Herpes, according to the American Social Health Association, is a common and usually mild skin condition characterized by episodic recurrence. Most infections are unrecognized and undiagnosed. Familiarizing yourself with herpes breakout symptoms may help you protect yourself and others from the disease.
Prodrome
In 60 percent of people, according to a 2008 article in the "Archives of Internal Medicine," the onset of a herpes breakout is signaled by warning symptoms called a prodrome. The prodrome of herpes includes symptoms such as tingling, itching, burning or hypersensitivity in the area where lesions later develop. In some cases, symptoms are accompanied by subtle swelling or redness. The prodrome may last as little as 2 hours or as long as 2 days, according to the Centers for Disease Control and Prevention.
Constitutional Symptoms
According to Dr. Lawrence Corey in "Harrison's Principles of Internal Medicine," many people with herpes complain of constitutional symptoms such as fever, headache, muscle or joint pain, malaise and lack of appetite in conjunction with a herpes outbreak. Fever may persist for 3 to 7 days. Other symptoms are more durable, lasting up to 14 days in some cases. Constitutional symptoms are usually most severe during the first outbreak and become progressively less severe in subsequent episodes.
Lesions
The characteristic skin lesion of herpes is a 1-2 mm blister that is filled with clear or cloudy yellowish fluid and features a central dimple or "umbilication." The lesions are typically painful. During the first outbreak, they frequently occur in clusters dispersed over a wide surface area. During recurrent outbreaks, they may occur as isolated lesions, often limited to a single side of the body, according to the 2008 article in "Archives of Internal Medicine." After 3 or 4 days, lesions usually rupture spontaneously and are replace by either a yellow-tinged scab (crust) or a well-defined, superficial ulcer (punched out lesion). Scabs are more common on skin. Ulcers are more common on mucous membranes such as the inside of the mouth or the folds of the vulva (female external genitalia).
Lesion-Related Symptoms
In some cases, the lesions of herpes produce their own set of symptoms. For women in particular, herpes lesions can make urination a problem, says Dr. Corey. Anorectal lesions can make bowel movements difficult or painful and are frequently subject to secondary bacterial infections from the bacteria in stool. Lesions in and around the mouth often complicate swallowing and even talking. While lesions and lesion-related symptoms usually resolve within 1 to 4 weeks according to the "Archives of Internal Medicine," repeated mechanical trauma can delay the process, creating a catch-22.
References
- American Social Health Association: Herpes Resource Center
- Herpes Simplex Viruses (Chapter); L. Corey; In: "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
