Herpes is the common name for infections caused by one or both types of the herpes simplex virus. Most people develop symptoms between six and eight days after they are infected, although sometimes it takes longer---up to 26 days, according to Dr. Lawrence Corey in "Harrison's Principles of Internal Medicine." Herpes lesions are frequently mistaken for pimples, insect bites, rashes and other skin problems, so identification of early symptoms plays a key role in establishing the diagnosis.
Prodrome
The onset of a herpes outbreak characteristically begins with a prodrome, or warning symptoms, that precede the full-blown disease. Prodromal symptoms of herpes, according to a 2008 report in the "Archives of Internal Medicine," include tingling, burning, soreness or sensitivity in the area where lesions later appear. Careful inspection may reveal blanching, redness or subtle swelling. The prodrome of herpes may last as little as two hours or as long as two days.
Constitutional Symptoms
Approximately 80 percent of people with herpes experience constitutional, or bodily, symptoms similar to those of flu at or shortly before the onset of an outbreak, according to a 2005 article in the "American Family Physician." Common complaints include fever, headache, muscle or joint pain, lack of appetite and a generalized feeling of ill health. Fever, according to "Harrison's Principles of Internal Medicine," lasts for three to seven days. Other symptoms are more persistent---lasting up to two weeks in some cases.
Skin Lesions
The classic skin lesion of herpes is a painful, 1 to 2 mm fluid-filled blister with a central dimple or umbilication. These lesions actually start out as small bumps or papules on a base of red, raised skin, according to the report in the "Archives of Internal Medicine." The bumps develop into blisters over the course of a few hours, so this stage is often missed. Blisters themselves last only three or four days before they rupture and give way to yellow, "sandy" crusts or shallow abrasions with clearly defined or punched-out borders.
References
- "Harrison's Principles of Internal Medicine, 17th edition;" A.S. Fauci, E. Braunwald, D.L. Kasper, S.L. Hauser, D.L. Longer, J.L. Jameson and J. Loscalzo (Eds.); 2008
- "Archives of Internal Medicine;" The Treatment of Herpes Simples: An Evidence-Based Review; C. Cernik, K. Gallina, and R.T. Brodell; June 2008
- "American Family Physician;" Genital Herpes: A Review; J.G. Beauman; Oct. 15 2005
