Overview

Monkeypox

Monkeypox is a rare infection that is usually found in west and central Africa, but it is now being diagnosed in the UK.

How it is transmitted

People of any gender or sex can get monkeypox. It can spread from person to person through:

  • touching monkeypox skin blisters or scabs (including during sex, or close sexual intimacy like skin-to-skin contact when kissing)
  • touching clothing, bedding or towels used by someone with the monkeypox rash
  • close contact with the coughs or sneezes of a person with the monkeypox virus

Common symptoms

If you get monkeypox, the first symptoms usually appear between 5 and 21 days later.

Symptoms of monkeypox include:

  • fever
  • headache
  • muscle aches
  • backache
  • swollen and painful lymph nodes
  • shivering (chills)
  • exhaustion
  • rash or spots on your genitals or around your bottom (anus and rectum)
  • pain in your bottom, including difficulty having a poo
  • sore throat and swollen tonsils
  • skin rash

The rash goes through different stages during the illness, before forming scabs which fall off. The rash usually lasts about 2 to 4 weeks. Most of these symptoms can be treated at home.

If you need to visit a GP, walk-in centre or A&E:

  • wear a facemask
  • cover up any spots
  • tell the staff that you might have monkeypox, or have tested positive, as soon as you arrive. They can look after you and make sure there’s no risk of passing it on to other people


Symptoms that need medical attention

You might need to get medical help if:

  • you have a skin infection from where monkeypox has damaged the skin, called cellulitis
  • your foreskin pulls back but will not go forwards again (paraphimosis)

Skin infection (cellulitis)

Sometimes bacteria can cause infection when the skin is damaged by the monkeypox rash or spots. This is called cellulitis.

Cellulitis can be serious if it's not treated quickly with antibiotics. Cellulitis can happen anywhere on the body, including your penis or scrotum.

Contact your nearest sexual health clinic, ask for an urgent GP appointment or go to a walk-in centre if:

  • your skin is painful, hot and swollen
  • you see spreading redness on your skin

Call 999 or go to A&E immediately

if you have cellulitis with:

  • a very high temperature, or you feel hot and shivery
  • a fast heartbeat or fast breathing
  • purple patches on your skin, but this may be less obvious on brown or black skin
  • feeling dizzy or faint
  • confusion or disorientation
  • cold, clammy or pale skin
  • unresponsiveness or loss of consciousness

Trapped foreskin (paraphimosis)

If the foreskin pulls back and will not go forwards, it can cause the glans (head of the penis) to become painful and swollen. An ice pack might reduce the swelling and allow you to gently pull your foreskin back into position.

If you can’t get your foreskin back into position, you might need emergency medical treatment to avoid serious complications, such as increased pain, swelling and restricted blood flow to the penis.

Go to your nearest emergency department (A&E) if

  • spots on or around the tip of your penis are stopping you peeing
  • your foreskin gets stuck and you can’t get it back into position


How to treat symptoms at home

Here are some common problems, and how you might be able to treat them yourself.

You can contact the sexual health clinic where you were tested to ask for advice or support if you need it. But sometimes problems happen at night or can’t wait until the clinic is open.

As you’ll be isolating, ask a family member or friend to go to a shop or pharmacy for you. If that isn’t possible you can go yourself but make sure you:

  • avoid contact with others
  • wear a face mask
  • cover up any visible spots 

Read the government advice about isolating for monkeypox.

Spots near or in your bottom

If you have spots near or in your bottom, they can be painful. It is important you use pain relief and avoid getting constipated (struggling to poo). Make sure you drink plenty of fluids (not alcohol) as it helps keep your poo soft enough to pass without pain.

It can help to use pain relief directly on the skin around your bottom to reduce discomfort. These usually contain local anaesthetic which can help numb the area. Useful medicines include:

  • Anodesyn (lidocaine and allantoin) ointment or suppositories
  • Germoloids® (lidocaine and zinc oxide) cream, ointment or suppositories

Constipation

If you are constipated, you can try using a laxative. Laxatives can help keep your poo soft, so it's easier and less painful to pass. These can be taken orally (by mouth) or as suppositories (in your bottom).

Docusate sodium (100mg capsules), lactulose oral liquid or macrogol (Movicol®) oral sachets are taken by mouth. Glycerine suppositories can be helpful too. You can buy these from a pharmacy or shop.

Throat and mouth

You can use sprays or mouthwash that contain painkillers such as benzocaine (Chloraseptic®) spray, benzydamine (Difflam®) spray or mouthwash, or lidocaine (Xylocaine®) spray.

If your pain is uncontrolled with simple pain relief or you start to have difficulty swallowing liquids, you should contact the sexual health team for advice.

Genitals

If you have spots from monkeypox on your penis or scrotum, we suggest you:

  • wash your hands before and after peeing or touching your genitals
  • wash your genitals every day
  • gently pull back your foreskin (if you have one), and wash the area with warm water
  • dry gently after washing
  • avoid perfumed soaps, bubble bath or baby wipes

If you get a lot of swelling (oedema) of your penis, an ice pack might help reduce the swelling and pain. You can wrap a bag of frozen peas in a cloth, such as a clean tea towel, and mould this around the swollen area.

Do not put ice or ice packs directly onto the skin. 

Do not wrap anything around the penis or scrotum, including bandages, a tourniquet, or sticky tape.

Get urgent medical attention if your foreskin pulls back but will not go forwards again (a paraphimosis).

    Pain relief

    You might have pain from headaches, lesions in your mouth, or in your bottom. You can try the products mentioned in this information which might help with your pain.

    You can also use regular painkillers that you can buy from a pharmacy or shop, such as paracetamol and ibuprofen. Always follow the instructions on the packet.

    Support and more information

    Resource number: /VER
    Last reviewed: August 2022
    Next review due: August 2023

    Contact us

    If this advice does not help, contact your GP or nearest sexual health clinic.

    You can also contact NHS 111 for advice.

    pals icon

    Do you have any comments or concerns about your care?

    Contact our Patient Advice and Liaison Service (PALS)

    Is this health information page useful?