Genital herpes most often appears as one or more blisters on or around the genitals or rectum. When these blisters burst they leave the tender sores known as ulcers. The first time a person has a herpes outbreak, the ulcers may take two to four weeks to heal. The next outbreaks may not occur for weeks, months, or even later. When they do, they usually are less severe than the first outbreak. Herpes infection doesn't go away, but the outbreaks tend to become less frequent over time.
Herpes simplex virus type 1 (HSV-1) is more often the cause of cold sores or fever blisters. But it can also be a cause of genital herpes.
Most people with genital herpes don't know they have it. That's because in most people it produces either no symptoms or very mild ones.
What Happens in an HSV Infection?
Genital herpes virus is passed from one person to another through sexual contact. This happens even if the person with the virus doesn't have symptoms or signs of infection.
Once the virus enters through the skin, it travels along nerve paths. It may become dormant (inactive) in the nerves and remain there indefinitely.
From time to time, the virus may become active. When that happens, the virus travels back along the nerve path to the surface of the skin, where additional virus is shed.
At this point the virus may cause an outbreak of symptoms. Or it may remain undetected.
In either case, the active virus is easily passed from one partner to another through sexual contact. Even wearing a condom may not protect the uninfected partner. The virus can be present on skin that remains uncovered.
The number of recurrences or outbreaks a person can have may vary.
What Are the Symptoms of Genital Herpes?
Even though you can still pass the infection, you may never notice symptoms from an HSV infection. On the other hand, you might notice symptoms within a few days to a couple of weeks after the initial contact. Or, you might not have an initial outbreak of symptoms until months or even years after becoming infected.
When symptoms occur soon after a person is infected, they tend to be severe. They may start as small blisters that eventually break open and produce raw, painful sores that scab and heal over within a few weeks. The blisters and sores may be accompanied by flu-like symptoms with fever and swollen lymph nodes.
Any of the following symptoms of a genital HSV infection can occur in a man or a woman:
Cracked, raw, or red areas around your genitals without pain, itching, or tingling
Itching or tingling around your genitals or your anal region
Small blisters that break open and cause painful sores. These may be on or around your genitals (penis or vagina) or on your buttocks, thighs, or rectal area. More rarely, blisters may occur inside the urethra -- the tube urine passes through on its way out of your body.
Pain from urine passing over the sores -- this is especially a problem in women.
Flu-like symptoms, including fever, swollen lymph nodes, and fatigue
Genital herpes is not the only condition that can produce these symptoms. Sometimes, HSV is mistaken for vaginal yeast infections, bacterial infections, or bladder infections. The only way to know whether they are the result of HSV or another condition is to be checked by a health care provider.
Genital herpes is diagnosed with a physical exam and typically confirmed with a swab test or a blood test.