While the first outbreak of genital herpes may be mild, in most people, the first outbreak is typically the worst.
This article will discuss the early signs of genital herpes, what to expect during the first outbreak, diagnosis, and treatment options.
Early Genital Herpes Symptoms
Not everyone with genital herpes will have symptoms. But in some people, early signs of genital herpes may appear two to 12 days after sexual contact with someone who has the virus.
These symptoms can include:
Tingling in an area that will soon develop lesionsBurning sensation in an area that will soon develop lesionsItching in the genital areaAn uncomfortable feeling in the genital areaBurning or tingling during urination
What to Expect During the First Outbreak
One of the first obvious signs of genital herpes can be the development of a cluster of lesions. These are blister-like sores or ulcers that appear on the skin.
They may appear on the:
VaginaVulvaPenisScrotumAnusThighsButtocks
They may be painful and can cause a burning sensation. Sometimes, herpes sores can be mistaken for other things, like pimples or an ingrown hair.
The appearance of lesions is referred to as an “outbreak” and may also be accompanied by other symptoms. These can include:
Fever Body aches, joint aches Headache Swollen glands Blisters on the mouth or lips Difficulty urinating Unusual vaginal discharge
Blisters may burst open and leave behind sores that can be painful. These may take a week or longer to crust over and heal.
The first outbreak of genital herpes is often the worst. Later outbreaks are often shorter in duration and less severe.
Diagnosis
If you think you may have been exposed to genital herpes or are experiencing symptoms that may be due to genital herpes, it is important to contact a healthcare provider. The only way to definitively diagnose genital herpes is through seeing a healthcare provider for an examination and testing.
Some other STIs, like syphilis, can appear similar to herpes but require different treatments.
A healthcare provider may use a variety of approaches to diagnose genital herpes. These include:
Conducting a physical exam to look for signs of sores that may indicate genital herpesUsing a swab to gently collect a sample of fluid from any sores that are present to send to the lab for testingCollecting a blood test to check for herpes (but this is not typically advised for people who don’t have any symptoms of herpes)
Testing for herpes will give either a negative result (no evidence of the virus) or a positive result (evidence of the virus). If a test returns a negative result, the herpes virus is not detected. Despite this, it is still possible an HSV infection is present.
The reason this can happen is a sample may not have contained enough virus to be properly found. If you return a negative result but have symptoms that suggest genital herpes, your healthcare provider may need to test you again.
A positive test result means that the herpes virus was detected in the sample. This can either mean the infection is active or you previously acquired it.
How Often Do Outbreaks Occur?
Recurrence of a genital herpes outbreak is common. For a person with genital herpes, the average number of outbreaks is four to five each year.
People who experience recurrent outbreaks may notice symptoms in the days to hours before lesions appear. These include:
Pain in the genitalsTingling in the legs, buttocks, or hipsShooting pain in the legs, buttocks, or hips
For most people, recurrent outbreaks aren’t as severe as the first outbreak and won’t last as long. Over time, outbreaks that cause symptoms will decrease.
Treatment
There is no cure for genital herpes, but there are treatment options to prevent and shorten outbreaks.
Taking an antiviral medication such as Zovirax (acyclovir) can reduce the duration of outbreaks, prevent outbreaks, and reduce the risk of transmitting the herpes virus to a partner. They may be taken during outbreaks or taken daily to prevent outbreaks.
In addition to antiviral medication, herpes outbreaks can be managed by:
Taking an over-the-counter (OTC) pain reliever such as Tylenol (acetaminophen), Advil (ibuprofen), or aspirinAppling cool compresses to soresTrying to avoid touching herpes soresWashing hands every time there is contact with herpes soresKeeping herpes sores dry and clean
To avoid transmitting herpes, do not have sexual contact of from the first appearance of symptoms until after all herpes sores have healed.
Summary
Genital herpes is a sexually transmitted infection that can cause symptom flare-ups known as outbreaks. In most people, the first outbreak is the most severe, and later outbreaks are milder and shorter in duration.
Not everyone with genital herpes will experience the same symptoms or severity of symptoms. Symptoms may include herpes sores, itching, tingling, difficulty with urination, and flu-like symptoms. The only way to definitively diagnose genital herpes is through seeing a healthcare provider.
While there is no cure, antiviral treatment can help reduce the spread of infection and the duration of outbreaks.
A Word From Verywell
Dealing with a sexually transmitted infection can be overwhelming, but it is important to remember help is available. If you think you may have been exposed to the herpes virus, or are experiencing symptoms that may indicate genital herpes, don’t be afraid to reach out to a healthcare provider for testing and support.
