genital herpes

genital herpes

Herpes Symptoms

Identifying the Symptoms of Herpes

Persons infected with HSV often experience symptoms within days of exposure to the virus, but it is possible to live with herpes for a long period of time without being aware of having been infected.  Investigating the various types of herpes symptoms, from mild to severe, and understanding the hidden symptoms of asymptomatic shedding, goes a long way in identifying and treating herpes.  When identifying herpes, other STD symptoms should also be considered.  Also common mistaken symptoms can be insect bites, jock itch, yeast infections, and ingrown hair follicles.


Genital Herpes

Herpes simplex virus type 2 (HSV-2) is commonly the cause of genital herpes.  However, HSV-1 can also cause genital herpes and incidents of HSV-1 genital infection account for a significant portion of genital herpes cases.

Following initial infection of herpes transmission with HSV-1 or HSV-2, also known as Primary infection, gential herpes symptoms can start within 2-15 days.  During the first outbreak the initial sign can be a tingling sensation in or around the site of infection.  The skin may become irritated and red, and this is often followed by blisters.  The blisters can look like small pimples and will rupture thereby forming an ulcer which will then crust over.

With symptoms in women, the lesions during a first episode can occur on the lips of the vagina (the vulva), urethra, cervix, upper thigh and around the anus. With symptoms in men, lesions can occur on the penis, urethra, scrotum, upper thigh and around the anus.  These lesions can be painful for a full week and can take up to 2-3 weeks to heal completely.  During primary infection symptoms can include flu-like symptoms along with fever, muscle pain, tiredness, and swollen lymph nodes around the groin.


Recognizing these herpes signs and symptoms as soon as possible is important and you should visit your physician immediately.  A swab can be taken from the blister to confirm diagnosis or a blood test may be performed to detect for HSV antibodies.  Herpes treatment can help to shorten the duration of the episode.

During the initial infection, the virus travels up the nerves to establish residency in nerve bodies (ganglia) near the spine. This is known as latency. Recurrent outbreaks are caused when the virus periodically emerges from latency to cause another outbreak.  These recurrences tend to be less severe than the primary infection outbreak. 

The onset of a recurrent episode can often be detected by a tingling feeling in the skin known as prodrome.  These sensory feelings often indicate that the virus is active and traveling through the nerve ganglia to the skin infection site.  It is during this time that herpes medication such as antiviral therapy is most effective in stalling out the virus to shorten or prevent the oncoming outbreak.

Recurrent outbreaks often occur in the same region or location of the body.  This is because the virus is transported from the nerve ganglia along the nerve paths to the skin, which limits where a recurrence can take place (generally below the waist if the genital area is infected). However, the symptoms do not always occur in exactly the same place.  Once the blisters burst, small ulcerations or sores remain and can be painful.

Some patients infected with genital herpes do not always display the classic symptoms of herpes blisters as seen in herpes photos.  Some experience symptoms that are very mild and can even go by unsuspected by the primary physician.  Having recurrent symptoms in the same location of the genital region is a strong indication that HSV infection may be the culprit.

Patients with genital herpes often shed the virus even when no obvious symptoms are present.  This is known as asymptomatic shedding and the virus is active and can be spread to infect others during this period.

Condoms do not offer complete protection from transmitting the virus as the virus may shed in an area that is not protected by a condom.  Damaged skin such as dry cracked skin or small cuts from the use of a razor allows the virus to more easily infect a person or spread over the skin.

HSV-1 can be spread during oral sex from the mouth to the genital tract.  Also genital herpes caused by HSV-1 can be transmitted via genital-to-genital contact just as HSV-2 can be transmitted.   Of people who have a first episode of genital herpes, as many as half of the cases are the result of HSV-1 infection.  Those experiencing genital herpes caused by HSV-1 may experience less pronounced symptoms and may have fewer and less severe recurrent genital herpes outbreaks.

Cold sores
Herpes simplex virus type 1 (HSV-1) is usually the cause of cold sores or herpes in and around the mouth.  The virus is transmitted via direct skin to skin contact.  HSV-2 which is most commonly associated with genital herpes infections may also cause cold sores.  Both symptoms in men and women are similar.

Initial infection with HSV-1, also known as Primary infection, typically occurs during childhood.  Primary infection carries no symptoms in approximately 75% of individuals.  When symptoms do occur, they often include flu-like symptoms such as fever and swollen lymph nodes.  Oral symptoms include blisters or ulcers can appear in the mouth, gums, tongue and on the lips.  These blisters or ulcers can be painful but are often mild and can last for up to 10 days.  Typically around day 5 the ulcers peak and then begin to decrease.  When primary infection occurs during teenage years and older, the symptoms can be more severe compared with primary infection acquired during childhood.


HSV-1 infection will permanently remain latent in the body and when active can cause recurrent cold sores.  While the majority of the global population is infected with HSV-1, only 20-40% will develop cold sores.  Those that do experience cold sores may have 2-3 recurrent outbreaks per year.  These recurrences tend to be shorter in duration and symptoms less pronounced when compared to primary infection.  This is because the body’s immune system has developed antibodies to defend against the virus.


The triggers that cause the herpes virus to activate and cause recurrent outbreaks are still not fully understood.  It is believed that certain triggers include stress, sunlight or UV light, a compromised immune system, and diets high in amino acid arginine. 


Once herpes symptoms are recognized it is important to complete genital herpes testing with your physician to make a conclusive herpes diagnosis .  While there is no herpes cure, there are treatments available to manage the virus.


*None of this site's content or referral resources constitutes any form of medical advice or diagnosis.  All patients are encouraged to seek medical advice from their own physician.