Genital herpes (HSV): recurrence, testing and treatment in Taichung

In short

• Genital herpes and shingles are not the same illness. They are caused by different viruses, and the shingles vaccine does not prevent genital herpes.
• It cannot be eradicated. The virus stays in the nerve ganglia (clusters of nerve cells). Medication can shorten an episode and reduce how often episodes return, but it cannot clear the virus.
• Most transmission is by asymptomatic shedding. On days with no blister and no sensation at all, the virus can still be released.
• Guidelines do not advise routine HSV antibody screening for adults who have no symptoms. A positive result only shows past contact. It cannot say where the virus is, or whether you are infectious now.
• Suppressive therapy is an option. The indication approved in Taiwan for these antiviral medicines includes the prevention and treatment of recurrent genital herpes.

First, which herpes are you looking for?

The word “herpes” covers several different conditions, so it is easy to read about the wrong one.

HSV-1 is now a common cause of genital herpes, mainly through oral sex. So “my partner only gets something on the lip” is not a reason to feel safe.

A first episode and a recurrence are very different

The first episode

This is usually the most severe one:

• Groups of small blisters. When they break, they form ulcers that hurt. This is the opposite of the syphilis ulcer, called a chancre, which is painless (Chinese).
• Fever, tiredness, and swollen, tender lymph nodes in the groin may come with it.
• Passing urine can be very painful. Some people avoid urinating because of it.
• The episode can last two to three weeks.

A recurrence

A recurrence is usually milder. It covers a smaller area and lasts a shorter time:

• There is often a warning sensation first (the medical term is the prodrome): tingling, burning, itching or numbness at the same spot, a few hours to one or two days before the lesion appears.
• There are fewer lesions, and they heal faster.
• Common triggers include tiredness, stress, a cold or fever, menstruation, and local friction.

That warning sensation matters. If you can recognise it, you can start treatment before the lesion appears, and you know which days to avoid sexual contact.

The part most often missed: asymptomatic shedding

Most transmission of genital herpes does not happen when a lesion can be seen. It happens on days with no symptoms at all: the virus can still be released from the skin and the mucous membrane, and the person feels nothing. This is called asymptomatic shedding.

It explains two things that confuse many people. First, why a partner who has never had a visible lesion can still pass the virus on. Second, why avoiding sex only during an episode is not enough.

Condoms lower the risk but do not remove it, because lesions and shedding can occur outside the area a condom covers. This is not a reason to stop using condoms, but a reason to set the expectation correctly: the risk goes down, but it is not blocked completely.

How the diagnosis is confirmed

The most reliable moment to confirm genital herpes is while the lesion is still there. A swab taken from the lesion for a nucleic acid amplification test (NAAT, a PCR-type test) is the most direct method. It confirms whether HSV is present, and separates HSV-1 from HSV-2. Once the lesion has crusted over or healed, the test is much less likely to find the virus.

So if you are having an episode now, do not wait until it has healed. A common problem is that people keep getting lesions but only come after they have healed, so a firm diagnosis is never made.

Why routine antibody testing is not advised

Many screening panels include HSV-1 / HSV-2 IgG antibodies. This result is easy to misread, so be clear about what it can answer.

Because it cannot answer any of the questions that matter, the US CDC sexually transmitted infections treatment guidelines do not recommend routine HSV antibody screening for general adults who have no symptoms. The most common outcome of a positive result is anxiety that cannot be acted on.

The antibody test does help in three situations:

• You get blisters repeatedly, but sampling is never done in time. This is where it has the most value.
• Your partner is known to have genital herpes, and you want to know whether you have been infected.
• Assessment related to pregnancy.

If this test was in your screening panel (Chinese) and the result is positive, there is no need to panic. First check whether you have symptoms, or a history of episodes.

Treatment: episodic therapy and suppressive therapy

One point has to be clear first: current antiviral medicines cannot clear the virus from the body. It stays in the nerve ganglia. Medication controls episodes and reduces how often they return. Any claim that genital herpes can be eradicated does not match current medical understanding.

1. Episodic therapy

This is a short course of antiviral medicine during an episode, started as early as possible — ideally as soon as the warning sensation appears. The aim is to shorten the episode and reduce symptoms. It suits people who have episodes only occasionally and can recognise the warning sensation. You keep the medicine with you and start it when the sensation begins.

2. Suppressive therapy

This means taking an antiviral medicine every day, to reduce how often episodes return. For the antiviral medicines approved in Taiwan for this use (for example valaciclovir), the approved indication covers herpes zoster, and the prevention and treatment of recurrent genital herpes. It is worth considering when episodes are frequent or severe, when they are a clear source of stress, or when your partner has not been infected and you want to lower the risk of transmission (see the note below).

The medicine, the dose and the length of the course are decided by a doctor, based on how often episodes occur, kidney function, whether you are pregnant, and your own situation.

3. Other measures that help

• Keep the lesions clean and dry, and avoid friction.
• If passing urine is very painful, the clinic can offer ways to ease the discomfort.
• Avoid sexual contact during an episode, including oral sex.

Telling a partner

Genital herpes cannot be eradicated, but recurrences can be reduced. It is also a very common virus, not a moral question. Some practical points:

• Confirm the diagnosis first. Discussing uncertain information only creates misunderstanding.
• Explain asymptomatic shedding. It shows why transmission does not mean that someone was unfaithful. Many people carry the virus for years without knowing.
• Talk about concrete steps, not only about risk. Avoiding contact during an episode, recognising the warning sensation, suppressive therapy where appropriate, and continued condom use are things you can do together.

If you do not know how to start the conversation, the clinic can provide a written explanation for you to give to your partner.

Pregnancy and delivery

If you or your partner have a history of genital herpes, and you are planning a pregnancy or are already pregnant, tell the obstetrician yourself.

Neonatal herpes is uncommon but serious, and the plan for delivery differs according to the mother’s infection status and whether an episode is active. A new infection during pregnancy carries a higher risk than one from the past. The obstetric team manages this, but only if they know. Many cases are missed because the person thought it was something from long ago.

Getting checked in Taichung: your visit

With genital herpes, timing matters more than anything else. If you have an episode now, come while the lesion is still there: sampling it is the most valuable opportunity. If it has healed and keeps coming back, an antibody test can be discussed. If you have no symptoms, the consultation starts with how you would use the result.

1. Book through the online form, on LINE, or by telephone. If you are not sure what you are seeing, you can describe it on LINE first.
2. Registration. Please bring your passport or resident certificate; it is needed to create the medical record. If you are not enrolled in Taiwan’s National Health Insurance, the consultation and tests are self-paid. Costs are explained at the consultation.
3. Examination. If a lesion is present, a swab can be taken the same day.
4. Discussion. Episodic therapy or suppressive therapy can be decided afterwards, without rushing.

The clinic uses separate consulting rooms and patient routes, so you do not have to explain why you are here in the waiting area.

Anonymous screening: what it covers

This clinic is listed on two registers published by the Taiwan Centers for Disease Control, under healthcare institution code 3503241524: anonymous HIV screening, and syphilis anonymous screening for young people and students aged 24 or under. Both registers can be checked on the Taiwan CDC page for anonymous counselling and screening.

For this service we do not check your National Health Insurance card or any identity document, so it is open to you regardless of nationality. There is no charge for it. No formal report can be issued, because no identifying information is recorded. The HIV part is a rapid blood test here. The syphilis part has its own eligible group, people aged 24 or under, and it is limited by test kit supply, so these are two separate services.

Herpes is not part of these services. Lesion sampling and antibody testing for herpes both need a separate registration. When genital herpes is confirmed, checking HIV and syphilis at the same time is reasonable, and the anonymous screening service can cover those on the same day, within the eligibility described above.

Common questions

Related pages

• Syphilis: symptoms and the window period (Chinese)
• Genital warts and HPV (Chinese)
• Full sexually transmitted infection screening (Chinese)
• Anonymous screening routes in Taichung (Chinese)

Appointments and access

Consultations are conducted in Mandarin, and can also be conducted in English.

昭安泌尿科診所 (Morning Urology Clinic)
No. 98, Boguan 2nd St., West District, Taichung City 403, Taiwan（403 臺中市西區博館二街98號）
Consulting hours: Monday to Saturday (closed Sunday). Online booking is open 24 hours.

This page was produced by 昭安泌尿科診所 (Morning Urology Clinic). Medical content last updated: August 2026 (same as the Traditional Chinese version). English version published: 4 September 2026. Medically reviewed by Dr. Chao-An Chen, urologist.

Sources: Workowski KA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021;70(4):1-187 / Taiwan FDA approved product information database, oral valaciclovir preparations / World Health Organization, herpes simplex virus. Indications and dosing follow the Chinese-language product information approved by the Ministry of Health and Welfare. This page makes no claim about the effect of antiviral medicines on transmission between partners.

This page provides general medical information and does not replace an individual diagnosis or treatment plan.