Genital herpes is caused by one of two strains of the herpes virus, either herpes simplex virus, type 1 (HSV-1), or herpes simplex virus, type 2 (HSV-2). While HSV-2 causes 90 percent of the cases in the United States, according to the University of South Carolina, HSV-1, the strain that most often causes oral herpes, can also infect the genital area.
Infection
The first sign of herpes infection takes place on the microscopic level when the virus transfers from one person to another. The herpes virus is spread from person to person through direct physical contact; the virus can transfer from skin to skin, or via bodily fluids including semen, vaginal secretions and saliva. Unfortunately, the infected person does not need to have active sores in order to spread the virus. Viral shedding can occur without visual symptoms of the disease. According to Pfizer, the virus needs direct access to the uninfected person in the form of injured tissue, either in the skin or in an area of mucus membranes. Once the virus has accessed the skin via vulnerable tissue, it attempts to reproduce within the nuclei of skin cells. Pfizer points out that, in the majority of cases, no symptoms are felt by the new carrier. The University of Maryland Medical Center (UMMC) reports that studies indicate that 10 to 25 percent of those who are infected with HSV-2 do not even know they have the disease.
Blisters and Lesions
When the virus multiplies within cells in its new host, it may destroy the cells it has colonized. When this happens, reports Pfizer, inflammation and blister development can follow. The first symptom the recently-infected person may notice is a tingling or itching in the groin area. This can be on the genitals, on the scrotum, on the buttocks, upper thighs, or around the anus. UMMC informs that this typically occurs within one to two weeks after exposure to the virus. A couple of days after the tingling begins, small bumps form on the skin. These grow into virus infused, fluid-filled blisters on a red, inflamed base. There can be one blister, or a cluster of blisters, or more than one cluster of blisters. The blisters eventually rupture, forming shallow ulcers on the skin or mucus membrane, and weep, forming a crust or scab. Medline Plus reports that the crusting and healing phase of the outbreak usually takes from 7 to 14 days, or more. Once the virus multiplies the first time, it travels from the skin to the nervous system where it establishes itself in the dorsal root ganglia at the base of the spine. It enters a period of latency, or hibernation, and reactivates at occasional times over the person's lifetime.
Other Signs and Symptoms
The majority of men do not show symptoms of herpes infection. UMMC reports that symptoms appear in only about 40 percent of men. When they do appear, the first outbreak is usually more pronounced than recurrent outbreaks. Medline Plus reports that, in addition to the blisters, common signs include fever, all-over malaise, muscle aches in the lower back, buttocks, thighs or knees. Swollen glands, either in the groin area or neck, can also occur, according to UMMC, as well as pain while urinating.
