Herpes Pain
When symptoms of herpes do show, they are often painful clusters of sores and blisters around the mouth or genitals.

Genital herpes typically manifests as a group of blister-like lesions in the genital region (head of the penis, labia, anus, or cervix). This spreads, combines, bursts and crusts over in about 4 to 15 days. These painful, itchy lesions produce a lot of infectious fluid.

Other classic symptoms of herpes include:

The pain is often associated with burning sensations at the site of the lesions. The initial exposure (often called primary episode) is characterized by symptoms, such as fatigue, headache, fever, and chills. Recurring episodes generally tend to be milder than the initial episode.

What is herpes?

Herpes simplex virus causes skin infections. The infection is persistent although the symptoms may go away and then recur to cause sporadic sores and blisters, which could be itchy or unpleasant.

Herpes simplex virus typically does not cause significant problems. However, young children and individuals with weaker immune systems might get a severe infection.

There are two main forms of herpes simplex:

  1. Herpes simplex virus type I (HSV I or oral herpes): Usually affects the mouth or face. It is transmitted from one person to another through saliva and typically causes fluid-filled sores or vesicles (cold sores) in infected people.
  2. HSV II (genital herpes): A sexually transmitted disease. When a person comes in contact with the genitalia of an infected person, the infection spreads and may cause sores on the skin in the genital area.

What are the symptoms of genital herpes?

Many infected individuals never show any herpes symptoms. If there are symptoms, they will vary depending on the first episode or a recurrence of herpes. The symptoms that return are typically less severe than the initial outbreak. Later outbreaks do not have the same long duration as the first one.

Only one or two recurrences may occur in a person's lifetime. Some people may experience up to four or five outbreaks annually.

Symptoms of first herpes breakout

  • Initial signs and symptoms could resemble the flu, including fever, chills, aches, pains in the muscles, exhaustion, and nausea.
  • The buttocks, genitalia, or other areas of the body may develop small, fluid-filled blisters.
  • The lesions typically cluster together, and the area around them might become painful and swollen.
  • If there are open sores on the genitalia, urinating results in a stinging or burning feeling.
  • The initial genital herpes infection may last two to four weeks. The sores rupture during this period and exude fluid. The sores crust over a few days and eventually heal without leaving any scars.

Symptoms of recurrent herpes breakout

  • When an infection is ready to develop again, there could be burning, stinging, or tingling felt close to the site where the virus first entered the body.
  • There could be a pain in the legs, knees, lower back, and buttocks even before the lesions appear. It is called a prodrome.
  • There is typically no fever or genital swelling during recurring outbreaks.
  • Sores heal more quickly, typically in three to seven days.
  • Recurring breakouts often result in less pain. Outbreaks caused by infections are usually more prevalent in the first year. For many people, the frequency of breakouts decreases over time.

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How is herpes simplex diagnosed?

By examining any sores that are present, your healthcare provider can identify genital herpes. Providers may collect a sample from the sores to test. If there are no sores, a blood test could be conducted to check for herpes simplex virus (HSV) antibodies.

Blood analysis lets your doctor know if you have ever been exposed to the herpes virus. If this is your first infection, there may not be enough time for your body to produce antibodies to test positive for herpes. You can test again for HSV I and HSV II antibodies in 8 to 12 weeks.

How does herpes simplex spread?

Herpes simplex virus (HSV) is spread by close contact with an infected person. Both saliva and skin can contain the virus. When you have sores, you are most likely to spread the virus to someone else. However, even if you do not have symptoms, you still have the potential to infect someone else (asymptomatic viral shedding).

HSV I can spread through:

  • Kissing
  • Contact with a person's skin close to their mouth
  • Sharing razors, lip balm, or cutlery
  • Oral sex with someone who has a cold sore

HSV II can be acquired through:

  • Sexual activity, including anal, vaginal-penile intercourse
  • Oral sex
  • Childbirth by an infected mother
  • Touching an open wound, including when nursing

Toilet seats cannot transmit genital herpes. However, shared sex toys can transmit genital herpes. To keep yourself safe, wash your sex toys both before and after use, and do not share them. If you do, use a condom to keep them safe.

What is the treatment of herpes?

Some people prefer not to receive treatment because they experience few or no herpes outbreaks. However, a lot of people choose to use drugs that minimize outbreaks and reduce symptoms.

Treatment minimizes the risk of the spread of infection. You can use an antiviral cream or ointment to ease your symptoms and hasten their disappearance during a breakout. This works only when you begin using it right away after the outbreak begins.

To prevent outbreaks, many with herpes simplex virus type II take daily oral medicines.

Your healthcare practitioner might suggest an oral or topical medicine:

Self-care treatment

  • Place an ice pack over the genitals. Apply the ice pack over your underpants by wrapping it in a washcloth.
  • Keep your private parts dry. Wear cotton or other non-synthetic underwear and stay away from tight clothing. Sores that are moist heal more slowly.
  • Have a warm bath.
  • Use nonsteroidal anti-inflammatory drugs to treat pain.
  • Could use one to two percent lidocaine as a topical numbing medication to relieve pain, itching, and burning.

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Medically Reviewed on 10/27/2022
References
Image Source: iStock image

Genital Herpes – CDC Basic Fact Sheet. https://www.cdc.gov/std/herpes/stdfact-herpes.htm

Herpes Simplex Virus. https://www.nationwidechildrens.org/conditions/herpes-simplex-virus

Genital Herpes. https://www.hopkinsmedicine.org/health/conditions-and-diseases/herpes-hsv1-and-hsv2/genital-herpes

Genital Herpes. https://kidshealth.org/en/teens/std-herpes.html

Genital herpes. https://dermnetnz.org/topics/genital-herpes