Herpes is the common name for infections caused by one or both types of the herpes simplex virus. According to the American Academy of Dermatology, symptoms typically appear six to eight days after the infection is acquired. Most people with the disease do not know they are infected and the first outbreak is usually the most severe, so recognizing the first symptoms of herpes plays in an important role in correct diagnosis and treatment.
Prodrome
The onset of a herpes outbreak characteristically begins with a prodrome, or set of premonitory symptoms, that precede the full-blown disease. In a 2008 report in the "Archives of Internal Medicine," the authors report that prodromal symptoms of herpes include tingling, burning, itching, soreness and/or hypersensitivity in the area where lesions later appear. Examination may reveal subtle blanching, redness or swelling.
Constitutional Symptoms
Many people with herpes experience constitutional symptoms that resemble the flu at or shortly before the onset of an outbreak. Dr. Lawrence Corey in "Harrison's Principles of Internal Medicine" states that common complaints include fever, headache, muscle or joint pain, lack of appetite and a generalized feeling of ill health. Fever, according to Corey, lasts three to seven days. Other symptoms are more durable---lasting up to two weeks in some cases.
Skin Lesions
The authors of the "Archives of Internal Medicine" report describe the classic skin lesion of herpes as a painful, 1 to 2 mm fluid-filled blister with a central dimple or belly button. The lesions first present as small bumps or patches of red, raised skin, however this stage lasts only a few hours and often goes unrecognized. The blisters themselves last only three or four days when they rupture spontaneously, yielding highly infectious straw-colored fluid, and give way to sandy yellow scabs commonly referred to as crusts.
References
- American Academy of Dermatology: Herpes Simplex
- "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
