Herpes, according to the American Academy of Family Physicians, is the common name for a group of viruses that cause painful blisters and sores. One kind of herpes causes sores around and inside the mouth; another kind of herpes causes sores around the genitals. Most infections are unrecognized and undiagnosed. Familiarizing yourself with herpes outbreak symptoms can help you protect yourself and others from the disease.
Prodrome
According to a 2008 report in the "Archives of Internal Medicine," 60 percent of people experience an early phase of premonitory symptoms called a prodrome. The prodrome of herpes includes symptoms such as tingling, itching, burning and extreme sensitivity in the area where lesions later erupt. In some people, symptoms are accompanied by subtle skin changes such as redness or swelling. Although these symptoms later become familiar, during the first outbreak patients may wonder what is wrong.
Flu-Like Illness
According to Dr. John G. Beauman in a 2005 article in the "American Family Physician," herpes outbreaks are associated with flu-like illness in up to 80 percent of people. Common symptoms include fever, headache, muscle or joint pain, malaise and lack of appetite. Characteristic respiratory symptoms of flu such as cough and sore throat are notably absent. As explained in "Harrison's Principles of Internal Medicine," fever usually resolves before other kinds of symptoms, which may last as long as 14 days. Symptoms are usually most severe during the first outbreak and become progressively less severe with each recurrence.
Sores
The single most common symptom of herpes are skin sores, which, according to the Mayo Clinic website, are often mistaken for acne, bug bites, shaving irritation, allergic reactions, heat rash, hemorrhoids or other kinds of irritations. Sometimes this is because sores are positioned in folds, fissures or other places where it's hard to get a good look. Other times, it's because people do not know what to look for.
According to the "Archives of Internal Medicine," the characteristic herpes skin sore is a 1- to 2-mm blister filled with clear or cloudy yellowish fluid and featuring a central dimple, or "umbilication." Sores are usually painful but may be itchy, too. For a first-time outbreak, they usually occur in clusters dispersed over a wide surface area, and new sores may continue to form for five to seven days, notes the Mayo Clinic website. During recurrent outbreaks, sores usually occur in just a few places, often on just one side of the body. After three or four days, sores usually rupture spontaneously, leaving behind either a faintly yellow, granular crust or a well-defined, shallow ulcer (punched-out lesion). Crusts 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).
Sore-Related Symptoms
In many cases, herpes sores cause their own set of problems. For women in particular, herpes lesions can make urination painful and difficult, notes Dr. Lawrence Corey in "Harrison's Principles of Internal Medicine." People with sores in and around the anus and rectum often complain of pain, discharge, bleeding and odor. Sores in and around the mouth may interfere with swallowing and even talking, in severe cases. Sore-related symptoms usually resolve at the same time as sores themselves--one to four weeks, according to the "Archives of Internal Medicine."
References
- "Archives of Internal Medicine;" The Treatment of Herpes Simples: An Evidence-Based Review; C. Cernik, K. Gallina, and R.T. Brodell; June 2008
- 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
- "American Family Physician;" Genital Herpes: A Review; J.G. Beauman; Oct. 15 2005
