Would I Know If I Had Herpes?

The first noticeable symptom of herpes for most people is a blister in the genital area. It is possible to transmit the disease even if you don’t show symptoms.

Genital herpes is a viral infection that may cause blisters and open sores on the genitals caused by herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Oral herpes (also called cold sores or fever blisters) are painful blisters that form on or near the lips and inside the mouth that are usually caused by HSV-1.

Some people with herpes may not know they have herpes because they never have symptoms, or symptoms are very mild. Others may develop symptoms of herpes within a few weeks of infection with the herpes virus. 

Symptoms of genital herpes include:

• Blisters in the genital area
• In women, this area includes the vagina, anus, buttocks, or thighs
• In men, this area includes the penis, scrotum, anus, buttocks, or thighs
• Blisters may become painful open sores, which crust over as they heal
• Blisters on the mouth or lips
• Fever
• Headache
• Pain in the joints
• Difficulty urinating

Symptoms of genital herpes are usually most severe the first time they occur, and symptoms may last 2 to 3 weeks. After that, outbreaks may occur where symptoms reappear. Outbreaks are usually not as severe as the first occurrence and do not last as long. In some cases, people know when an outbreak is about to happen, because they feel itching or pain beforehand, but other people have no symptoms. Herpes outbreaks tend to become less frequent over time.

Symptoms of oral herpes may include: 

• Painful blisters on the lips, mouth, nose, or throat, 
• Blisters eventually open and form scabs
• Mouth and throat pain
• Neck swelling 
• Fever
• Body aches
• General ill feeling (malaise)

The first attack of cold sores usually happens during childhood and lasts about 12 days. After that, pain and blisters may return but the other symptoms usually do not, the symptoms are milder, and they usually last 8 days or less. Sometimes people know when cold sores are recurring and they feel pain, tingling, burning, or itching on the lips about a day before blisters form.

Genital herpes is caused by herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) that is passed from person to person during vaginal, oral, or anal sex. 

Oral herpes is usually caused by HSV-1 that is passed from person to person from kissing, sharing a fork or knife, or some other type of close contact.

People who give oral sex to people with genital herpes can get cold sores on their mouth.

Herpes spreads more easily when a patient has blisters and open sores, though it is also possible to spread the virus when no symptoms are present. 

Certain triggers can make outbreaks more likely to occur, such as:

• Stress
• Sunlight
• Menstrual periods
• Illness
• Recent fever
• Physical injury 
• Surgery

Both genital and oral herpes are diagnosed with a physical exam. Herpes can often be diagnosed by a doctor with a visual examination of the sores. 

If you have blisters or sores, tests to look for herpes may include:

• A sample of cells or fluid from a sore is sent to a lab
• If you don't have symptoms a blood sample may be taken to check for herpes antibodies
  • A herpes blood test cannot determine who gave you the infection or how long you have been infected

There is no cure for herpes, but the virus usually causes the most symptoms during the first few years. After that, it causes mild to no symptoms. When the virus is active, medications can help reduce and prevent symptoms.

Antiviral medicines can help reduce symptoms of genital herpes and speed up the healing of an outbreak, such as:

• Acyclovir (Zovirax)
• Valacyclovir (Valtrex)
• Famciclovir (Famvir)

Home remedies to help reduce the pain of genital herpes during an outbreak include:

• Using a portable bath ("Sitz bath") or your bathtub and sit in warm water for about 20 minutes
• Keeping the genital area clean and dry
• Avoiding tight clothing
• Over-the-counter (OTC) pain medicines such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain

Most people will need treatment for oral herpes the first time it occurs. Recurrences or mild symptoms may not need treatment.

When needed, treatment for oral herpes may include:

• Antiviral medications
  • Acyclovir (Zovirax)
  • Valacyclovir (Valtrex)
  • Famciclovir (Famvir)
• Antiviral topical ointments
  • Acyclovir (Zovirax ointment or cream)
  • Penciclovir (Denavir topical)
• Pain-relieving pills and gels applied to the mouth, which may be available over-the-counter (OTC)
  • Docosanol 10% (Abreva) 
  • Dimethicone with sunscreen (Herpecin-L) 
  • Benzyl alcohol (Zilactin)
• Sucking on ice or popsicles may also help relieve pain of oral herpes sores