Signs and Symptoms of Herpes

Herpes refers to infections caused by the herpes simplex virus (HSV). There are two types of the herpes simplex virus that can cause herpes. The herpes symptoms you develop can occur anywhere on the body and are very similar for both types of viruses.

Herpes simplex type 1 (HSV-1), which can be spread from the mouth or genitals through saliva when kissing, sharing drinks, or any direct contact typically causes oral herpes. Herpes simplex type 2 (HSV-2) usually causes genital herpes, a type of sexually transmitted infection (STI). Both oral and genital herpes can cause open sores in the affected area.

Some people who contract oral or genital herpes don’t experience any symptoms. Others experience repeated herpes outbreaks. Between outbreaks, the virus lies inactive in your body. Outbreaks usually become milder over time.

Common Symptoms

Not all herpes infections will cause symptoms. If you do have symptoms, they can range from mild to severe.

There are some symptoms that oral and genital herpes have in common. A few days or weeks after you're exposed to HSV-1 or HSV-2, you may notice warning signs of an outbreak, such as:

• Burning, itching, and/or tingling in the affected area of the mouth or genitals
• Sore throat
• Fever
• Muscle aches
• Swollen glands

These symptoms are typically more noticeable during the first herpes outbreak. As time goes on, you might find that your symptoms before or during an outbreak are less severe.

Oral Herpes Symptoms

In addition to the general symptoms of a herpes infection, you can develop painful mouth ulcers—commonly known as cold sores—after being exposed to HSV-1 or HSV-2. These sores can appear as blisters or a rash on your lips, mouth, gums, or throat. 

Oral herpes might look like:

• A hot, reddened spot on the lip
• A group of smaller blisters that develops into a larger blister
• Blisters that fill with clear fluid that then break and ooze
• Open sores that crust over

As the blisters heal, they may become yellow and crusted, eventually returning to pink skin.

You might experience only one oral herpes outbreak, or you could develop blisters many times. Several factors can trigger an outbreak:

• Stress
• Heat or cold
• Exposure to the sun
• Fever or illness
• Menstruation
• Hormonal shifts
• Weakened immune system
  

Genital Herpes Symptoms

In addition to the general symptoms of a herpes infection, you can develop sores on your genitals if you have HSV-1 or HSV-2. Genital herpes symptoms can appear between two days and three weeks after exposure to HSV-2. Some people mistake the initial signs of genital herpes for ingrown hairs or pimples.

Signs and symptoms of a genital herpes outbreak may include:

• A patch of red, darkened, or swollen skin on your anus, genitals, thigh, or buttocks
• One or more small blisters on the rectum or genitals
• Painful sores that burst open, scab over, and heal within two to six weeks
• Atypical vaginal or penile discharge
• Burning and itching sensations 
• Difficulty urinating
• Pain or irritation during sex

Genital herpes sores can form in a small cluster or all over the pelvic area. 

The following can trigger repeated outbreaks of genital herpes:

• Surgery
• Sex
• Stress
• Fatigue
• Illness
• Menstruation
• Treatments that affect the immune response, such as chemotherapy

Men, people who are immunocompromised, and people with human immunodeficiency virus are more likely to experience severe or repeated symptoms during a genital herpes outbreak.

When to See a Healthcare Provider

If you have a cold sore, your symptoms might resolve on their own within a few weeks.

You can make yourself more comfortable in the meantime by applying ice to the affected area, taking over-the-counter (OTC) pain medications, or gargling with salt water. If your pain is severe or doesn’t go away, your healthcare provider may prescribe an antiviral medication.

If you notice any signs of genital herpes, you should see a healthcare provider right away. You may have an STI.

Talk to your doctor if you experience any signs of an STI, such as:

• Sores, burning, or itching in or around your genital area
• Pain or burning during urination
• Pain during sex
• Bleeding between menstrual cycles
• Unusual genital discharge

Genital herpes can’t be cured. However, you can take steps to prevent outbreaks, manage your symptoms, and lower your risk of spreading the disease.

A Quick Review

Both oral and genital herpes infections are caused by the herpes simplex virus (HSV). 

Oral herpes symptoms typically include itching, burning, and pain in the mouth area, followed by the appearance of painful mouth blisters known as cold sores. See a healthcare provider if your cold sores get worse or don’t go away on their own.

People with genital herpes may develop painful blisters on their genitals during an outbreak. The blisters can then break open and turn into open sores. If you notice any signs of genital herpes, visit a healthcare provider to get a diagnosis.