Genital herpes is still contagious if it recurs twenty years after it has healed. Genital herpes is a sexually transmitted disease (STD) caused by herpes simplex virus type 2 infection, which is transmitted through direct sexual intercourse and indirectly. It is categorized as primary and recurrent, meaning that it may recur after the initial outbreak is cured. Recurrent infections may occur twenty years after genital herpes has healed and are contagious if they recur. Excessive stress, fatigue, anxiety, alcohol consumption, and female menstruation are the triggering factors for genital herpes recurrence, which is mainly manifested by the occurrence of small blisters, ulcers, pain, itching, and oozing of secretions in the genital area of both men and women. Treatment includes oral and topical antiviral medication, such as oral acyclovir and topical acyclovir cream, which can shorten the course of the disease, alleviate the symptoms, and reduce the recurrence, etc. If left untreated, the lesions will also heal on their own in about 7 to 10 days, but they may still recur. For those who have questions about whether genital herpes is contagious after twenty years of healing, you can consult your doctor.