Signs of Genital Herpes

Dr Kathryn Basford

Medically reviewed by

Dr Kathryn Basford

Last reviewed: 26 Feb 2019

What are the symptoms of herpes simplex?

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Key takeaways

  • The first signs of a genital herpes outbreak are typically an itchy or painful inflammation of the skin, which turns into blisters or sores

  • Other signs can include fever and flu-like symptoms, feeling sick, muscle aches, and painful peeing

  • Not everyone gets the same symptoms, but there’s no difference between the symptoms for men and for women

  • Herpes outbreaks are what cause the signs and symptoms, but getting the herpes infection doesn’t always cause an outbreak straight away

  • Some people never have any outbreaks, even though they’ve got the herpes virus infection

The first herpes outbreak typically causes an itchy or painful inflammation of the skin, which manifests itself as blisters or sores. If you notice any rash or blisters around your genitals, you should talk to a doctor, test at home for genital herpes, or do a more general STI test. You could also visit a sexual health clinic for a test.

Primary genital herpes – signs and symptoms

During the first outbreak, the early symptoms of genital herpes include:

  • fever and flu-like symptoms
  • nausea or feeling sick
  • muscle aches
  • painful urination
  • tingling, burning or itching sensation in the area where blisters will appear

After the initial tingling and itching, one or more clusters of small blisters (sometimes painful) appear, which are filled with slightly cloudy liquid. The blisters can be located in different areas:

  • In men, genital herpes sores can appear inside or on the penis, scrotum, groin & thighs, buttocks and around the anus
  • In women, these blisters can appear on the labia, inside the vagina, groin & thighs, on the buttocks and around the anus

Through different sexual activities (e.g. oral sex) it is possible to get genital herpes in the mouth, tongue, lips and on other parts of the body. However, this type of transmission is most likely to happen when the virus is very active – i.e. when blisters or sores have appeared or are about to form.

In women, it’s possible for the herpes virus to cause blisters inside the vagina, which might not be easy to see, but can cause pain when passing urine and an abnormal vaginal discharge.

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Does everyone have the same herpes symptoms?

Not everyone suffers the same symptoms of genital herpes – and some people infected with the virus may never have a single outbreak. However, it is still possible for them to infect other people.

The virus is most likely to be passed on when there are open sores or blisters, but it can be passed on from the moment you start to notice itching or tingling. Sometimes the virus can be passed on even when there are no symptoms at all.

Since genital herpes affects the private parts, people tend to think that the virus acts differently on men and women. However, the symptoms of genital herpes are very similar in males and females. The most important difference is that the virus can cause complications in pregnant women, who can pass the infection on to their babies. Other than that, there is no such thing as a male or female genital herpes virus, the infection is caused by the same virus in both sexes.

Primary infection and first outbreak

Getting infected with the herpes virus isn’t the same thing as having an outbreak. You may not experience any symptoms at all when you first get the virus, because it’s actually an outbreak that causes symptoms. As we said above, some people who have the virus never get any outbreaks at all.

But, it’s quite common to get a first outbreak within 1 to 2 weeks after getting the herpes virus. During these first weeks, the virus can multiply inside your cells, until its presence causes an outbreak. The symptoms of this first outbreak can be quite mild, though – it can look like a spot or an ingrown hair.

Outbreaks usually follow the same pattern. They begin with an itching or tingling sensation, then blisters appear and burst open into sore ulcers. As the outbreak progresses, the ulcers turn into scabs and heal without causing any scarring. Some patients also experience a fever, headaches and a burning sensation when peeing.

The first outbreak can last for many weeks and take a long time to heal.

Following this first episode, the virus becomes dormant again until something triggers a new outbreak. There’s more information on this further down this page.

The outbreaks following the first one tend to be less severe. Patients often learn how to recognise the early signs of genital herpes, which allows them to begin antiviral treatment, such as aciclovir, before the symptoms get too unpleasant.

Recurrent genital herpes – signs and symptoms

After the first outbreak, the symptoms and signs of genital herpes tend to be less severe and last fewer days – somewhere between 5 to 10 days, depending on when you’ve started your antiviral treatment.

Other than that, the signs and symptoms to look out for are the same with recurrent outbreaks as with first outbreaks.

Early treatment, ideally within 24 hours of the first signs of a genital herpes outbreak, can alleviate the symptoms within a few days.

In very rare cases, recurrent outbreaks can cause flu-like symptoms and nausea. The most noticeable sign of recurrent genital herpes is a tingling or itching sensation you can feel about 12 to 24 hours before blisters appear. This is the best time to begin treatment.

How often can you get herpes outbreaks?

The frequency with which outbreaks recur depends on your immune system. Why some people have only one outbreak per year while others encounter over 6 outbreaks is not known. However, a healthy immune system tends to keep the virus at bay.

You should avoid consuming large quantities of alcohol as well as stress and eat a healthy diet. In some cases, sunburn has been found to be a herpes trigger. You should try to find out what triggers the virus’s activity in your case, so that you can prevent genital herpes episodes in future.

The number of outbreaks and the symptoms they cause depend on the type of herpes virus you are infected with. People with herpes simplex 1 (HSV1 or herpes type 1) - which causes most herpes outbreaks above the waist – causes much less attacks and less severe symptoms than herpes simplex 2 (HSV2), which typically causes genital herpes symptoms.

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Medically reviewed by:
Dr Kathryn Basford

Dr Kathryn Basford is a qualified GP who works as a GP in London, as well as with ZAVA. She graduated from the University of Manchester and completed her GP training through Whipps Cross Hospital in London.

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Last reviewed: 26 Feb 2019

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You can treat genital herpes two ways. One treatment option is for when you experience an individual outbreak (acute therapy) and the other is treatment for when you need to avoid regular outbreaks (suppressive). ZAVA offers both types of treatment through a discreet, convenient service.

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