Does a positive HSV IgG test mean I need medicine?
Not always. HSV IgG usually shows past exposure, not an active outbreak. Symptoms, HSV type, examination and sometimes lesion PCR guide decisions.
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✦ Private STD / STI consultation • Dehradun
Genital Herpes Treatment in Dehradun
Genital herpes can cause painful, grouped blisters or small sores. Some people have very mild symptoms or none at all, and the infection can sometimes recur.
Your privacy matters. Discuss sensitive symptoms and test results in a respectful, non-judgmental clinical setting. You choose what to share.
Dr Neeraj Garg · MBBS (IMS-BHU), MD (IMS-BHU) · Dermatologist & STD / STI Specialist, Dehradun
Request an Appointment ↗For privacy, send only a simple appointment request through WhatsApp. Medical details can be discussed during consultation.
Educational illustration, not an actual clinical photograph. Signs vary and a diagnosis requires assessment.
What should you know first?
A blood antibody report and a swab from a fresh sore answer different questions. HSV IgG alone does not show when an infection was acquired.
Which test may help?
When a fresh blister or sore is present, HSV PCR/NAAT from the lesion is preferred. HSV IgM testing is not recommended for diagnosis.
Can it be treated or managed?
Antiviral medicines can shorten outbreaks. Daily suppressive medicines may be considered for frequent recurrences or particular transmission concerns after discussion.
Symptoms & signs
- Grouped painful blisters or shallow ulcers
- Tingling or burning before recurrence
- Some people have mild or unrecognised symptoms
Not everyone develops obvious blisters. When a fresh sore is present, a swab for HSV PCR/NAAT can help confirm the cause.
How does genital herpes spread?
- HSV spreads through direct oral or genital skin or mucosal contact, including oral sex.
- HSV can pass to a partner even when no blisters are visible because of asymptomatic shedding.
- Condoms and suitable suppressive antiviral treatment lower, but do not completely eliminate, risk.
When should you see an STD specialist?
People commonly book an appointment for:
- Painful grouped blisters, sores or burning before a recurrence
- A positive HSV-1 or HSV-2 IgG result with no symptoms
- Repeated episodes or questions about protecting a partner
Assessment helps identify the likely cause, choose useful tests and explain treatment and follow-up without unnecessary medication.
Diagnosis and tests
HSV PCR/NAAT from a fresh lesion is preferred when available. Type-specific blood tests have limited selected uses; HSV IgM is not recommended.
A lesion swab for HSV PCR/NAAT is preferred when blisters or ulcers are present. Type-specific HSV IgG can sometimes help with counselling, but does not date the infection; HSV IgM is not recommended.
Questions people ask before an STD consultation
Common concerns explained in plain language. A test result or photograph alone may not tell the whole story.
HSV-1 or HSV-2 IgG positive but no herpes symptoms
A positive herpes IgG blood test indicates past exposure, but it does not automatically prove that a current genital complaint is caused by herpes or that daily medicine is needed. HSV-1 IgG also cannot locate the infection in the mouth or genitals. If fresh blisters or ulcers appear, a lesion swab for HSV PCR/NAAT is often the most informative test.
Repeated painful blisters or tingling before an outbreak
Recurrent genital herpes can begin with burning, tingling or local tenderness before grouped blisters develop. Early episodic antiviral treatment can shorten a recurrence, while daily suppressive treatment may help selected patients with frequent outbreaks or transmission concerns. The choice is individual, not based on an IgG result alone.
Can oral sex or a symptom-free partner transmit herpes?
Yes. Oral HSV-1 may cause genital HSV-1 infection through oral-genital contact, and both HSV-1 and HSV-2 can sometimes spread without visible sores. Condoms and avoiding contact during symptoms lower risk without removing it completely. A confidential consultation can address testing results and partner questions without assumptions.
First episode versus recurrent genital herpes
A true first episode may cause extensive painful blisters or ulcers, fever, tender nodes and painful urination; however, the first *recognised* episode is not always a newly acquired infection. Recurrent episodes are often shorter and milder, especially with genital HSV-2. Treatment decisions depend on the episode, severity, pregnancy status and recurrence pattern.
HSV PCR, IgG and IgM: what they mean
PCR/NAAT from a fresh blister or ulcer is the preferred direct test when lesions are present. Type-specific HSV-1/HSV-2 IgG indicates prior exposure but cannot reliably determine the site of HSV-1 infection or whether a current symptom is caused by HSV; early infection may test negative. Some low-positive HSV-2 IgG results require confirmation. HSV IgM is not recommended because it is unreliable and not type-specific.
Can herpes spread without blisters?
Yes. HSV can be shed from skin or mucosa without visible sores or symptoms. Condoms and, for selected patients, daily suppressive antiviral treatment can lower transmission risk but cannot eliminate it. Avoid sexual contact during prodromal tingling or active lesions.
Prodrome and early treatment
Some people notice tingling, burning, itching or local discomfort before blisters appear. When a clinician has prescribed episodic antiviral therapy for known recurrent herpes, starting it at the first prodromal sign or within about one day of lesion onset offers the greatest benefit. Do not delay evaluation of a first episode to self-treat.
When is daily suppressive treatment considered?
Daily antiviral suppressive treatment may be considered for frequent or troublesome recurrences, substantial distress, or to reduce the risk of transmitting genital HSV-2 to a partner who does not have HSV-2. The decision is individual and depends on recurrence frequency, HSV type, kidney function, pregnancy status and patient preferences. Suppressive treatment lowers but does not eliminate shedding or transmission; it should be reviewed periodically with a clinician.
Can oral sex transmit genital HSV-1?
Yes. HSV-1 commonly causes oral cold sores and can spread to a partner’s genital area through oral sex, including when there is no visible cold sore because asymptomatic shedding occurs. Genital HSV-1 generally recurs and sheds less frequently than genital HSV-2, particularly over time. Avoid oral-genital contact when cold sores or warning symptoms are present; barrier methods lower, but do not remove, risk.
Treatment and follow-up
Antiviral treatment can shorten episodes; suppressive therapy may reduce recurrences and transmission. Avoid sexual contact during lesions or prodromal symptoms; condoms reduce but do not eliminate risk.
Prescription antivirals can shorten outbreaks. Daily suppressive therapy may help people with troublesome recurrences and can lower genital HSV-2 transmission in selected couples. Medication does not remove latent HSV from the body.
What happens during your confidential STD consultation?
A focused, non-judgmental assessment is tailored to your symptoms and exposure history. An examination or test is recommended only when clinically appropriate, with your consent.
1. Private discussionDiscuss symptoms, onset, relevant exposures, past tests and treatments in a confidential setting.
2. Focused examinationSkin or mucosal examination only if needed; the reason and your comfort are discussed first.
3. Appropriate testingSelect lesion swabs, first-catch urine, site-specific NAAT or blood tests as relevant. Not everyone needs a full STD panel.
4. Treatment and follow-upExplain treatment options, prevention, partner considerations and when repeat testing or review is needed.
A space to discuss sensitive health questions
Confidentiality is central to your STD consultation
We understand that concerns about genital symptoms, sexual contact or a positive test can feel personal. Your appointment is approached respectfully, without blame or judgment.
Discreet conversationDiscuss what happened and what worries you in a clinical setting, with ordinary medical confidentiality protections.
No unnecessary questionsHistory and examination focus on what helps diagnosis and care. Examinations are explained and require your consent.
No automatic “full STD panel”Tests are suggested according to symptoms, exposure, site and timing—not as a blanket requirement for everyone.
Partner concerns handled sensitivelyYou can ask how to communicate with a partner, and what evaluation or treatment might be appropriate.
Medical confidentiality is subject to applicable law and clinical obligations. Please avoid sending intimate photographs or detailed sexual histories in an appointment enquiry.
Why visit Dr Neeraj Garg for Genital Herpes?
Dr Neeraj Garg holds MBBS (IMS-BHU) and MD (IMS-BHU) qualifications and provides dermatology and venereology consultations in Dehradun. The focus is on explaining symptoms, interpreting appropriate tests and discussing a practical next step.
MBBS • IMS-BHUMD • IMS-BHUDehradun • Uttarakhand
- Dermatology and venereology-focused clinical assessment, including conditions that resemble STIs.
- Confidential, respectful consultation without assumptions about relationships or sexual history.
- Tests chosen according to symptoms, exposure sites and appropriate diagnostic windows—not unnecessary blanket testing.
- Discussion of treatment, prevention, partner evaluation and follow-up when relevant.
Prevention and partner advice
- Avoid oral, vaginal and anal sex during tingling prodrome or active lesions.
- Discuss condom use and, if appropriate, daily suppressive antiviral treatment.
- Talk openly with your partner without assuming the date or source of an infection from a blood-test result.
When to seek urgent care: Seek prompt medical assessment for fever, severe pain, rapidly spreading inflammation, pregnancy, persistent ulcers, or symptoms that worsen despite treatment.
Frequently asked questions
Can herpes spread without visible sores?
Yes. HSV can be shed from normal-looking skin, so infection can sometimes spread even without blisters.
Does positive HSV IgG mean I need antiviral medicine?
Not by itself. IgG usually shows previous exposure and does not establish an active outbreak. Treatment depends on symptoms and clinical context.
Is HSV IgM recommended?
No. HSV IgM can be misleading and is not recommended for diagnosing genital herpes.
Which test is best when blisters are present?
A swab from a fresh sore for HSV PCR/NAAT is usually the preferred test.
Can oral sex cause genital HSV-1?
Yes. Oral HSV-1 can transmit to genital skin during oral sex, even if no cold sore is visible.
Is genital HSV-1 different from genital HSV-2?
Genital HSV-1 generally recurs and sheds less often than genital HSV-2, particularly over time.
When should I start medicine for a recurrence?
If you have a prescribed episodic plan, starting antivirals during early tingling or within about one day of lesion onset provides the most benefit.
When is daily suppressive herpes medicine considered?
It may help with frequent or distressing outbreaks and may reduce genital HSV-2 transmission in selected couples. Your clinician will discuss suitability.
Will herpes ever leave the body completely?
HSV remains latent after infection. Antiviral medicines control symptoms and shedding but do not eradicate the virus.
Does a herpes diagnosis tell me when or from whom I got it?
Usually not. Symptoms may appear long after acquisition, and a blood result cannot establish who transmitted HSV.
Not sure which STD page you need?
Symptoms overlap, and some infections cause no symptoms. These links help you find information, not diagnose yourself.
Medical information and sources
This patient guide is educational and does not replace an individual clinical assessment. Treatment and testing recommendations may change with local guidance, pregnancy, other conditions and antibiotic resistance.
Need to speak privately about Genital Herpes?
Request a confidential STD / STI consultation with Dr Neeraj Garg, MBBS (IMS-BHU), MD (IMS-BHU), in Dehradun. Get individual guidance about symptoms, reports, testing and next steps.
Request an Appointment ↗Appointment enquiry only: there is no need to send intimate images or detailed medical information through WhatsApp.
Patient information updated 10 October 2026. This page provides general education and cannot replace an individual medical assessment. The appearance of a symptom does not by itself prove an STI.