What does herpes look like?

A Cold Sore

Before a cold sore appears the area will sometimes tingle, feel slightly raised and may appear red and inflamed. This pain or tingling sensation is called the prodrome (or warning symptom) and typically occurs 1 to 2 days before the cold sore appears.

A cold sore generally appears as a small, fluid-filled blister which goes through a cycle of phases. The blister will usually weep (ulcerate) and form a scab or ‘crusting’ before healing and disappearing completely. The duration of a typical cold sore outbreak may last from 8 to 12 days.

Genital Herpes

One or more of the following symptoms may be experienced if the infection is located in the genital area:

  • Muscle aches or pains near to the area
  • A blister, cut, tear, sore, bump or rash in the infected area
  • Itching, tingling, or burning sensations
  • Vaginal or penile discharge
  • Burning and/or pain when urinating
  • Flu-like symptoms such as headache, fever and swollen glands

Time before any symptoms show

Herpes Incubation Period

The herpes virus can lay dormant for various time periods and may be in your system for a time period before any symptoms begin to show. The usual incubation period of the virus (time before any symptoms show) is approximately two to twelve days after the first exposure to the virus.

However, there are many possibilities. Some people never experience active symptoms and others may not experience a recognizable outbreak for several months or even years after exposure.

Recurring Symptoms

What is an outbreak or episode?

Most of the time when herpes symptoms are not present on the skin the virus remains in a latent (sleeping) state in the central nervous system, where it does no damage.

When the virus reactivates (wakes up) it travels nerve paths to the surface of the skin, sometimes causing what is known as an “outbreak” or episode of symptoms.

When and where can outbreaks reoccur?

The first outbreak is normally the worst and many people do not experience a recurrence until months and sometimes even years after their first primary outbreak.

If and when a recurrence does happen it is sometimes related to a time when the immune system is weakened or under pressure, such as after an illness, during times of stress, due to a poor lifestyle, surgery, etc. In the case of cold sores, sometimes being in the sun can cause a recurrence. It is different for everybody.

During the body’s first exposure to the herpes virus, the immune system develops antibodies and other weapons against the virus. During a recurrence, then, this “immune memory” can help to fight off infection more quickly.

As a result, as time goes on there are usually fewer sores, they heal faster, and the outbreak is less painful. Some people never experience another recurrence, which is often attributed to a strong immune system response.

Nerves can have many ‘axons’ which is why the herpes virus can travel different pathways to your skin. This is why outbreaks may naturally appear in different areas “nearby” to one another.

However, each nerve has a particular area of skin that it serves called a dermatome. The herpes lesions are limited to the dermatome it initially infected unless you infect yourself somewhere else.

This means that the outbreaks are limited to the body area where the infection exists (for example, the genital area) unless you contract or spread the infection somewhere else.

The nerves in the genitals, upper thighs and buttocks are connected; therefore, in the case of genital herpes a person could experience outbreaks in any of these areas. Such areas include the vagina, vulva, penis, scrotum, anus, buttocks and thigh.

Although the above scenario is possible, if the virus reoccurs it typically surfaces in the same spot or directly nearby the ‘original’ site of infection.

You can learn more about outbreaks and what to expect in the Herpes Recurrence section.

What should I do if I think I have herpes?

If you have noticed something different don’t delay

If you suspect that you have herpes and have not had your condition diagnosed it is important that you visit your health care provider as soon as possible for a professional analysis.

Genital herpes can be mistaken for many different conditions and should always be diagnosed professionally.

Where to Now?