How to know a herpes outbreak is coming

Herpes is a common disease. Still, it can be surprisingly hard to detect. For instance, about one of every five or six people has genital herpes, but perhaps as few as 10% are aware of it. One reason is many people have no symptoms, while other people have very mild symptoms. Sometimes people think their symptoms are from something else. They mistake herpes for an ingrown hair, an insect bite, a pimple, or a rash.

What happens with a herpes infection varies a great deal from person to person. Some people have an outbreak within days of exposure to the virus. For others, symptoms may not begin for years.

No matter when it happens, there are some common signs and symptoms to watch for so you can get the proper treatment for a herpes infection.

First Warning Signs

Sores or blisters on the skin are the most common signs of herpes. However, you might have some subtle warning signs before any blisters appear. The skin in the affected area might tingle or itch for a day or two. Some people describe this as a burning or painful feeling. This is not always a sign of herpes. Still, it could mean that an outbreak is on the way. Often this early symptom occurs if you've had a herpes outbreak before and the sores are about to “reactivate.”

What to Look For

There are two types of herpes: oral herpes (usually caused by a virus called HSV-1) and genital herpes (usually caused by a slightly different virus called HSV-2). Oral herpes sores are often called cold sores or fever blisters. They usually form on the lips. They can also appear on the tongue, around the mouth and elsewhere on the face. Genital herpes blisters are usually found on the buttocks, on the penis, on the anus, and around or inside the vagina.

These are not the only places where herpes sores can appear. They can show up almost anywhere on your skin, depending on where the virus entered the body. You can also spread the virus from one area of your body to another. For instance, if you touch an active lesion and then rub your eyes, you can infect your eyes.

No matter where they are, herpes sores usually start as small red blisters or pimples. The number can vary from one to a large cluster. In almost all cases, the blisters break open and release fluid. A crusty scab forms over the top. Then they begin to heal and go away.

An outbreak of oral herpes often lasts two to three weeks. Genital herpes can last as long as six weeks.

Often, the first outbreak is the worst. Most of the time you can expect later outbreaks to be less severe. They're also usually less widespread, and they heal more quickly than the first one. After the first one, herpes outbreaks usually last two to 12 days.

Other Symptoms You May Experience

Some people get flu-like symptoms during a herpes infection. They ache and have a fever. Having swollen lymph nodes around the area of the outbreak also is common. People with genital herpes may have a burning sensation when urinating. Sometimes they have trouble urinating.

If you have pain or a gritty feeling in your eyes, it's possible that the herpes infection has spread to your eyes. Fluid leaking from the eye or sensitivity to light are other signs of an eye infection related to herpes. Get immediate medical attention if you think you have a herpes infection in your eyes. Permanent damage is possible.

What is herpes?

Herpes is the name of a group of viruses that cause painful blisters and sores. The most common viruses are:

  • Herpes zoster.This causes chickenpox and shingles.
  • Herpes simplex virus (HSV) type 1 and type 2. Type 1 usually causes cold sores or fever blisters around the mouth. Type 2 usually causes sores on the genitals (sexual organs).

Genital herpes is a sexually transmitted infection (STI). Once you’re infected, you have the virus for the rest of your life.

Symptoms of herpes

Many people who get herpes never have symptoms. Sometimes the symptoms are mild and are mistaken for another skin condition. Symptoms of genital herpes may include:

  • Painful sores in the genital area, anus, buttocks, or thighs
  • Itching
  • Painful urination
  • Vaginal discharge
  • Tender lumps in the groin

During the first outbreak (called primary herpes), you may experience flu-like symptoms. These include body aches, fever, and headache. Many people who have a herpes infection will have outbreaks of sores and symptoms from time to time. Symptoms are usually less severe than the primary outbreak. The frequency of outbreaks also tends to decrease over time.

Stages of infection

Once you have been infected with the virus, you’ll go through different stages of infection.

Primary stage

This stage starts 2 to 8 days after you’re infected. Usually, the infection causes groups of small, painful blisters. The fluid in the blisters may be clear or cloudy. The area under the blisters will be red. The blisters break open and become open sores. You may not notice the blisters, or they may be painful. It may hurt to urinate during this stage.

While most people have a painful primary stage of infection, some don’t have any symptoms. They may not even know they’re infected.

Latent stage

During this stage, there are no blisters, sores, or other symptoms. The virus is traveling from your skin into the nerves near your spine.

Shedding stage

In the shedding stage, the virus starts multiplying in the nerve endings. If these nerve endings are in areas of the body that make or are in contact with body fluids, the virus can get into those body fluids. This could include saliva, semen, or vaginal fluids. There are no symptoms during this stage, but the virus can be spread during this time. This means that herpes is very contagious during this stage.


Many people have blisters and sores that come back after the first herpes attack goes away. This is called a recurrence. Usually, the symptoms aren’t as bad as they were during the first attack.

Stress, being sick, or being tired may start a recurrence. Being in the sun or having your menstrual period may also cause a recurrence. You may know a recurrence is about to happen if you feel itching, tingling, or pain in the places where you were first infected.

What causes herpes?

The virus that causes genital herpes is usually spread from one person to another during vaginal, oral, or anal sex. The virus can enter your body through a break in your skin. It can also enter through the skin of your mouth, penis, vagina, urinary tract opening, or anus.

Herpes is most easily spread when blisters or sores can be seen on the infected person. But it can be spread at any time, even when the person who has herpes isn’t experiencing any symptoms. Herpes can also be spread from one place on your body to another. If you touch sores on your genitals, you can carry the virus on your fingers. Then you can pass it onto other parts of your body, including your mouth or eyes.

How is herpes diagnosed?

Your doctor will do a physical exam and look at the sores. He or she can do a culture of the fluid from a sore and test it for herpes. Blood tests or other tests on the fluid from a blister can also be done.

Can herpes be prevented or avoided?

The best way to prevent getting herpes is to not have sex with anyone who has the virus. It can be spread even when the person who has it isn’t showing any symptoms. If your partner has herpes, there is no way of knowing for sure that you won’t get it.

If you are infected, there is no time that is completely safe to have sex and not spread herpes. If you have herpes, you must tell your sex partner. You should avoid having sex if you have any sores. Herpes can spread from one person to another very easily when sores are present.

You should use condoms every time you have sex. They can help reduce the risk of spreading herpes. But it’s still possible to spread or get herpes if you’re using a condom.

Herpes treatment

If you think you have herpes, see your doctor as soon as possible. It’s easier to diagnose when there are sores. You can start treatment sooner and perhaps have less pain with the infection.

There’s no cure for herpes. But medicines can help. They may be provided as a pill, cream, or a shot. Medicines such as acyclovir and valacyclovir fight the herpes virus. They can speed up healing and lessen the pain of herpes for many people. They can be used to treat a primary outbreak or a recurrent one.

If the medicines are being used to treat a recurrence, they should be started as soon as you feel tingling, burning, or itching. They can also be taken every day to prevent recurrences.

Herpes and pregnancy

It’s important to avoid getting herpes during pregnancy. If your partner has herpes and you don’t have it, be sure to always use condoms during sexual intercourse. Your partner could pass the infection to you even if they are not currently experiencing an outbreak. If there are visible sores, avoid having sex completely until the sores have healed.

If you’re pregnant and have genital herpes, or if you have ever had sex with someone who had it, tell her doctor. The doctor will give you an antiviral medicine to start taking toward the end of your pregnancy. This will make it less likely that you will have an outbreak at or near the time you deliver your baby.

If you have an active genital herpes infection at or near the time of delivery, you can pass it to your baby. When the baby passes through the birth canal, it may come in contact with sores and become infected with the virus. This can cause brain damage, blindness, or even death in newborns.

If you do have an outbreak of genital herpes at the time of delivery, your doctor will most likely deliver your baby by C-section. With a C-section, the baby won’t go through the birth canal and be exposed to the virus. This lessens the risk of giving herpes to your baby.

Living with herpes

It’s common to feel guilty or ashamed when you are diagnosed with herpes. You may feel your sex life is ruined or that someone you thought you could trust has hurt you. You may feel sad or upset. Talk to your family doctor about how you’re feeling.

Keep in mind that herpes is very common. About 1 in 6 adults have it. Herpes may get less severe as time goes by. You can help protect your sex partner by not having sex during outbreaks and by using condoms at other times.

How do I know Im having a herpes outbreak?

Genital herpes.
Pain or itching around the genitals..
Small bumps or blisters around the genitals, anus or mouth..
Painful ulcers that form when blisters rupture and ooze or bleed..
Scabs that form as the ulcers heal..
Painful urination..
Discharge from the urethra, the tube that releases urine from the body..

What does it feel like right before a herpes outbreak?

You might notice some warning signs a few hours or days before outbreaks flare up, like itching, burning, or a tingly feeling on your genitals. Herpes outbreaks are no fun, but the first one is the worst. Repeat outbreaks are usually shorter and less painful.

What happens at the beginning of a herpes outbreak?

When symptoms do occur, herpes lesions typically appear as one or more vesicles, or small blisters, on or around the genitals, rectum or mouth. The average incubation period for an initial herpes infection is 4 days (range, 2 to 12) after exposure.

What to do when you feel a herpes outbreak coming on?

To ease symptoms:.
Take acetaminophen, ibuprofen, or aspirin to relieve pain..
Apply cool compresses to sores several times a day to relieve pain and itching..
Women with sores on the vaginal lips (labia) can try urinating in a tub of water to avoid pain..