Herpes is a viral infection that can cause blisters and sores around the mouth, genitals, or anus. Herpes that affects the anus is called anal herpes.

Herpes does not always cause symptoms. When it does, people with anal herpes may notice blisters or sores in or around their anus. Because the symptoms are similar, anal herpes may be confused with hemorrhoids or syphilis.

In this article, we give an overview of anal herpes, including how to identify and diagnose the condition, treatment for it, and how to reduce the risk of infection.

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Anal herpes is considered a sexually transmitted infection.

The herpes simplex virus causes all types of herpes. It is a contagious virus, meaning that people can catch it from physical contact with each other.

Sexual contact is often how genital herpes and anal herpes are transmitted. Because of this, they are considered sexually transmitted infections or STIs.

There are two kinds of herpes virus:

  • herpes simplex virus type 1, or HSV-1, which primarily affects the mouth
  • herpes simplex virus type 2, or HSV-2, which mostly affects the genitals and anus

HSV-2 causes most cases of anal herpes in humans and sexual contact with an infected individual is how the virus is transmitted.

The World Health Organization estimates that 417 million people, or 11 percent of those aged 15–49 years of age worldwide, have the HSV-2 infection.

Many people do not experience symptoms immediately, and the infection can go undetected for years. Even if people have no symptoms, they can transmit the infection to others.

Common symptoms of anal herpes include:

  • persistent pain or itching around the anus
  • red bumps or colorless, painful blisters
  • blisters, sores, or ulcers around the anus
  • change in bowel habits

The symptoms of anal herpes are similar to the symptoms of several other conditions, including hemorrhoids and syphilis. A doctor may be able to identify the condition by sight or physical examination.

Doctors may recommend a blood test to look for the herpes virus.

Otherwise, they may take a swab of the affected area and use the sample to run a DNA test called nucleic acid amplification testing, or NAAT. These newer tests are fast, accurate, and can tell if a person has an HSV-1 or HSV-2 infection.

Since anal herpes is a viral infection, treatment is usually with antiviral medications. These types of drugs fight off the virus activity in the system and help reduce or control symptoms.

Antiviral medicines also reduce the duration of the infection and the risk of the virus being passing on to a sexual partner.

Doctors should treat people as soon as possible since early treatment decreases the risk of transmission to others.

Examples of antiviral medicines to treat anal herpes include Famvir, Valtrex, and Zovirax.

Intimate sexual contact with an infected person is how anal herpes spreads. Hence, people can get anal herpes by having vaginal, anal, or oral sex with a person who has the virus.

Direct mouth or skin contact allows the virus to be transmitted easily via:

  • herpes sore or scab
  • saliva
  • genital secretions

Below is a 3-D model of herpes which is fully interactive.

Explore the 3-D model, using your mouse pad or touchscreen, to understand more about herpes.

Anal herpes is contagious, but not everyone with the herpes virus shows symptoms. This means that people can contract the virus without their knowledge.

Ways to reduce the risk of contracting herpes include:

  • using barrier protection, such as condoms, during vaginal, anal, and oral sex
  • getting regular sexual health screenings for STIs
  • making sure that all sexual partners undergo routine sexual health screening

If someone's sexual partner has anal herpes, they can lower the risk of transmission by using barrier contraception and avoiding sexual activity when their partner has an outbreak or active infection.

People who have had herpes should take any prescribed antiviral medication, as instructed by a doctor, and attend follow-up appointments to make sure they keep the virus under control.

There is no current cure for HSV-2 infections so the condition may require lifelong management.

However, even if people have the herpes virus, it will not always produce symptoms and is not always transmissible.

The infection is known to recur in some people under certain conditions that re-activate the virus, such as illness, stress, sunlight, or fatigue.

Repeated outbreaks tend to be shorter and less severe than the first outbreak. Although the virus remains in the body for the rest of the person's life, the number of outbreaks may gradually decrease over time.

Anal herpes is a type of genital herpes. It is more common today than it was some decades ago.

While doctors cannot cure the infection, there are now many antiviral medicines available that reduce symptoms and decrease the risk of transmitting it to others.

Awareness is key to reducing the spread of anal herpes, as is practicing sex with condoms and following good personal hygiene.