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Herpes: Signs, Symptoms, Causes and More

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Herpes: Signs, Symptoms, Causes and More

writtenByWritten by: Christina Wedberg
Christina Wedberg

Christina Wedberg

Christina has been a writer since 2010 and has an M.F.A. from The New School for Social Research. Christina specializes in writing about health issues and education.

Read more posts by this author.

April 5, 2021 Read Time - 11 minutes

What is Herpes?

Herpes is a viral infection that can be found on the mouth or the genitals. This infection belongs to a family of over 70 different related viruses. The infection causes small, fluid-filled blisters to form on the skin and mucous membranes.

There are a total of eight herpes simplex viruses that can be contracted by men, women, and children—the most common of which are HSV-1 and HSV-2.

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What Causes Herpes?

Herpes is caused by the transmission of the herpes simplex virus (HSV) by direct contact with an infected person. Someone may be infected with herpes when they catch the virus through sexual contact with another person who already has the infection. It is passed via skin-to-skin transmission with infectious secretions on the mouth, genitals, or buttocks.

HSV-1 is most commonly transmitted by mouth-to-mouth contact. HSV-2, also called genital herpes, is considered a sexually transmitted disease. It is transmitted through oral, anal, or vaginal sex.

“You can get herpes from a sex partner who does not have a visible sore or who may not know he or she is infected,” according to the United States Centers for Disease Control. “It is also possible to get genital herpes if you receive oral sex from a sex partner who has oral herpes.”

Risk Factors for Herpes

Some risk factors for herpes may include:

  • Having unprotected sex
  • Having sex with multiple partners
  • Kissing someone with a herpes virus that is active
  • Abuse of cigarettes, alcohol, and drugs
  • Spreading the virus by touching a cold sore and then touching something else
  • Having an autoimmune disorder or illness, such as hepatitis or HIV/AIDS
  • Poor eating habits that cause nutritional deficiencies

Symptoms of Herpes

In many cases, the symptoms of herpes can be mild or not occur at all. Sometimes, mild symptoms of herpes can resemble a skin condition and be mistaken for something else.

Some symptoms of herpes may include:

  • Painful urination
  • Vaginal discharge
  • Itching
  • Sores that are painful on the thighs, buttocks, anus, or genitals
  • Lumps in the groin area that are tender to the touch

How Long Does It Take to Show Symptoms of Herpes?

On average, it takes about 4 days after exposure to start showing the symptoms of herpes. The herpes incubation period ranges between 2 and 12 days. The most common early sign of herpes is sores around the genitals or mouth.

The first time you get the herpes virus, it may cause flu-like symptoms, such as a fever, headache, and body aches. Then, subsequent outbreaks may cause sores and less severe symptoms. Generally, the frequency of outbreaks lessens over time.

What Does Herpes Look Like?

Oral Herpes

The oral herpes virus, known as HSV-1, looks different depending on what stage of herpes infection you have.

  • Stage 1: Prodrone – As the herpes virus comes in contact with your skin, it may cause a tingling sensation and cause the skin to redden. After 1–2 days, you may feel pain, itchiness, or irritation at the affected area.
  • Stage 2: Swelling and inflammation – Stage 2 is characterized by inflamed or swollen skin at the affected area.
  • Stage 3: Formation of blisters – Red, white, or clear blisters and/or cold sores filled with fluid may begin to form. They last about 2 days and will appear in a cluster as a single sore that is painful or sensitive to the touch.
  • Stage 4: Ulceration – After 1–2 days, the sores may burst, releasing fluid and becoming more painful. This generally disappears after about 1 day.
  • Stage 5: Scabbing or crusting – The sores begin to heal. A crust may develop over the burst blister that develops into a scab. After 2–3 days, new skin will begin to form underneath the scab.
  • Stage 6: Healing – That scab that formed over the blister will start to heal. Take care not to peel the scab off until the wound is completely healed to avoid scarring.

Genital Herpes

Like HSV-1, genital herpes (HSV-2) has six stages of development:

  • Stage 1: Prodrome – People in this stage are highly contagious. Pain, tingling, or itching may begin in the affected area as the first sign of herpes. During this stage, the herpes virus becomes active inside the skin and heads toward the surface to start an outbreak.
  • Stage 2: Skin redness – In this stage, the skin in the affected area may turn red and become sensitive. This lasts 1–4 days, and the infected person will still be highly contagious.
  • Stage 3: Formation of lesions – Lesions or herpes sores will begin to appear. Sores may appear around the anus or genitals in clusters or individually. These blister sores will fill with fluid and may become very painful. The sores will last for 2–6 days.
  • Stage 4: Development of lesions – The infected person will be the most contagious. The lesions or sores will continue to grow and eventually burst to release the buildup of fluid. The sore may stay open and runny for 1–4 days.
  • Stage 5: Scabbing – After the fluid drains from the herpes sores, it will dry out and become a scab for a few days.
  • Stage 6: Healing – The sore is fully healed when the scab falls off. Sometimes, a scab doesn’t develop, and the sores will just fade away. This process takes about 3–7 days.

Signs of Herpes in Men

In about two-thirds of cases, men will have no symptoms of herpes. Symptoms of herpes in men may include:

  • Body aches
  • Headache
  • Fatigue
  • Fever
  • Swollen lymph nodes
  • Blisters or sores on the penis

Other symptoms that are less common include:

  • Blisters or sores inside or on the anus and around the thighs and buttocks
  • Eye infection
  • Eczema herpetiform
  • Encephalitis
  • Meningitis

It is unclear if genital herpes affects fertility in men because it affects such a large part of the population. However, a recent study found that herpes may lower the sperm count in men and may have an effect on men’s ability to get pregnant with a partner.

Signs of Herpes in Women

Like men, women who have HSV-1 or HSV-2 may have no symptoms or signs of the infection. Some women may only have an initial outbreak and no other recurring symptoms. Others may have chronic recurring outbreaks of the herpes virus, and some women may not have an outbreak for months or even years after they have first been infected.

In the first herpes outbreak, symptoms usually start within 2 weeks of contracting the virus. The initial symptoms may include:

  • Headache
  • Swollen glands
  • Painful or uncomfortable urination
  • Vaginal discharge
  • Itching or burning in the anal or vaginal area
  • Flu-like symptoms
  • Fever
  • Pain in the vagina, buttocks, or legs

After 1–2 days, women may develop painful blisters or sores around the affected area, including:

  • On the mouth, vagina, or anus
  • Inside the vagina
  • Around the buttocks or thighs
  • Inside the cervix or urinary tract
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Signs of Herpes in Pregnant Women

If you are pregnant and have genital herpes, there may be a risk of your baby being infected with the virus during delivery. This condition is called neonatal herpes and can be serious or fatal. 

Neonatal herpes can result in damage to the central nervous system and can cause mental retardation.

Only about 0.1% of babies born in the United States are infected with neonatal herpes even though about 25% to 30% of pregnant women have genital herpes.

Generally, if you are infected with herpes, your doctor will deliver your baby by cesarean section to avoid any risk to your newborn infant.

Women who have herpes before becoming pregnant are at very low risk of transmitting the herpes virus to their babies. When you are pregnant, your immune system makes antibodies that pass on to the baby through your placenta. These antibodies help protect the baby from catching the virus.

If a woman is infected with the herpes virus after becoming pregnant, her baby faces a higher risk of contracting neonatal herpes. Women who are newly infected haven’t had time to develop the antibodies against the virus and cannot pass them on to the baby for protection.

Talk with your OB/GYN or your midwife and let them know if you have genital herpes. At the time of your delivery, ask your doctor to examine you early in labor to make sure you don’t have any sores or signs of infection like pain, tingling, or itching.

Other preventions you can take during your delivery if you have genital herpes include:

  • Requesting that your doctor not use a fetal scalp monitor during labor. The fetal scalp monitor makes a tiny puncture in your baby’s head to check your baby’s heart rate and may allow the virus to enter. Ask to use an external monitor as an alternative.
  • If you deliver vaginally, request that your doctor keep the bag of water around the baby intact to protect him from any possible virus in the birth canal.
  • Request that your doctor does not use forceps or a vacuum during delivery. Forceps or a vacuum can also cause cuts in a baby’s head, posing a greater risk of infection.
  • After you give birth, keep a close eye on your baby for about 3 weeks to check for symptoms of neonatal herpes. Symptoms of neonatal herpes may include fever, skin rash, crankiness, or lack of appetite. These are all common symptoms of other mild illnesses, but you may want to consider taking your baby to the pediatrician and let the doctor know that you have genital herpes.

Signs of Herpes in Children

The herpes virus can be spread to babies and children if they are kissed by someone that is infected and has active cold sores. Although rare, it is also possible to spread herpes to a child or infant by touch if a person touches their cold sore and then touches the baby or child.

Precautions can be taken to protect infants and other children from getting the virus. Avoid kissing children if you have a cold sore and ask other people not to as well. Wash your hands frequently if you have a cold sore and you are around children.

How Long Does a Herpes Outbreak Last?

Most cases of herpes take about 2–3 weeks to completely heal. Later, outbreaks are usually less severe and last only a few days. Symptoms and sores lesson over time with each outbreak.

Is There a Cure for Herpes?

No, there is no cure for herpes. Unfortunately, once you are infected with the herpes virus, you will have it throughout your life. On the positive side, there are medications available that are likely to shorten and prevent outbreaks and make it harder for you to pass it on to your partner.

How to Prevent a Herpes Outbreak

You can protect yourself and your partner by taking steps to prevent an outbreak of herpes. Some things that you can do include:

  • Always wear condoms or a dental dam during anal, vaginal, and oral sex.
  • If you already have herpes, don’t have sex until the outbreak is completely gone, even with a condom.
  • Try to learn the signs of an impending outbreak, such as itching, tingling and burning, and stop having sex as soon as you notice.
  • If you wear contact lenses, don’t wet your lenses with your saliva. This could spread your herpes infection to your eyes.
  • Don’t have sex with your partner until your herpes sores are completely healed.
  • Always tell your partner if you are infected with the herpes virus before you have sex. Even though it can be embarrassing and difficult, herpes is very common, and telling your partner will help keep the infection from spreading.
  • Book on our free mobile app or website.

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  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.

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Herpes Treatment

Although there is no cure for herpes, you can be treated with prescription antiviral medications. These medications may help your sores heal up sooner during your initial outbreak. They may also reduce the number of times an outbreak occurs, lessen the severity of symptoms in recurrent outbreaks, and reduce the chances of passing the infection on to your partner.

When you see your doctor, genital herpes can usually be diagnosed based on a physical exam and a herpes test which may include a viral culture, a blood test, and a polymerase chain reaction (PCR) test. PCR tests are used to take a sample of your DNA from your blood or tissue from your sore.

If you test positive for herpes, your doctor may put you on an antiviral medication used for genital herpes such as Acyclovir or Valtrex.

Depending on your symptoms, your doctor might recommend a treatment plan that includes taking the medication only when you have symptoms or taking medication every day. Most people tolerate these medications well with few side effects.

Think you may be experiencing symptoms of herpes? Book an appointment with a PlushCare physician and get a prescription today.


Read More About Herpes


Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

Centers for Disease Control and Prevention. Genital Herpes – CDC Fact Sheet. Accessed on March 13, 2021 at https://www.cdc.gov/std/herpes/stdfact-herpes.htm 

National Institutes of Health. Asymptomatic seminal infection of herpes simplex virus: impact on male infertility. Accessed on March 13, 2021 at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596154/ 

Mayo Clinic. Genital herpes. Accessed on March 13, 2021 at https://www.mayoclinic.org/diseases-conditions/genital-herpes/symptoms-causes/syc-20356161

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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