Initial and Recurrent Genital Herpes Outbreaks
An outbreak of genital herpes may occur as an "initial" or first outbreak or it may be a recurrent
infection. Read on to learn more about each of these types of outbreaks, as well as what triggers an outbreak.
Initial Genital Herpes Outbreak
An initial genital herpes infection occurs in people who have never been
previously exposed to the herpes simplex virus (HSV). Symptoms of an initial outbreak are usually the most severe
because the body does not have any type of immunity to the herpes virus. This is important because your body does
not have the "resources" to fight this first infection.
When your body is first exposed to the herpes virus, it responds by
attacking the virus with antibodies (a type of protein that is made by your body to fight a virus). Specific
immune cells and antibodies now present in your body learn how to target and keep the herpes virus in check.
However, the antibodies that attack the virus during specific outbreaks do not eliminate the virus overall,
which is why once genital herpes is contracted a person has it for life. Herpes outbreaks are usually milder
after your body has produced these antibodies, and after several years you may experience fewer outbreaks or no
outbreaks at all.
After first becoming infected with the genital herpes virus most
people develop symptoms within 2 to 12 days, but it can take days, weeks, months, or even years for any symptoms
to appear. Remember, the amount of time it takes for symptoms to appear and the severity of these symptoms can
vary greatly from person to person. Because of this, it may be difficult to know when and from whom you may have
contracted genital herpes. Some people may have mild symptoms and not even realize they are having an outbreak
of genital herpes, while other people have severe outbreaks and others may have no symptoms at all.
You may experience any of the following symptoms during an initial
- You may feel
sick like you have the flu, with fever, muscles aches, and pain.
- Sores are more
likely to develop during an initial infection, especially in women. These sores can range in size, and may
appear in several areas, including the genitals, mouth, thighs, buttocks, and around the anus.
- The skin in the
affected area may feel raw, painful, and itchy.
- There may also
be a lot of swelling in affected areas. This is normal because your body is attacking the
- Lymph nodes
(glands) may be swollen in the groin area, which means that your immune system is fighting off the
- In women, the
cervix is infected in about 80% to 90% of initial infections, and vaginal discharge may occur.
- It's possible to
have GH without any symptoms
Without treatment, the first outbreak of genital herpes can last as
long as 3 to 4 weeks, but in many cases, symptoms usually completely resolve within 2 to 12 days. If you are
experiencing symptoms that you suspect may be from a genital herpes outbreak you should see your doctor or go to
a health clinic while you are still experiencing the symptoms.
New diagnostic tests are now available that more accurately diagnose
Note: The effectiveness of FAMVIR has not been established for
treating initial episodes of genital herpes.
Recurrent (Repeated) Genital Herpes Outbreaks
Once you have had an initial outbreak of genital herpes, chances are you
will probably have additional symptoms or outbreaks from time to time. The frequency and severity of recurrent
genital herpes outbreaks can vary a lot. Some people may experience several outbreaks during a year, while others
have only 1 or 2 outbreaks during their lifetime.
The number of outbreaks you experience can also change over time.
Usually you have more outbreaks during the first year you have genital herpes. The average number of outbreaks
is 4 to 5 a year. Many people notice that their outbreaks lessen in frequency and severity with time. The
Centers for Disease Control and Prevention (CDC) recommends suppressive genital herpes treatment for people with
6 or more outbreaks per year. And statistics show that 7 out of 10 people have less than 6 outbreaks per year.
If you're one of these people, or if you don't want to take an antiviral medication every day, episodic
treatment may be right for you.
When you are not having symptoms, the herpes virus may be quietly
sitting in the nerves (ganglia) at the base of your spine and may be inactive. When the herpes virus becomes
active, it travels down nerve fibers to the skin in an area near the site of your first outbreak. Sores, bumps,
or redness may appear in this area. You may also experience burning, itching, and pain in or around the genital
There are effective oral prescription antiviral medicines available
to reduce the discomfort of your symptoms. Single-Day FAMVIR is one of them. In a clinical study of Single-Day
FAMVIR, patients started treatment within 6 hours of either symptom onset or lesion appearance and were able to
stop or shorten an outbreak with just a single day of treatment. Single-Day FAMVIR also relieved pain and
burning within 24 hours in the majority of patients. The effectiveness of FAMVIR has not been established when
treatment is started more than 6 hours after the onset of symptoms or lesions.
Sometimes you can have outbreak without any symptoms; this is
referred to as a silent outbreak or asymptomatic viral shedding. During asymptomatic viral shedding you are
contagious and can spread the herpes virus, but not have any signs or symptoms.
The herpes virus can also be shed from sores that cannot be seen
(e.g., on the cervix in women), from the skin at or near the area of the first infection, and in fluids from the
penis, vagina, and mouth.
Because you don't always know when you may be shedding the virus, it
is important to always use a latex condom or latex barriers during sex. (Please see your doctor for alternative
barrier methods if you're allergic to latex.) Even when condoms are used they are not always effective. Avoid
sexual contact with the affected areas completely when you do have physical symptoms until the skin has
What Triggers a Genital Herpes Outbreak?
There are some trigger factors that may cause the genital herpes virus to become active. If you have
experienced the symptoms of genital herpes some of these may sound familiar, and you probably have already noticed
the link between the trigger and the symptoms even if you didn't know that you were experiencing a herpes
Trigger factors vary from person to person and usually can't be
avoided. Some triggers are believed to be:
- Another illness
(especially with fever)
medication (e.g., asthma medication)
the Stress in Your Life