What Does A Herpes Outbreak Feel Like
Symptoms usually appear within 2 weeks of exposure.
The first outbreak is usually the worst. At first, you might develop some flu-like symptoms. Then you might feel itchy or have an uncomfortable feeling around your genitals or mouth before the lesions appear.
Future outbreaks are likely to be milder and resolve faster.
You may have heard that herpes is only contagious during an outbreak. However, it can be transmitted even though there are no visible signs. You can have herpes and not know it.
For those reasons, its important to try to talk with your sexual partners before assuming or blaming.
It can be a challenging situation to cope with. Learning you have herpes can stir a variety of emotions. Its normal to have mixed feelings and wonder what to expect.
Its important to make an appointment with your healthcare provider as quickly as possible. If you have herpes, your healthcare provider can provide important information about managing your condition.
Make a list of questions before you go, which can help you get the most out of your visit. Let your healthcare provider know if youre having trouble understanding the information.
The more you know and understand about herpes, the better prepared youll be to manage your symptoms and condition. Your healthcare provider will help you create a treatment plan that works best for your medical needs.
What Is The Treatment
Antiviral medication can be prescribed when herpes first develops, or if the blisters are painful or happen often. The antiviral treatments will not cure herpes, but can help to reduce discomfort and how long it takes for a sore to heal.The medication works best if it is started as soon as possible. It can also decrease the chance of spreading it to others by preventing the virus from multiplying.
To ease discomfort when you have symptoms, try the following:
- Take acetaminophen or Ibuprofen to help with the pain
- Wear loose-fitting clothing and cotton underwear
- Soak in warm water baths
- Keep the infected area dry, e.g., use a blow dryer on a cool setting after bathing instead of rubbing the area with a towel
- Apply an ice-pack, wrapped in a clean cloth, to sores
- Drink plenty of fluids to keep urine diluted . If urinating hurts, pour warm water over your genitals while urinating or pee when you are in a warm shower or bath
- Do not use medicated or non-medicated ointments or creams, unless they are prescribed by your health care provider
- Avoid breaking blisters and any sexual contact until symptoms have resolved
Herpes And Newborn Infants
Herpes infection in a newborn can cause a range of symptoms, including skin rash, fevers, mouth sores, and eye infections. If left untreated, neonatal herpes is a very serious and even life-threatening condition. Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis. It also can lead to intellectual disability, cerebral palsy, and death. Herpes can also spread to internal organs, such as the liver and lungs.
Infants infected with herpes are treated with acyclovir, an antiviral drug. They usually receive several weeks of intravenous acyclovir treatment, often followed by several months of oral acyclovir. It is important to treat babies quickly, before the infection spreads to the brain and other organs.
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How Can I Manage The Symptoms
- Keep the area clean to avoid infection. You can use an ice pack wrapped in a towel to reduce pain and soothe your skin.
- Some people find topical anaesthetic creams such as Emla help
- Drink plenty of fluids – this will dilute your urine and make passing urine less painful.
- Avoid tight clothing as it may irritate the blisters and sores further.
Ingrown Hair And Pseudofolliculitis
When the hair is not properly shaved on fragile skin, it can curl inside it, forming a bump, and can progress to pseudofolliculitis or even folliculitis.
The skin in the genital area is particularly fragile, and ingrown hair can easily occur there as a result of a nonoptimal shaving technique. The bump of ingrown hair is usually small and firm, but it can look like a blister, which makes it look like a herpes lesion. It can also be painful, but its pain does not resemble the distinctive burning pain of herpes. It also does not ulcerate, and if it pops open it usually heals very quickly, unlike herpes.
When there is recurrence of ingrown hair, inflammation can occur in that area and present as redness of the surface of the skin and a chronic recurrence of itchy buttons. The condition is commonly seen in the beard area, especially on the neck and under the chin where the skin is more fragile, but it can also be seen in the pubis and other areas.
The skin lesions of pseudofolliculitis are, like ingrown hair and contrary to herpes, unlikely to ulcerate. They follow the pattern of hair growth, and they have particularly more pruritis or pain a day or two after shaving.22
Image 7. Ingrown hair and pseudofolliculitis .
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How Is Postherpetic Neuralgia Treated
If shingles is caught within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir , valacyclovir or famciclovir . These medications help the rash/blisters heal faster, keep new sores from forming, decrease pain and itching and reduce length of pain after sores have healed.
If your shingles outbreak is not caught early, your healthcare providers has many options to manage your postherpetic neuralgia symptoms.
If your pain is mild, your healthcare provider may recommend:
- Acetaminophen or NSAIDs such as ibuprofen .
- Creams and patches include lidocaine and capsaicin .
If your pain is more severe, your healthcare may prescribe:
- Antiseizure drugs gabapentin and pregabalin .
- Antidepressants, such as escitalopram , quetiapine or amitriptyline.
- Botulinum toxin injections in the area where you are having pain.
Theres no clear-cut superior treatment for PHN. Your provider may need to try more than one medication or prescribe the use of several medications at the same time. You and your provider will discuss options and what makes sense to try for you. Contact your provider if your pain is not lessening after taking your medicine. Take all your medications exactly as prescribed.
When To See A Healthcare Provider
If you have a cold sore, you do not necessarily need to make an appointment with your healthcare provider because the sore will likely go away on its own within a few days. However, make an appointment for an evaluation if you have signs and symptoms of cold sores that are persistent and/or extremely painful, especially if they are associated with fevers, swelling, bleeding, or oozing. Though cold sores are generally not serious and rarely cause complications, you’ll want to get outbreaks under control.
If you have any signs of genital herpes, however, you should see a healthcare provider within a few days, before the lesions go away.
Sores on or near the genital area can herald a sexually transmitted infection , or they may be the result of some other type of irritation. Most STIs are treatable, but it is difficult to know which one you may haveor if you have one at allunless you are trained in diagnosing them.
Many people do not freely communicate with sexual partners when it comes to STI status, so it’s best to get a definitive answer on what’s causing your symptoms.
If you have pain or bleeding with urination, pain with sexual activity, or if you notice that lesions in the genital area seem to be inflamed, you should call your healthcare provider, even if you have already been diagnosed with and treated for herpes.
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Can Postherpetic Neuralgia Be Prevented
The Food and Drug Administration has approved a shingles vaccine, which can reduce your chance of getting shingles and PHN. The recombinant herpes-zoster vaccine is recommended to prevent shingles in adults ages 50 and older. The vaccination is given in two doses, two to six months apart. The two-dose vaccine is 90% effective at preventing shingles and PHN. Protection lasts at least for four years after you get vaccinated.
If you have never had chickenpox or have children who have never had chickenpox, getting the chickenpox vaccine can help prevent getting this infection in the first place. If you never get chickenpox, you will not have the varicella-zoster virus in your body and will not get shingles or PHN.
Recurrence Course Triggers And Timing
Course of Recurrence
Most cases of herpes simplex recur. The site on the body and the type of virus influence how often it comes back. Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection.
The virus usually takes the following course:
- Prodrome. The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itchy skin, pain, or an abnormal tingling sensation at the site of infection. Headache, enlarged lymph glands, and flu-like symptoms may occur. The prodrome, which may last from 2 hours to 2 days, stops when the blisters develop. About 25% of the time, recurrence does not go beyond the prodrome stage.
- Outbreak. Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. After blisters erupt, they typically heal in 6 to 10 days. Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area.
Triggers of Recurrence
Herpes outbreaks can be triggered by different factors. They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress. Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction.
Timing of Recurrences
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Treatment For Genital Herpes
There is no medication to cure your body of the herpes virus. Treatment is aimed at easing symptoms, reducing the frequency of recurrences and reducing transmission.
Symptoms can be improved by:
- ice packs to the affected area
- pain-relieving medication such as paracetamol
- antiviral medication such as acyclovir, famciclovir and valaciclovir. These can reduce the severity of an episode if taken early enough . Topical antivirals usually used for cold sores on the lips or face are not suitable for use on the genitals.
How Does Genital Herpes Spread
Herpes can be spread when an infected person has lesions blisters and open sores on their body or when you do not have any symptoms. Taking antiviral medicine can help you reduce the risk of spreading genital herpes to your sexual partners. You can also:
- Inform your sexual partner that you have genital herpes.
- Use a condom every time you have sex.
- Refrain from having sex when you have symptoms.
- Abstain from performing oral sex if you have blisters or open sores around your mouth.
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How Do You Prevent Shingles
Vaccination is a safe and effective way to protect against shingles in most people. The shingles vaccine should not be given to people who are immunocompromised.
For more information on shingles immunisation, see Shingles immunisation service.
Shingles is less contagious than chickenpox. The risk of spreading the disease is low if the rash is covered. When the rash has developed crusts, you are no longer infectious.
If you have shingles, you should:
- wash your hands often to prevent the virus from spreading.
Avoid contact with these people until the rash has developed crusts:
- pregnant women who have never had chickenpox or the chickenpox vaccine
- premature or low birthweight babies
- children who have not had chickenpox or the chickenpox vaccine
- people with weakened immune systems, such as people who:
- have had chemotherapy
- are taking other medicines that weaken their immune system
- have had a transplant
- are living with HIV.
What Causes Or Triggers A Recurrence
You may not always be able to tell when youre having a herpes outbreak. However, some common early warning signs that signal an impending attack, can include tingling, itching, and pain. This can happen 1 or 2 days before blisters start to show.
If you have HSV-2, you might have four or five outbreaks a year. How often outbreaks occur varies a lot from person to person. Outbreaks may also decrease over time.
People with HSV-1 tend to have fewer outbreaks.
In time, some people can pinpoint things that trigger an outbreak, such as:
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What Happens At A Sexual Health Clinic
The doctor or nurse at the sexual health clinic will:
- ask about your symptoms and your sexual partners
- use a small cotton bud to take some fluid from 1 of your blisters or sores for testing
The test cannot:
- be done if you do not have visible blisters or sores
- tell you how long you have had herpes or who you got it from
Symptoms might not appear for weeks or even years after you’re infected with the herpes virus.
How Long Do Symptoms Last
The initial outbreak of herpes symptoms is usually the most severe and can last up to six weeks before going into remission. Recurring outbreaks are typically less severe, and can last anywhere from a few days to about two weeks. Some people experience more severe symptoms than others and not everyone infected with herpes will experience symptoms.
If you are experiencing tingling in your feet and any other herpes symptoms, visit your local FastMed location. We can perform an STD test to determine if you are infected with herpes and if so, can prescribe the necessary medication to treat it.
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Treatment If The Blisters Come Back
Go to a GP or sexual health clinic if you have been diagnosed with genital herpes and need treatment for an outbreak.
Antiviral medicine may help shorten an outbreak by 1 or 2 days if you start taking it as soon as symptoms appear.
But outbreaks usually settle by themselves, so you may not need treatment.
Recurrent outbreaks are usually milder than the first episode of genital herpes.
Over time, outbreaks tend to happen less often and be less severe. Some people never have outbreaks.
Some people who have more than 6 outbreaks in a year may benefit from taking antiviral medicine for 6 to 12 months.
If you still have outbreaks of genital herpes during this time, you may be referred to a specialist.
Symptoms Of Genital Herpes
Many people who have genital herpes may not be aware they have the infection, because they may not have any symptoms.
The first episode of herpes can cause considerable pain and distress. Symptoms of the first episode may include:
- flu-like symptoms such as feeling unwell, headaches and pains in the back and legs, with or without enlarged glands in the groin
- small blisters around the genitals these break open to form shallow, painful ulcers, which scab over and heal after one to two weeks
- small cracks in the skin with or without an itch or tingling
- redness or a distinct rash
- some people also have considerable pain and swelling in the genital area, and hence may have additional pain and difficulty passing urine.
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How Can Herpes Be Prevented
Correct and consistent use of latex condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.25,26
The surest way to avoid transmission of STDs, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested for STDs and is known to be uninfected.
Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV.
Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. 27 Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences.
What To Look Out For
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“Genital herpes outbreaks can differ in severity. While some people encounter multiple painful blisters, some only have one single sore.” – Dr Zenon Andreou |
“Genital herpes outbreaks can differ in severity. While some people encounter multiple painful blisters, some only have one single sore.”
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Ask About Sexual History
Ask all partners whether theyâve been tested recently for STIs before sexual contact. Limiting the number of sexual partners you are exposed to will also decrease your risk of contracting genital herpes and other STIs.
If youve had unprotected sex, or if you experience symptoms of genital herpes, visit your healthcare provider or local STI clinic for an STI screenings.
If you have genital herpes, be open with your partner and talk about the risks of transmission.
Douching should be avoided, as this may actually increase chances of contracting an STI .
Researchers are working towards the development of other preventative strategies, such as an HSV vaccine and topical microbicides to help prevent the spread of herpes .
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