Symptoms of Genital Herpes

Symptoms of herpes are called outbreaks. The first outbreak after initial infection typically occurs after a 2 to 12 day incubation period and can last several weeks. The average incubation period is 4 days.

Symptoms of herpes outbreaks include tingling or sores near the area where the virus has entered the body, such as on the genital or rectal area, on buttocks or thighs, or occasionally on other parts of the body where the virus has entered through broken skin.

They also can occur inside the vagina and on the cervix in women, or in the urinary passage of women and men. Small red bumps appear first, develop into small blisters, and then become itchy, painful sores that might develop a crust and will heal without leaving a scar. Sometimes, there is a crack or raw area or some redness without pain, itching, or tingling.

Other symptoms that may accompany the first (and less often future) outbreak of genital herpes are fever, headache, muscle aches, painful or difficult urination, vaginal discharge, and swollen glands in the groin area.

Often, though, people don’t recognize their first or subsequent outbreaks. People who have mild or no symptoms at all may not think they are infected with herpes. They can still transmit the virus to others, however.

Up to 90% of people with herpes types 2 have no clinical history of anogenital herpes outbreaks. Most however, have mild, unrecognized disease, and probably all shed virus from the genital area intermittently.

Recurrence

In most people, the virus can become active and cause outbreaks several times a year. This is called a recurrence, and infected people can have symptoms. HSV remains in certain nerve cells of your body for life. When the virus is triggered to be active, it travels along the nerves to your skin. There, it makes more virus and sometimes new sores near the site of the first outbreak.

Recurrences are generally much milder than the first outbreak of genital herpes. HSV-2 genital infection is more likely to result in recurrences than HSV-1 genital infection. Recurrences become less common over time, particuarly if prescription or non-prescription genital wart medication is utilized.

Symptoms from recurrences might include itching, tingling, vaginal discharge, and a burning feeling or pain in the genital or anal area. Sores may be present during a recurrence, but sometimes they are small and easily overlooked.

Sometimes, the virus can become active but not cause any visible sores or any symptoms. During these times, small amounts of the virus may be shed at or near places of the first infection, in fluids from the mouth, penis, or vagina, or from barely noticeable sores. This is called asymptomatic (without symptoms) shedding. Even though you are not aware of the shedding, you can infect a sexual partner during this time. Asymptomatic shedding is an important factor in the spread of herpes.

Herpes Complications

Genital herpes infections usually do not cause serious health problems in healthy adults. In some people whose immune systems do not work properly, genital herpes outbreaks can be unusually severe and long lasting.

Occasionally, people with normal immune systems can get herpes infection of the eye, called ocular herpes. Ocular herpes is usually caused by HSV-1 but sometimes by HSV-2. It can occasionally result in serious eye disease, including blindness.

A woman with herpes who is pregnant can pass the infection to her baby. A baby born with herpes might die or have serious brain, skin, or eye problems. Pregnant women who have herpes, or whose sex partner has herpes should discuss the situation with her health care provider. Together they can make a plan to reduce her or her baby’s risk of getting infected. Babies who are born with herpes do better if the disease is recognized and treated early.
Genital herpes, like other genital diseases that cause sores, is important in the spread of HIV infection.

Encephalitis (inflammation of the brain) may result from primary or recurrent infection and is associated with fever, alterations in the state of consciousness, and convulsions.

Sources: US Department of Health & Human Services