Genital herpes symptoms and early signs to look out for

Dr. Babak Ashrafi

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 27 Jan 2022

Symptoms of genital herpes include painful blisters on the genitals, bottom, and thighs. These can show up in the area that boxer shorts or full briefs would cover.

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The early signs and stages of genital herpes you need to look out for are:

  • a skin rash that develops 4 to 7 days after exposure to herpes simplex virus (HSV)
  • blisters that burst to form erosions (red skin sores)
  • headache, fever, tiredness, pain passing urine or tenderness underneath the skin

Other symptoms may include discharge, swelling or a tingling sensation in the genital area. A genital herpes episode may last up to 20 days. If you are having a recurrent episode it may be shorter or milder.

You may have some or no symptoms at all if you have the herpes simplex virus. Sex and stress are triggers that can cause a recurrence. If you think you have genital herpes, you should speak to a doctor, and you may want to consider doing an at home genital herpes test or general STI test.

A doctor can help confirm or rule out other conditions that may be causing you discomfort. They can recommend the right treatment for you and advise you on what your next steps should be.

What is genital herpes?

Genital herpes is an infection of the genitals that’s caused by the herpes simplex virus (HSV). For the majority of people, genital herpes is mild. Although there is no vaccine or cure for HSV, you can get treatment to help heal blisters and sores by speaking to a doctor as soon as you can. At ZAVA Online Doctor, you can request genital herpes treatment and have it delivered straight to your door within 24 hours.

The best way to protect yourself from getting genital herpes is to wear a condom during sex. You should not have sex with someone if you or your partner has an active flare up or outbreak, as the infection remains permanently. This will help prevent herpes infection from spreading.

With the HSV virus, you will not have genital herpes symptoms all the time. This is because the virus sleeps (lays dormant) in your nerves until something happens that triggers an infection. Then you will start to get symptoms and may feel unwell.

What causes genital herpes?

Genital herpes is caused by the herpes simplex virus (HSV). There are two forms of HSV that can affect the genitals, HSV-1 and HSV-2. Both cause similar symptoms, but HSV-1 tends to cause cold sores in the mouth too.

How do you get herpes?

You get herpes when you come into contact with the liquid from a herpes blister, infected sexual fluids or infected skin. This is mostly through sexual contact, by either having penetrative sex or oral sex. You can also spread herpes if you rub infected skin or eyes and touch another part of your body or another person’s body.

You’re more likely to spread herpes when you have sores or blisters that you can see, than when you are not experiencing symptoms. However, keep in mind that you can still spread the virus even if you do not have symptoms that you can feel or are visible.

Most people with herpes are unaware they have it and in fact, it may only start to cause symptoms a few years after you first get it.

What are the symptoms of genital herpes in men?

Symptoms of genital herpes in men include:

  • tingling in the genital area including the penis, scrotum, anus, bottom, or thighs
  • red bumps that form blisters
  • blisters that burst to form ulcers (deep skin wounds)

Early signs of genital herpes in men

Early signs of genital herpes in men may include some flu-like symptoms and you may have:

  • tingling, burning or stinging on or in the genitals
  • swollen glands
  • headaches, tiredness, fever, and muscle aches
  • discomfort passing urine

What are the symptoms of genital herpes in women?

Symptoms of genital herpes in women include:

  • tingling in the labia, vagina, anus, bottom, or thighs
  • red bumps which form blisters
  • blisters which form ulcers (deep skin wounds)

Early signs of genital herpes in women

Early signs of genital herpes in women may include mild flu-like illness, and you may have:

  • changed sensation in the genitals
  • swollen glands in the groin , neck, and armpits
  • aches in the body
  • difficulty or pain when passing urine

Primary infection and first outbreak

Primary infection and first outbreaks tend to be worse than later infections or outbreaks. Primary infection is when you are exposed to the herpes virus for the first time.

A first outbreak is when you start to experience symptoms for the first time. Red bumps in the genital region form blisters. These may burst to form ulcers or erosions. Often it takes a few days after first getting HSV to develop symptoms and up to a few weeks for symptoms to get better.

If you do start to get symptoms, see a doctor straight away and get tested because herpes treatment is more effective when you start it early.

Signs of recurrent genital herpes

Signs of recurrent genital herpes are like your first ever outbreak but milder.

You may start to feel an infection coming on, such as tingling or burning in the genital area followed by bumps, blisters and ulcers. Recurrent genital herpes tends to occur at a single site on the body on one side. Fever, aches, and tiredness are symptoms that are less common in recurrent genital herpes.

How long does a recurrent herpes outbreak last?

Recurrent herpes outbreaks tend to be shorter and milder than first outbreaks. They tend to last a couple of days and heal within a couple of weeks.

With recurrent herpes outbreaks tingling or burning usually happens within 48 hours before the lesions appear.

You can request treatments that prevent recurrent outbreaks of herpes from ZAVA Online Doctor.

How often can you get herpes outbreaks?

How often you get herpes outbreaks depends on many factors, such as which type of HSV virus you have and your triggers.

HSV-2 tends to cause an average of 4 to 5 outbreaks per year. The average for HSV-1 is less than 1 outbreak per year.

Herpes outbreaks occur more often in the first year after the first outbreak. After some time, you may find the symptoms you get are milder and happen less often as you get fewer outbreaks.

There may be triggers that can lead to herpes outbreaks including:

  • being ill or feeling run down
  • stress
  • friction or rubbing in the genital region during sports or sex
  • intense sunlight and UV exposure, such as sunbeds at tanning salons
  • damage to the skin, such as an injury or during surgery
  • using steroid creams or tablets

How long does a herpes outbreak last?

A herpes outbreak can last a few weeks, but you can shorten this time by getting treatment as soon as possible.

If your herpes outbreak is recurrent, which means it’s not the first time you’ve had an outbreak, it may last around a week. Recurrent herpes outbreaks tend to be milder, but we would still recommend you treat your symptoms. Treatment will help you recover faster, prevent discomfort and avoid skin scarring.

If you’re unsure whether you have herpes, you can get a herpes test that you can do at home. You should see a doctor if you feel like your symptoms are getting worse or you’re just not getting better. This will also help you find out whether or not something else might be causing you to feel unwell. Then your doctor can give you the treatment that’s right for you.

Treatment options for genital herpes

Treatment options for genital herpes include:

  • making lifestyle changes to avoid triggers, such as quitting smoking or cutting down on alcohol
  • using painkillers or numbing creams to help with discomfort
  • taking antiviral treatment which prevents the genital herpes virus from multiplying and spreading

Antivirals are effective if you take them as soon as your herpes symptoms appear. You should start to feel better within a few days of starting a course of antiviral medicines. Examples of antivirals that can help treat genital herpes are:

The length of your treatment course with an antiviral will depend on whether this is your first outbreak and what symptoms you have.

Typically 5 days of treatment with aciclovir or valaciclovir is enough to treat a first outbreak, though you may need a longer 10 day course. If you have recurrent outbreaks, your doctor may recommend you regularly take a low dose antiviral treatment. This may help to suppress the HSV virus, so you get fewer genital herpes outbreaks.

Before you use antiviral treatment, you should tell your doctor if:

  • you are pregnant
  • have conditions that affect your immune system, such as HIV
  • take any other medication

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Medically reviewed by:
Dr Babak Ashrafi Clinical Lead for Service Expansion

Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.

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Last reviewed: 27 Jan 2022

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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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