How long does herpes symptoms take to show

Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) cause oral and genital herpes infections. After acquiring the virus, symptoms may not show up immediately. The time between exposure and symptom onset is called the incubation period.

On average, it can take four days for symptoms to appear. However, it can vary between two to 21 days after exposure. There are different stages of a life-long herpes infection, though the exact timeline and symptoms (or lack of symptoms) can vary from person to person.

This article discusses the timeline of a herpes simplex infection, transmission stages, and management.

Can You Have Herpes and Not Know it?

Yes, it is possible to have herpes and not know it.

Some people may have an asymptomatic infection, which means they do not experience any symptoms. Others have symptoms that are mild, go unnoticed, or mistaken for another skin issue. Because of this, they're less likely to seek out a diagnosis to confirm herpes.

How Long Can Herpes Be Dormant?

Once contracted, herpes remains in the body indefinitely. After an initial outbreak, the virus will become inactive within the body's nerve cells.

Reactivation at a later time can cause additional outbreaks. The amount of time between outbreaks will vary from person to person.

Herpes Symptoms

A primary outbreak symptom is small, fluid-filled blisters at the site of infection. These often occur in clusters in or around the mouth (oral herpes) or on the genitals or rectum (genital herpes).

Flu-like symptoms are also possible, such as:

• Fever
• Swollen glands
• Headache
• Body aches

Those who have an oral herpes infection may also experience:

• Sore throat
• Pain while swallowing

Additional genital herpes symptoms may include:

• Atypical vaginal discharge
• Pain while peeing
• Difficulty emptying the bladder
  

It's possible to have herpes simplex and not experience symptoms.

Transmissible Even When Dormant

It's possible to transmit herpes to another person whether you experience an outbreak or not.

Transmission with no symptoms is due to asymptomatic viral shedding. For example, research has found that in people with HSV-1, the virus can be reactivated in the body and allow for transmission to others without any lesions (blisters) present. HSV-2 also can be transmitted without symptoms present.

Herpes Outbreak Timeline

Though the typical symptoms and time to appearance may vary between people, there is a common timeline for herpes infections.

First Outbreak

Symptoms may depend on whether you already have one of the HSV strains. These are broken out into two types:

• Primary infection: If you've never had HSV before, the first outbreak can last for an average of 20 days. Viral shedding occurs for about 12 days before the lesions heal.
• Non-primary infection: If you've previously been exposed to HSV, the initial outbreak may be shorter and milder. On average, they can last for 17 days, with viral shedding occurring on about seven of those days if not treated.

The shorter duration of a non-primary infection may be due to having some antibody protection from previously contracting one of the HSV strains.

Again, some people may not have symptoms at all.

Latent Stage

After the lesions heal, the virus remains in the body. It becomes dormant (inactive) within the nerve cells until it is reactivated at a later time. The amount of time the virus is dormant can vary from person to person.

Reactivation and Recurrent Outbreaks

The virus can be reactivated by certain triggers, such as:

• Stress
• Surgery
• Extreme temperatures
• Menstrual periods

The virus then travels to the skin (epithelial cells) and can cause another, often milder, outbreak. However, reactivation may not cause any symptoms.

Before an outbreak, some people experience prodrome. This is characterized by tingling, itching, or pain in the affected areas before the lesions appear.

Types of Tests Used to Diagnose Herpes

There are a number of tests used to diagnose herpes, depending on whether lesions are present.

• Symptomatic testing: Samples taken from lesions can be used to detect the virus with a viral culture or nucleic acid amplification test (NAAT). Of the two, NAAT is more sensitive (referring to the test's ability to accurately identify whether a person has a disease). A polymerase chain reaction (PCR) test may be used if herpes is suspected as the cause of a systemic or central nervous system infection, such as encephalitis or meningitis.
• Asymptomatic testing: A blood test may be used to detect HSV antibodies. This is an option for people who had a previous outbreak or had recent exposure. Very recent herpes infections may not be detected. Retesting in a few months may be necessary for accurate results. Some blood tests can also specifically identify an HSV-1 or HSV-2 infection.
  

Due to the high rates of false-positives, screening for genital herpes in asymptomatic adults and adolescents is not recommended.

Living With Herpes

Herpes simplex infections are very common. Worldwide, it's estimated that 90% of people have HSV-1, HSV-2, or both.

Knowing more about herpes can help you manage the virus and seek additional medical care when needed.

When to See a Healthcare Provider

If you've been diagnosed with herpes, there are some circumstances where you may benefit from medical care. These may include having:

• An outbreak that isn't helped by treatment and self-care strategies
• Serious pain
• Lesions that don't heal
• Frequent outbreaks
• Symptoms while you're pregnant

Treatment for Herpes

While there is no cure, there are effective treatments to manage HSV.

Antiviral medications can suppress the virus. Suppressive therapy reduces the frequency and duration of outbreaks. It also reduces the risk of transmitting the virus to others.

Common medications include:

• Acyclovir
• Famciclovir
• Valacyclovir
  

Self-care strategies during outbreaks can help with pain and discomfort, including:

• Keeping the affected area clean and dry
• Using over-the-counter pain relievers
• Place cold compresses over affected areas

For at-home care for cold sores specifically:

• Apply non-prescription antiviral ointment
• Avoid eating spicy, acidic, or salty foods
• Use petroleum jelly to keep surrounding skin moisturized

How to Prevent Herpes Flare-Ups

In addition to antiviral medications, everyday activities that support overall health can help prevent flare-ups. These include:

• Getting enough quality rest
• Managing stress levels
• Eating foods with plenty of nutrients
• Protecting yourself during extreme temperatures and wind or sun exposure
  

Outlook

Herpes simplex is a chronic (life-long) condition. It can't be cured, though it can be effectively managed with the help of a healthcare provider.

There is stigma associated with having herpes, which may impact sexual relationships in particular. However, many people are able to manage it well and live fulfilling lives.

Summary

The typical incubation period (time from exposure to when symptoms appear) for herpes simplex is between two and 21 days. Symptoms of an initial outbreak include flu-like symptoms and fluid-filled blisters that appear in clusters. These can last between 16 and 20 days.

After the initial outbreak, the virus goes dormant in the body. If triggered, the virus may reactivate and may or may not cause additional outbreaks. Transmission to others is possible in either case.

Testing for HSV depends on whether you are experiencing symptoms. Treatment includes antiviral medications and self-care strategies. While there is no cure, herpes can be effectively managed and not interfere with daily life.

A Word From Verywell

Being diagnosed with herpes isn't anything to be ashamed of. Knowing your status means you can have conversations with healthcare providers and sexual partners that help you make educated decisions about your health. If you experience symptoms, seek medical care in order to get the treatment you need.

Frequently Asked Questions

• How long does it take for HSV-2 to show up?

  It can take between two and 21 days from the time you're exposed to HSV-2 for symptoms to show up. On average, it takes about four days to develop symptoms after exposure. This is referred to as the incubation period.

• When is the best time to take a herpes test?

  If lesions are present, a viral culture or nucleic acid amplification test (NAAT) can detect the virus by taking a sample from the lesion. Ideally, samples are taken within the first 48 hours after lesions appear. For those with no symptoms, it may take 12 to 16 weeks after exposure to accurately detect HSV-2 antibodies in a blood test.