Herpes often shows no symptoms at all. If you get symptoms, they may be:

• Groups of itchy or painful blisters on your vagina, vulva, cervix, and/or groin area that can break and turn into painful red sores
• Stinging or tingling
• Inflammation that looks like a rash or cracked skin
• Difficulty urinating 
• Thick and clear, white, or cloudy liquid vaginal discharge, sometimes with a ‘fishy’ smell
• New infections can include fever, body aches and swollen lymph nodes. 

Herpes is often asymptomatic. If signs or symptoms are present, there may be:

• Groups of itchy or painful blisters on your penis, scrotum and/or groin area that can break and turn into painful red sores
• Stinging or tingling
• Inflammation that looks like a rash or cracked skin
• Difficulty urinating 
• Thick and clear, white, or cloudy liquid penile discharge, sometimes with a ‘fishy’ smell
• New infections can include fever, body aches and swollen lymph nodes 

Herpes often has no symptoms. If signs or symptoms are present, there may be:

• Groups of itchy or painful blisters on your anus and/or rectum that can break and turn into painful red sores
• Stinging or tingling
• Inflammation that looks like a rash or cracked skin
• An urgent need to poo
• Bloody or mucous discharge
• Constipation 
• Rectal and lower back pain
• New infections can include fever, body aches and swollen lymph nodes. 

Most people do not display symptoms of Herpes/HSV. If signs or symptoms are present, there may be:

• Group of itchy or painful blisters around your mouth or at the back of your throat (cold sores) that can break and turn into painful red sores
• Tingling, itching or burning sensation around your mouth before the appearance of sores
• A sore throat (herpes of the throat)
• Chest pain (herpes of the throat)

• Redness of the eye    
• Aches or pain in the eye     
• Watering     
• Blurred vision    
• Light sensitivity

• Swab from a blister or sore
• There is a blood test available, but this will only tell you whether you have ever been exposed to a herpes virus.

• You should get tested if you show symptoms of genital herpes (HSV-2). 
• It is best if the sore is less than 4 days old. 
• It is not recommended to test people who do not have any symptoms of herpes/HSV, and herpes testing is not part of routine sexual health screening. 

• A negative test could either mean that you don’t have the infection, or just that the virus was not present on the skin when the swab was collected.
• If you are concerned that you have been exposed to herpes but do not have any symptoms, discuss this with your doctor or sexual health nurse. 
• You can be tested for HSV-1, but most people can treat cold sores at home. 
• Sexual health clinic testing is often bulk billed, even if you don’t have Medicare, so the test will most likely be free. 
• If you see a GP, you may pay a fee or be bulk billed. A negative test could either mean that you don’t have the infection, or just that the virus was not present on the skin when the swab was collected.
• If you are concerned that you have been exposed to herpes but do not have any symptoms, discuss this with your doctor or sexual health nurse. 

Oral Herpes (HSV-1)

• Topical therapy (cream or ointment) is available through pharmacies. 
• Oral antiviral medication is available over-the-counter from pharmacies or by prescription from a doctor, and is usually a single dose. 
• The sooner you start to treat a HSV-1 outbreak (ideally at the first sign of tingling or burning), the more effective it will be. 
• Cold sores usually clear up without treatment within 7 to 10 days. 

Genital Herpes (HSV-2)

• Antiviral medication prescribed by a doctor can reduce the severity of an episode if taken early enough (ideally as soon as you become aware of any symptoms appearing). 
• Topical antiviral medications used for HSV-1 (cold sores) are not suitable for use on the genitals. 
• You can gently bathe the area with a warm salt solution (1 teaspoon to 2 cups water, or 1 cup of salt in a bath). 
• If sores are painful, you can use paracetamol or ibuprofen for relief, or a local anaesthetic ointment or cream (available from the pharmacy). 

• Most over-the-counter cold sore creams cost $10 to $15.
• Most one-dose over-the-counter cold sore oral tablets cost $10 to $15.
• Sexual health clinic treatments are often bulk billed, even if you don’t have Medicare, so the treatment may be free. 
• If you see a GP, you may pay a fee or be bulk billed.
• Infection with HSV-2 can increase the risk of acquiring and transmitting HIV infection. 

• It is recommended that you do not have sex during a genital herpes outbreak, or provide kissing/oral sex services with an active outbreak on the mouth. Herpes is most infectious between the first signs of sores developing (including tingling and numbness) until the scabs have gone. 
• If you can’t avoid having sex, then using external or internal condoms can help lower the chance of transmitting herpes, but only skin covered by the condom is protected.
• You can also consider offering alternative services and use condoms and/or other safer sex PPE (gloves, dams, etc), or do online or phone sex work during time away from face-to-face sex work.
• Preventative measures such as using medication to control an outbreak, taking care of your overall health, and identifying outbreak triggers are the best way to reduce your chances of an outbreak and any impact on your work.
• If you know or suspect a client may have symptoms or herpes, you can offer alternative services or refuse service. 
• You should inform any recent or current doubles partners if you test positive for HSV-2 or are experiencing an outbreak.

• Some states and territories may have laws that criminalise sex working with STIs and/or BBVs. There may also be laws about BBV and STI prevention that apply to everyone. See our BBV, STI and the law resource for more information on your jurisdiction and/or contact your local sex worker organisation to find out more information.