According to the Centers for Disease Control and Prevention (CDC) in 2008, one in five American adults and adolescents is infected with herpes. However, most people are unaware of their infection. Although not all people have every symptom, herpes outbreaks do have certain characteristics.
Prodrome
The onset of a herpes outbreak usually begins with a prodrome, or early stage, which may last for two hours or two days, according to the CDC. This prodrome is characterized by pain, tingling and burning in the area where lesions later appear. During the initial outbreak, people are usually unaware that they have contracted herpes and may not realize what is wrong.
Constitutional Symptoms
According to a 2005 article in "American Family Physician," approximately 80 percent of people with herpes report constitutional symptoms, such as fever, headache, muscle or joint pain, lack of appetite and malaise. Fever may persist for three to seven days, according to "Harrison's Principles of Internal Medicine." Other symptoms are more durable, lasting up to 14 days. Constitutional symptoms are usually worse during the first outbreak and become less severe during recurrences.
Skin Lesions
Herpes infection is associated with skin lesions that pass through distinct, characteristic phases, says the CDC. Lesions usually begin as painful, red bumps that develop into fluid-filled blisters over the course of one to two days. The blisters eventually rupture and crust over. Around this time, they may become extremely itchy. Skin lesions in the primary outbreak may take up to six weeks to heal. In recurrent outbreaks, the process is much faster--usually about a week. Lesions almost always heal without scarring, unless another process interferes with healing, such as a secondary bacterial infection.
Lesion-Related Symptoms
In some cases, herpes skin lesions produce symptoms of their own, warns Dr. John Beauman in a 2005 article in "American Family Physician." Particularly in women, lesions can make it difficult or painful to urinate. Lesions in the rectal area are more common among people who engage in anal sex, and they often complicate bowel movements. Oral lesions may make it difficult to eat, particularly when the lesions are at the corners of or inside the mouth.
References
- Centers for Disease Control and Prevention: Genital Herpes
- 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; 2008
- American Family Physician; Genital Herpes: A Review; J.G. Beauman; Oct. 15, 2005
