Sacral Herpes:
Information for adults

Herpes simplex infection of the lower back and buttocks—also called sacral herpes simplex or genital herpes—is a common recurrent skin condition associated with infection by the herpes simplex virus (HSV). HSV infection usually appears as small blisters or sores around the mouth, nose, genitals, buttocks, and lower back, though infections can develop almost anywhere on the skin. Furthermore, these tender sores may come back periodically in the same sites.

Infections with the herpes simplex virus are very contagious and are spread by direct contact with the skin lesions. There are 2 types of HSV: Type 1 and Type 2.  HSV Type 1 (HSV-1) infections usually occur around the mouth, lips, nose, or face, while HSV Type 2 (HSV-2) infections usually involve the genitals, lower back, or buttocks. However, HSV-1 can sometimes cause infections in the genitals or buttocks, while HSV-2 can occasionally cause infections around the mouth, lips, nose, or face.

Both types of herpes simplex virus produce 2 kinds of infections: primary and recurrent. Because it so contagious, HSV causes a primary infection in most people who are exposed to the virus. However, only about 20% of people who are infected with HSV actually develop visible blisters or sores. Appearing 2–12 days after a person's first exposure to HSV, the sores of a primary infection last about 1–3 weeks. These sores heal completely, rarely leaving a scar. Nevertheless, the virus remains in the body, hibernating in nerve cells.

Certain triggers can cause the hibernating (latent) virus to wake up, become active, and travel back to the skin. These recurrent herpes simplex virus infections may develop frequently (every few weeks), or they may never develop. Recurrent infections tend to be milder than primary infections and generally occur in the same location as the primary infection.

HSV-2 infections are transmitted sexually or from a mother's genital tract to her newborn baby. HSV-2 is often spread through direct skin-to-skin contact with active lesions on another person. However, people who have herpes simplex virus infections may be contagious even when they do not have any skin lesions, which is called asymptomatic shedding.

Because sacral HSV is not located in the groin area, people may not realize that they have a form of genital herpes. In fact, they may think that they have a recurrent skin condition such as shingles, a yeast infection, or an allergic reaction. However, sacral herpes is considered to be a form of genital herpes.