Mild Genital Herpes First Outbreak: What to Expect - Verywell Health

Genital herpes is a sexually transmitted infection (STI) that can cause outbreaks of symptoms, including blister-like sores. In some people, genital herpes will cause mild, barely noticeable symptoms, but in others, there may be pain and discomfort.

While the first outbreak of genital herpes may be mild, in most people, the first outbreak is typically the worst.

This article will discuss the early signs of genital herpes, what to expect during the first outbreak, diagnosis, and treatment options.

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Early Genital Herpes Symptoms

Not everyone with genital herpes will have symptoms. But in some people, early signs of genital herpes may appear two to 12 days after sexual contact with someone who has the virus.

These symptoms can include:

• Tingling in an area that will soon develop lesions
• Burning sensation in an area that will soon develop lesions
• Itching in the genital area
• An uncomfortable feeling in the genital area
• Burning or tingling during urination
  

What to Expect During the First Outbreak

One of the first obvious signs of genital herpes can be the development of a cluster of lesions. These are blister-like sores or ulcers that appear on the skin.

They may appear on the:

• Vagina
• Vulva
• Penis
• Scrotum
• Anus
• Thighs
• Buttocks

They may be painful and can cause a burning sensation. Sometimes, herpes sores can be mistaken for other things, like pimples or an ingrown hair.

The appearance of lesions is referred to as an "outbreak" and may also be accompanied by other symptoms. These can include:

• Fever
• Body aches, joint aches
• Headache
• Swollen glands
• Blisters on the mouth or lips
• Difficulty urinating
• Unusual vaginal discharge

Blisters may burst open and leave behind sores that can be painful. These may take a week or longer to crust over and heal.

The first outbreak of genital herpes is often the worst. Later outbreaks are often shorter in duration and less severe.

How Bad Are Symptoms in the First Outbreak?

Symptoms of genital herpes are often the worst in the first outbreak. Mild symptoms of herpes will usually occur at the start of an outbreak but may worsen as the outbreak continues. Not everyone will experience the same symptoms or the same severity of symptoms.

Diagnosis

If you think you may have been exposed to genital herpes or are experiencing symptoms that may be due to genital herpes, it is important to contact a healthcare provider. The only way to definitively diagnose genital herpes is through seeing a healthcare provider for an examination and testing.

Some other STIs, like syphilis, can appear similar to herpes but require different treatments.

A healthcare provider may use a variety of approaches to diagnose genital herpes. These include:

• Conducting a physical exam to look for signs of sores that may indicate genital herpes
• Using a swab to gently collect a sample of fluid from any sores that are present to send to the lab for testing
• Collecting a blood test to check for herpes (but this is not typically advised for people who don't have any symptoms of herpes)

Testing for herpes will give either a negative result (no evidence of the virus) or a positive result (evidence of the virus). If a test returns a negative result, the herpes virus is not detected. Despite this, it is still possible an HSV infection is present.

The reason this can happen is a sample may not have contained enough virus to be properly found. If you return a negative result but have symptoms that suggest genital herpes, your healthcare provider may need to test you again.

A positive test result means that the herpes virus was detected in the sample. This can either mean the infection is active or you previously acquired it.

How Often Do Outbreaks Occur?

Recurrence of a genital herpes outbreak is common. For a person with genital herpes, the average number of outbreaks is four to five each year.

People who experience recurrent outbreaks may notice symptoms in the days to hours before lesions appear. These include:

• Pain in the genitals
• Tingling in the legs, buttocks, or hips
• Shooting pain in the legs, buttocks, or hips

For most people, recurrent outbreaks aren't as severe as the first outbreak and won't last as long. Over time, outbreaks that cause symptoms will decrease.

Herpes Is Contagious Even With Mild Symptoms

Genital herpes can be transmitted by someone with mild symptoms and someone who doesn't know they have the infection. Therefore, avoiding sexual contact during a herpes outbreak is important, even if symptoms are only mild.

Treatment

There is no cure for genital herpes, but there are treatment options to prevent and shorten outbreaks.

Taking an antiviral medication such as Zovirax (acyclovir) can reduce the duration of outbreaks, prevent outbreaks, and reduce the risk of transmitting the herpes virus to a partner. They may be taken during outbreaks or taken daily to prevent outbreaks.

In addition to antiviral medication, herpes outbreaks can be managed by:

• Taking an over-the-counter (OTC) pain reliever such as Tylenol (acetaminophen), Advil (ibuprofen), or aspirin
• Appling cool compresses to sores
  
• Trying to avoid touching herpes sores
• Washing hands every time there is contact with herpes sores
• Keeping herpes sores dry and clean

To avoid transmitting herpes, do not have sexual contact of from the first appearance of symptoms until after all herpes sores have healed.

Summary

Genital herpes is a sexually transmitted infection that can cause symptom flare-ups known as outbreaks. In most people, the first outbreak is the most severe, and later outbreaks are milder and shorter in duration.

Not everyone with genital herpes will experience the same symptoms or severity of symptoms. Symptoms may include herpes sores, itching, tingling, difficulty with urination, and flu-like symptoms. The only way to definitively diagnose genital herpes is through seeing a healthcare provider.

While there is no cure, antiviral treatment can help reduce the spread of infection and the duration of outbreaks.

A Word From Verywell

Dealing with a sexually transmitted infection can be overwhelming, but it is important to remember help is available. If you think you may have been exposed to the herpes virus, or are experiencing symptoms that may indicate genital herpes, don't be afraid to reach out to a healthcare provider for testing and support.

Frequently Asked Questions

• Typically, the first outbreak of genital herpes will last between 14 days and four weeks. During this period, blisters may burst before eventually crusting over and healing.

• In some people, early symptoms of genital herpes may include a tingling or itching sensation in the genital area. This may be more noticeable during urination.

• Outbreak symptoms and severity can be variable between people. Some people will barely notice symptoms, while others may experience pain or discomfort. Often, the symptoms of herpes will start mild and worsen throughout an outbreak. The first outbreak is the worst in most people, and later outbreaks cause milder symptoms.