Someone who has been exposed to the genital herpes virus may not be aware of the infection and may never have an outbreak of sores. However, if a person does have an outbreak, the symptoms can cause significant discomfort. Many people with HSV-2 infection never have sores, or they have very mild symptoms that they do not even notice or mistake for insect bites or another skin condition.
If signs and symptoms do occur during the first outbreak, they can be quite severe. This first outbreak usually happens within 2 weeks of being infected. Generalized or whole-body (systemic) symptoms may include:
* Decreased appetite
* General sick feeling (Malaise)
* Muscle aches in the lower back, buttocks, thighs, or knees
* Enlarged and tender lymph nodes in the groin during an outbreak
* Painful urination
* Women may have vaginal discharge or, occasionally, be unable to empty the bladder and require a urinary catheter
Genital symptoms include the appearance of small, painful blisters filled with clear or straw-colored fluid. They are usually found:
* In women: on the outer vaginal lips (labia), vagina, cervix, around the anus, and on the thighs or buttocks
* In men: on the penis, scrotum, around the anus, on the thighs or buttocks
* In both sexes: on the tongue, mouth, eyes, gums, lips, fingers, and other parts of the body
* Before the blisters appear, the person may feel the skin tingling, burning, itching, or have pain at the site where the blisters will appear
* When the blisters break, they leave shallow ulcers that are very painful. These ulcers eventually crust over and slowly heal over 7 – 14 days or more
A second outbreak can appear weeks or months after the first. It is almost always less severe and shorter than the first outbreak. Over time, the number of outbreaks may decrease.
Once a person is infected, however, the virus hides within nerve cells and remains in the body. The virus can remain “asleep” (dormant) for a long period of time (this is called latency).