herpes in men can be contained, not cured. In order to reduce the duration, severity and frequency of outbreaks, the following preventive measures should be taken:

• Dietary restrictions may impede the frequency of herpes outbreaks in men. Alcohol, coffee, nuts, popcorn and chocolate may encourage HSV-2 flare-ups.

• Triggers and environmental factors can vary from man to man, however exposure to extreme environments that create stress in the body should be reduced. This includes physical or emotional stimulus which promotes cortisol production in the body and triggers the nerve response that could encourage reactivation of the virus.

• Vigorous sexual activity can enflame and irritate the skin, due to excessive friction. Lubricants and condoms that contain nonoxynol-9 may also prove to be a catalyst for skin irritation that results in the prodrome stage of genital herpes. 
• Although it may seem to be helpful, some men report that frequent bathing or showers – or utilising multiple skincare products – aggravates their herpes symptoms. Some products, including soaps, laundry care and fragrances contain chlorine and other potential irritants that clog the mucous membranes and activate outbreaks.
• Lifestyle considerations should be taken into account when attempting to restrict the frequency of herpes outbreaks for men. Lack of sleep and elevated stress levels can lower immune system function, resulting in an increased risk of recurring symptoms.

Can herpes make you infertile?

There is no conclusive evidence that herpes affects sperm count. However, studies examining a possible link between the two have been conducted. The National Library of Medicine reports the findings of one study, entitled Asymptomatic seminal infection of herpes simplex virus: impact on male infertility, which indicates that although HSV infection is not associated with sperm mobility, it is correlated to a reduced sperm count in seminal fluid. The findings suggest that asymptomatic seminal infection of HSV affects male infertility by adversely impacting sperm count.

While some studies report a correlation, the link between herpes in men and infertility has yet to be concretely proven.

Can it be cured?

While male herpes outbreaks can be restricted with proper treatment, there is currently no cure. Taking a daily anti-herpes medication can make it less likely to pass the sexually transmitted infection onto a partner, although the virus remains contagious throughout all phases of outbreak.

For men who are otherwise healthy, living with herpes shouldn’t cause any long-term medical complications. Recurrent outbreaks are common, and the treatments designed to combat the effects will have a significant impact on the severity, duration and frequency of flare-ups. While the use of medications, combined with lifestyle adjustments as part of a preventative protocol can reduce the discomfort associated with the genital herpes virus, it is a lifelong infection once contracted.

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.