Is it Genital Herpes? Symptoms of an Initial Outbreak

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Jay W. Marks, MD

Genital herpes is a sexually transmitted viral infection (STD) that is relatively common worldwide. In the U.S., it is estimated to affect about 45 million people. While the hallmark of this recurring condition is the presence of raised, reddened, and usually painful bumps or blisters in the genital area, the initial outbreak of genital herpes may look and feel different than the later characteristic flare-ups.

In a person who has never been exposed to the herpes simplex virus (genital herpes is caused by herpes simplex virus type 2 or HSV-2; and, less commonly, herpes simplex virus type 1 or HSV-1), symptoms (if present) typically develop within two to 12 days, with an average time of four days. The symptoms and appearance of the initial infection (known as the primary infection) vary widely among individuals.

It is possible for someone to become infected with the herpes simplex virus and not display any symptoms at all. Other people may have a mild infection that may even go unnoticed. Still others will develop a more severe illness including the typical skin lesions. In an initial infection, the skin blisters often are associated with systemic (body-wide) symptoms that may mimic those associated with the flu or other viral illnesses.

Often, symptoms other than the skin blisters will develop before the skin outbreak is noticed or may accompany the skin blisters. These can include:

• Fever and flu-like symptoms
  
  
• Pain, itching, or tingling in the genital area
  
  
• Headache
  
  
• Pain with urination (dysuria)
  
  
• Enlarged, tender lymph nodes in the groin area
  
  
• Vaginal discharge in women
  
  
• Muscle aches

The skin blisters generally resolve over a period of weeks, with a mean time to resolution of 19 days.

If you believe you may have been infected with the genital herpes virus or have the symptoms of an infection, seek the advice of your health care provider. While there is no cure for genital herpes, he or she may prescribe antiviral medications that can shorten or even prevent outbreaks and help prevent transmission of the virus to others.