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Anal herpes is caused by the herpes simplex virus (HSV1 and HSV2). It causes red bumps, white blisters, ulcers, scabs, pain, and itching around the anus. It can also affect your bowel movements.

Herpes is a family of viruses that cause infections in humans.

Anal herpes is an infection caused by the herpes virus that erupts as sores or blisters around the anus, the opening through which bowel movements pass. Anal herpes are caused by the herpes simplex virus (HSV) — in particular, types of HSV called HSV1 and HSV2.

Syphilis, chancroid, and donovanosis are infections that can cause different types of lesions around the anus.

All of these conditions, including those caused by HSV, are acquired through sexual contact.

Symptoms of anal herpes include:

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

Anal HSV is a sexually transmitted infection (STI). It’s passed from person to person through sexual contact or intercourse.

According to the Centers for Disease Control and Prevention (CDC), more than 24 million Americans had HSV2 in 2013, and an additional 776,000 Americans were being diagnosed each year.

In the United States, 1 in 6 people has genital herpes, according to the CDC. The same virus that causes genital herpes can cause lesions in the genitals, anus, or perianus. But, not everyone with genital herpes has anal herpes.

If you have obvious symptoms of anal herpes, your doctor may decide to treat you after a physical exam. However, if a doctor isn’t sure, they may want to do additional testing.

Because several different sexually transmitted microorganisms can cause anal symptoms, your doctor may want to verify the exact cause of your infection with testing before starting treatment.

To do this, your doctor will either take a culture from the blisters or ulcers or draw a blood sample. That sample will be sent to a laboratory where tests will determine the cause of your symptoms. With that information, your doctor can discuss treatment options.

Treatment for anal herpes helps reduce the length of the outbreak and the intensity. It may also reduce your risk for passing the condition to a sexual partner.

The main treatment for anal herpes is antiviral therapy. HSV is a virus. Antiviral medications fight the virus. People with HSV are given antiviral medications to reduce the symptoms until the outbreak ends. In addition, a doctor may prescribe an antiviral medication to take regularly.

Long-term use of antiviral medication is also known as suppressive therapy. People who use suppressive therapy to manage HSV reduce their risk of passing HSV to a sexual partner.

In cases of severe anal herpes, your doctor may suggest intravenous antiviral therapy. This means the antiviral medications will be injected directly into your bloodstream through a needle inserted into a vein.

Antiviral medication will help reduce the frequency and severity of anal HSV recurrence. When HSV does erupt again, the ongoing antiviral treatment can help shorten the duration.

Over time, episodes of herpes outbreaks around the anus will decrease. Ultimately, you and your doctor may decide to end suppressive therapy. If so, you might begin using antiviral medications again when a new outbreak occurs.

Infections caused by HSV can’t be cured. They are considered a lifelong condition. After the first outbreak, the virus will move to your nerve cells. The virus will stay in your nerve cells for the rest of your life.

Even though the virus is still present in your body, it may be dormant or inactive for long periods of time. Outbreaks are typically triggered by an external factor such as stress, illness, or sun exposure.

Anal herpes is contagious. It’s most likely to be transmitted to another person when lesions are present on skin in or around the anus.

You can get the virus if you have sexual contact with a person who has the virus. In addition, you can pass the virus to a sexual partner even when the virus isn’t causing obvious symptoms.

It’s possible not to know you have HSV. Symptoms aren’t always obvious, so you might not realize you have the condition. In that case, you may pass the virus to others without knowing.

Because STIs like HSV are passed during sexual contact, you can lower your risk by practicing safe sex. Use these safe sex measures to reduce your risk:

  • Wear a condom or LINK: barrier protection during every sexual encounter, including anal or oral sex.
  • Reduce your number of sexual partners.
  • If you’re in a relationship, practice monogamy.
  • Abstain from sex altogether.

If you’re sexually active, ask your doctor to conduct regular STI screenings. Regular testing keeps you and your sexual partners safe.