Herpes is an infection caused by one or both types of the herpes simplex virus. According to the American Social Health Association, up to 90 percent of people with herpes are unaware they have the disease. Because the first outbreak is usually the worst, recognizing how herpes first starts can lead to correct diagnosis and treatment.
Incubation Period
According to Dr. Lawrence Corey in "Harrison's Principles of Internal Medicine," the interval between exposure and appearance of symptoms ranges from one to 26 days. Six to eight days is the median.
Early Symptoms
Herpes begins with warning symptoms that precede the full-blown outbreak. According to a 2008 report in the Archives of Internal Medicine, people with herpes frequently describe tingling, itching, burning, stinging, soreness or hypersensitivity in the area(s) where lesions later appear.
Systemic Symptoms
Toward the end of the pre-outbreak symptoms period, people with herpes will often develop systemic symptoms similar to the flu or a cold. Common complaints include low-grade fever, fatigue, lethargy, headache, muscle or joint pain, and/or poor appetite. Notably absent, however, are characteristic respiratory symptoms of the flu and colds, such as cough or runny nose.
Exudative Skin Lesions
Herpes is associated with two kinds of lesions: "exudative" and "ulcerative." Exudative lesions consist of flaccid, 1- to 2-millimeter blisters filled with clear or cloudy yellow fluid. These lesions begin as bumps--called papules-and mature into blisters over the course of a few hours.
Ulcerative Skin Lesions
Ulcerative lesions of herpes consist of well-demarcated, shallow erosions of the surface layer of tissue. They begin as pale patches of uniform swelling, or "edema," which slough off over the course of a few hours.
References
- American Social Health Association: Learn About Herpes--Oral Herpes
- "Treatment of Herpes Simplex: An Evidence-Based Review"; C. Cernik, K. Gallina and R.T. Brodell; June 2008
