Genital Herpes - What Happens

What Happens

You can become infected with genital herpes when the herpes simplex virus (HSV) enters the body through sexual or other direct contact with herpes sores. HSV infections cannot be cured. After you are infected with HSV, the virus remains in your body for the rest of your life. Many people do not have symptoms and thus are unaware that they have the virus.

First-time (primary) outbreak

The incubation period—the time from exposure to genital herpes until the primary outbreak of infection—is generally 2 to 14 days. But most people may not notice their first infection. The entire body may be affected, causing you to feel as though you have the flu. Blisters appear around the genitals or anus or in the area where the virus entered the body. The blisters break within a few days and become painful, oozing sores. The sores usually heal within 3 weeks (without treatment) and do not leave scars. Sores that occur in women usually take longer to heal than sores that occur in men.

Recurrent outbreak

After the primary outbreak, the herpes simplex virus remains in the nerve cells below the skin in the area where the sores first appeared. The virus stays in the nerve cells but becomes dormant, causing no symptoms. In most people, the virus becomes active from time to time, traveling from the nerve cells to the skin and causing repeated blisters and sores (recurrent outbreaks).

Sores from recurrent outbreaks usually heal faster and are less painful than those from the primary outbreak. People report that certain factors such as stress, illness, new sex partners, or menstruation may trigger recurrent outbreaks.

About half of the people who have recurrent outbreaks of genital herpes feel an outbreak coming a few hours to a couple of days before it happens. They may feel tingling, burning, itching, numbness, tenderness, or pain where the blisters are going to appear. This is called the prodrome.

People who have symptoms average five outbreaks a year during the first few years. Most have fewer outbreaks after that. The pattern of recurrent outbreaks—how often genital herpes infections return and how long outbreaks last—varies greatly. Some people have many outbreaks each year while others have only a few or none at all.

Genital herpes infections caused by HSV-1 recur less frequently than those caused by HSV-2 and often cause less severe symptoms.

Other problems from the herpes simplex virus

Genital herpes can affect many body systems and cause other health problems, especially the first time a person becomes infected (primary outbreak).

People who have an impaired immune system are more likely to have longer and/or more severe outbreaks of genital herpes than people whose immune systems are healthy.

Genital herpes in newborns

Newborns may be infected with HSV at birth. This usually happens when a woman has her primary outbreak close to the time of delivery and the baby is delivered through the vagina. Usually in these cases the woman either does not have symptoms or is unaware of symptoms. The risk of passing the virus to the baby is greatly reduced during recurrent outbreaks, occurring less than 1% of the time.¹

A pregnant woman who has visible signs of an outbreak near her due date may be tested for HSV. The risk of passing HSV to the baby during delivery is much higher during a primary outbreak than a recurrent outbreak.

If a genital herpes blister or sore is present at the time of labor and delivery, whether it is part of a primary or recurrent outbreak, a cesarean section is usually done. Cesarean section may be recommended if a woman has tingling or pain (prodromal symptoms) suggesting an impending outbreak.

Because their immune systems are not fully developed, newborns with herpes infection can have serious health problems affecting many body systems. It may take up to 3 weeks after a newborn is infected before he or she becomes ill.