doctor showing colleague the results of a test

In short, what you’re looking for in the case of a first outbreak is an inflammation of the skin that may be itchy or painful, as well as possible blisters or sores.

If you worry you may have genital herpes, you can go to your doctor and get tested or you can take our free photo assessment (if you have sores).

Alternatively, if you’ve been diagnosed with genital herpes, we offer the first line antiviral treatment which you can order and receive at home – following an online assessment.

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Does everyone have the same herpes symptoms?

Not everyone has symptoms of genital herpes – and some people infected with the virus may never have a single attack. However, it’s still possible for them to infect other people.

The virus spreads the most when it’s active, which is the whole period around the formation of blisters until the end with scab formation. In fact, the beginning and the end of an outbreak are the moments when the virus is most contagious.

Since genital herpes affects such private parts of your body, people tend to think that the virus acts differently on men and women… but it doesn’t really. The only difference is with pregnant women who may suffer different complications. Other than that there is no really male or female genital herpes virus, the infection spreads the same for everyone.

Primary infection & First attack

Most people who get a primary attack directly following an infection tend to have it about 1-2 weeks following the moment the virus first entered the body. This is the time the virus needs to multiply inside your cells in a quantity that is sufficient to cause an outbreak.

However the reason most people don’t notice this first outbreak is because it can be so mild that they don’t really pay attention to it. The infection usually follows a similar pattern with first a small inflammation of the skin, which may burn or itch. Then, blisters appear and often burst open into sore ulcers, until scabs form and finally heal.

Some patients also have fever, headaches and a burning sensation when peeing. Note that 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 infection (see below).

On the upside, following outbreaks tend to be less severe than the first one and people often get to know how to recognise the early signs of genital herpes - which allows them to start treating the infection very early on.

Primary genital herpes – signs and symptoms

During the first attack, the early symptoms of genital herpes generally include the following:

  • Fever & flu-like symptoms
  • Nausea or feeling sick
  • Muscle aches
  • Painful urination
  • Tingling, burning or itching sensation in the area where blisters will appear

After this, a cluster of small blisters (sometimes painful) appear filled with slightly cloudy liquid. These 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 vaginal lips, inside the vagina, groin & thighs, on the buttocks and around the anus.

Through different sexual activities (e.g. oral sex), it’s possible to get genital herpes in the mouth, tongue, lips and other parts of the body. However this remains quite rare and happens mostly when the virus is very active – i.e. when blisters or sores have appeared or are about to.

In the case of female genital herpes, patients tend more often to suffer from painful urination and abnormal vaginal discharge. Note as well that blisters inside the vagina can last up to three weeks, after what they heal on their own. The inflammation of the cervix (neck of the womb) is one of the signs of female genital herpes.

Recurrent genital herpes – signs and symptoms

As we’ve mentioned before, the symptoms and signs of genital herpes usually tend to be less severe and last fewer days – somewhere between 5-10 days depending on when you’ve started your antiviral treatment. An early treatment - during the first 24 hours of the signs of genital herpes outbreak – can get rid of the problem within a few days.

Moreover, it’s very rare that patients still suffer from flu-like symptoms and nausea in cases of chronic genital herpes. The most easily recognisable signs of genital herpes activity is a tingling or itching sensation you can feel about 12 to 24 hours before the blisters appear. This is the best time to start a treatment.

How often can you get outbreaks? Well, it depends on you and on your immune system. Sometimes it’s hard to tell why some people have only one outbreak per year while someone else has over 6 outbreaks annually. What we know however is that a healthy immune system tends to keep the virus at bay, so avoid any excess of alcohol, stress or unhealthy diet. In some cases, sunburns can also be a trigger of herpes. You should try to find out what triggers the virus’s activity in your case so that you can better prevent future episodes.

On average, the number of outbreaks and the symptoms they cause also depends on the type of herpes virus you are infected with. People with herpes simplex 1 (HSV1 or herpes type 1) - which is more common in herpes outbreaks above the waist – causes much less attacks and less severe symptoms than herpes simplex 2 (HSV2) which is the typical genital herpes virus.

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