Signs and Symptoms
A few days after exposure to HSV, a newly infected person typically develops a group of painful blisters or pus-filled bumps in the genital region. Because these fluid-filled lesions easily burst, many people never even notice them but instead see small, painful red sores or ulcers. These lesions usually last for 2–6 weeks for a primary infection and 5–10 days for recurrent infections. Eventually, a scab develops over each sore, which then falls off, leaving a red area that fades with time.
In women, the most common locations for HSV-2 infection are the external genitalia, vagina, cervix, and anus. In men, the most common locations for HSV-2 infection are the penis, scrotum, upper thighs, buttocks, and anus.
Primary genital HSV infection can be severe, with many painful blisters causing pain or burning with urination and vaginal or urethral discharge. People may also develop fever, headache, muscle ache, and fatigue with a primary outbreak.
Recurrent HSV infections are usually milder than the primary infection, though the lesions look similar. Many people with recurrent HSV infections have burning, tingling, or pain in the area of the outbreak up to 24 hours before any visible signs. This is called the prodromal phase of the infection. Because many people never develop the symptoms of a primary HSV infection, they may mistake a recurrent infection for a primary infection.
Most people will have a recurrence of genital herpes during the first year after a primary infection. On average, most people will get about 4 outbreaks per year, although the frequency of recurrence is extremely variable and tends to decrease over the years.
A recurrence of genital herpes usually occurs spontaneously, but it can also be triggered by the following:
- Fever or illness
- Sun exposure
- Hormonal changes, such as those due to menstruation or pregnancy
- Stress
- Trauma, such as those caused by dental work or cuts from shaving
- Surgery
- Immunosuppression
- Friction to the area – for example, with sexual intercourse or tight-fitting clothes
Who's At Risk
