Getting diagnosed with genital herpes

Getting diagnosed with genital herpes can only be done when you have symptoms. (For example, a spot, blister, little cut, ulcer, etc.) The only way to find out what is causing a genital problem is to a sexual health clinic or department of genitourinary medicine (GUM clinic). There may be one at your local hospital. Sometimes it is in a separate building in a town centre.  Some GPs do sexual health testing too, so you can ask your GP if you prefer.

Since it is only possible to diagnose genital herpes when symptoms are present, don’t delay.

You may need to make an appointment. If they say you do, tell them you think it is genital herpes: they should give you an appointment the next day as they should know that it can only be diagnosed while you have symptoms. Ring your nearest hospital for the address and clinic times – or search the list of clinics you can find here.

They will take a swab of the area where you have symptoms. A swab is like a cotton bud/Q tip which is wiped over the symptoms. A positive result from the swab will confirm the diagnosis.

Do not apply creams to the area before attending the clinic as a cream will interfere with the swab test. A routine sexual health check-up does not include any test for herpes simplex, unless there are signs on the skin. If you don’t have symptoms, they cannot check for herpes simplex.

Blood tests are not used to diagnose genital herpes. You may see blood tests for herpes advertised but these cannot be used to diagnose genital herpes. They check for antibodies. Having antibodies does not identify the part of the body that might be affected – only a swab of a sore can do that. An asymptomatic facial cold sore infection will also cause the immune system to make antibodies. Antibody tests are not very reliable: one in three negative test results may be wrong; one in ten positive results may be incorrect.

The US Food and Drug Administration issued a letter to all doctors in December 2023 advising them not to use the antibody test because one in ten positive results for herpes is wrong.

Urine tests should not be used to diagnose genital herpes. Beware, these may be offered inappropriately by private testing services.

Your symptoms may not be caused by genital herpes. There are more than 24 other conditions that could be causing them. See the section on “What else?” at the end of this page.  You cannot diagnose yourself. Herpes photos on other websites are usually chosen to show really bad examples of the infection. Yours will likely be much milder. There are other conditions that cause blisters or sores that look just like genital herpes. Getting diagnosed with genital herpes can only be done with a swab test: a positive result will confirm it is genital herpes.

Urine tests should not be used to diagnose genital herpes. Beware, these may be offered inappropriately by private testing services.

Virus is not in the urine unless the urine has run over a sore and collected the pus as it flows out. This is not a common situation, therefore the tests are not to be used.

No, you can arrange this yourself.

No. Your visit to the clinic is confidential. You don’t even have to use your real name. The clinic may ask for your doctor’s details but this is simply to allow internal charging within the NHS.
If you took a letter with you from your GP, the clinic will wish to write back to the GP with your test results but you can tell the clinic not to do this.

Don’t self-diagnose just because it looks like herpes. There are over 24 other things that a well-informed doctor would be considering if your herpes simplex test is negative. An Australian survey found that 3% cases of ‘genital herpes’ were actually shingles, which is the name for a recurrence of chickenpox. (That’s one person in 33.) Other possibilities caused by viruses are syphilis and the emerging monkeypox [see photo]. It could also be molluscum contagiosum, pityriasis rosacea and very rarely, orf.

There are also look-alike conditions caused by bacterial or fungal infections. Or symptoms maybe be from an autoimmune condition such as eczema. You don’t catch these, you just develop them.

_{This page was updated 23-5-2024 – to be reviewed no later than May 2027.}