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 need to consult a doctor and find the cause of your symptoms. Your GP or nearest GUM clinic will be able to help.
Alternatively, our online doctor offers a free photo assessment for genital herpes (you only pay if you are diagnosed with herpes and choose to buy a treatment from us). If you have already been diagnosed with herpes, we can provide a quick and discreet antiviral treatment.
Not everyone suffers the same symptoms of genital herpes – and some people infected with the virus may never have a single attack. However, it is still possible for them to infect other people. The virus is most likely to be transmitted when it is active, while blisters are present. The beginning and the end of an outbreak, before the blisters turn to scabs, are the times during which the virus is most contagious.
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.
Most people who get a primary attack directly following the infection experience symptoms within 1-2 weeks after exposure (sexual intercourse with an infected partner). During this so-called incubation period, the virus multiplies inside your cells, until its presence causes an outbreak. However, many people don’t notice the first outbreak, because it can be very mild (symptoms are sometimes mistaken for a spot or an ingrown hair). Outbreaks usually follow the same pattern and 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 attack (see below).
The outbreaks following the first tend to be less severe. Patients usually 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.
During the first attack, the early symptoms of genital herpes include the following:
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:
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 quite rare and it 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, the herpes virus most commonly causes the symptoms of painful urination and abnormal vaginal discharge. Blisters inside the vagina can last up to three weeks, before they heal on their own. The inflammation of the cervix (neck of the womb) is also a typical sign of genital herpes in women.
After the first outbreak, the symptoms and signs of genital herpes tend to be less severe and last fewer days – somewhere between 5-10 days (depending on when you’ve started your antiviral treatment). Early treatment, ideally within 24 hours of the first signs of a genital herpes outbreak, can alleviate the symptoms within a few days.
It is very rare for recurrent outbreaks to cause flu-like symptoms and nausea. The most noticeable sign of chronic genital herpes is a tingling or itching sensation you can feel about 12 to 24 hours before the blisters appear. This is the best time to begin treatment.
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 future episodes. 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.