Lots of people who have been infected with either HSV-1 or HSV-2 don’t know it because they have never noticed any signs or symptoms.
People often mistake a herpes outbreak for another problem. You may think you have the flu, another STI, or that you have pimples or ingrown hairs, when in fact you have genital herpes symptoms.
Primary Herpes Outbreak
Generally, first outbreaks last two to four weeks.
During a primary outbreak of genital herpes, you may experience symptoms that mimic the flu, such as:
- Fever
- Achy muscles
- Headaches
- Swollen lymph nodes in the groin
- Malaise, a general feeling of discomfort
Later Outbreaks
Repeat or recurrent outbreaks can appear weeks or months later and are especially common in the first year of a herpes infection.
If you have a repeat outbreak, it may begin with some low-level warning symptoms during a period called a prodrome. A few hours before the outbreak, you may feel itchy, tingly, or burning sensations in the area where the virus first entered your body. You may feel pain in your legs, buttocks, and lower back.
“Most people do have a prodrome with a recurrent outbreak, with tingling and burning in their skin. Then they usually break out in sores in the same place over and over when they actually become symptomatic,” says I. Cori Baill, MD, an obstetrician-gynecologist and a professor at the University of Central Florida College of Medicine in Orlando.
For most people, recurrences are somewhat less painful and shorter than the initial outbreak. The frequency of any later outbreaks, or recurrences, varies from person to person. Outbreaks may not occur at all or they may arise several times a year, or less often. Sores that occur in recurrences usually heal faster than the sores associated with a first episode of illness.
In many cases, outbreaks become more widely spaced as years pass.