Herpes Outbreaks: Causes, Symptoms, Stages, Treatment


Herpes is caused by the herpes simplex virus type 1 (HSV). Once you become infected with a virus, it remains in your system for life. HSV causes small blisters to form around the mouth and nostrils. The blisters burst and turn into cold sores.

Anyone can get herpes. Most people become infected with HSV through physical contact with an infected person. Even without visible herpes, a person can infect others through saliva.

This article looks at the causes, symptoms, and stages of a herpes outbreak. It also explains how to treat herpes and prevent future outbreaks.

Symptoms of a herpes outbreak

The herpes simplex virus generally remains inactive in the body. This means that you will not have any symptoms until it is activated.

Some people experience a cold sore outbreak for several days after infection. Other people carry the virus but never experience symptoms.

Symptoms of a cold sore outbreak can include:

  • Red, fluid-filled blisters around the lips, nose, or cheeks.
  • Pain in the affected area.
  • Blister liquid
  • Crusting after dry blisters
  • Itching and irritation of the affected area.

During your first outbreak, you may also experience flu-like symptoms in addition to cold sores. This includes:

  • Slight fever
  • Headache
  • Swollen lymph nodes
  • Muscle aches or general body pain
  • Throat pain
  • Difficulty to swallow
  • Fatigue

The initial HSV infection is usually the most serious. This is because the body has not yet strengthened its defense against the virus. If you or your loved one are experiencing the following, see your doctor:

  • High and persistent fever
  • Swallowing problems
  • Irritated red eyes
  • Sores near the eyes
  • Difficulty breathing

After the first infection, the virus remains within the nerve cells of the face. You may no longer experience symptoms if the virus does not work.

If you experience an outbreak in the future, expect herpes to develop there as well. The virus usually reactivates in the same place each time. However, in later outbreaks, the symptoms should be less severe.

Children can develop herpes in the mouth. They are usually mistaken for sores (small lesions in the mouth). If your child begins to develop mouth ulcers, see your pediatrician for a diagnosis.

Get Medication Information / Brianna Gilmartin

Stages of herpes

Herpes can last two to four weeks from the first symptoms to complete healing. During this time, it goes through three different stages. These stages can range from the first flare-ups to relapses.

Level 1

The first stage of a herpes outbreak lasts one to two days. Tingling, itching, or even pain around the mouth is common during this time.

If it is a rerun, you will probably feel it in the same places as the previous flashes.

Also, some people only experience this first stage and do not get herpes.

Stage 2

After a few days, small, hard, fluid-filled blisters begin to form on the lips, nose, cheeks, or other parts of the face.

At this stage, the blisters and fluid are extremely contagious. Avoid close physical contact with other people.

The blisters can also spread to other parts of the body. If you touch a cold sore, wash your hands immediately to avoid spreading the virus.

Be especially careful not to touch the cold sore and not your eyes. A doctor should evaluate blisters near the eyes, sensitivity to light, pain, or sand in the eyes.

Stage 3

In the final stage, the blisters can coalesce and burst. The result is small open sores that ooze fluid.

These sores are very painful and very contagious. After a few days, the open sores begin to dry out and crust over.

Cold sore scabs can cause severe itching and cracking. Do not bite or hit them, as this can increase discomfort.

The scabs will start to fall off and heal 5-15 days after the ulcers first appear.


Herpes is contagious until it forms a scab. If you have herpes, avoid:

  • Touching herpes
  • Kisses
  • Intimate contact (such as oral sex)
  • Sharing food, drinks, or personal items.
  • Physical contact with anyone with a weakened immune system.
  • Physical contact with children.

Herpes can cause serious health problems in newborns, children, and people with weakened immune systems. It is important to take steps to avoid infecting other HSVs.


Herpes is caused by the herpes simplex virus 1. They are extremely contagious. You can contract the virus through physical contact with an infected person. This includes:

  • Intimate contact
  • Kisses
  • Exchange of food or drinks
  • Sharing personal items like lip balm, razors, or towels.

A 2014 report in the journal Human Genome Variation suggests that genetics are at play here. Researchers have discovered a gene that makes a person more susceptible to herpes. However, the exact mechanism of this gene is unknown.

After contracting herpes simplex, you will be infected with the virus for the rest of your life. Recurring outbreaks of herpes can be due to many different factors. This includes:

  • Stress
  • Fatigue
  • Hormonal changes (including menstruation)
  • Disease
  • Dental work
  • Exposure to extreme weather conditions.


Research shows that more than half of all Americans between the ages of 14 and 49 are HSV carriers. Up to 90% of Americans will have at least one cold sore in their lifetime.

Watch out

Herpes causes pain, irritation, and even embarrassment. Fortunately, you can get rid of the pain and symptoms so you feel better faster.


Some prescription oral antiviral medications can shorten the duration of herpes. For these medications to be effective, they must be taken within 72 hours of the outbreak. This includes:

  • Famvir (famciclovir)
  • Valtrex (valacyclovir)

Your healthcare professional may recommend antiviral ointments. They are applied directly to cold sores and include:

  • Abreva (10% docosanol cream) without prescription
  • Denavir (penciclovir 1% cream)
  • Zovirax (5% acyclovir cream)

Remember to wash your hands after applying topical medications.

Over-the-counter pain relievers such as Advil (ibuprofen) or Tylenol (acetaminophen) can relieve pain, swelling, and irritation caused by blisters or open sores.

Home remedies and lifestyle

A cold compress can reduce pain and irritation. Make sure to use a cool, damp towel, not an ice pack. Apply compresses several times a day for 5 to 10 minutes at a time.

Otherwise, keep the affected area clean and dry. Avoid applying makeup on herpes.

Stay away from foods that make symptoms worse. Anything sour, like citrus fruits, tomatoes, or coffee, can irritate herpes and prolong symptoms.

When to contact a healthcare provider

See your doctor if herpes:

  • Develop near the eyes
  • Repeated often
  • Valid more than 15 days

If you have cold sores and a weakened immune system, call your doctor.

Your healthcare provider can manage herpes to avoid possible complications, which can include ocular herpes (transfer of HSV-1 to the eyes) and various skin infections.

Get the word of drug information

Fortunately, cold sores are usually harmless and go away within a few weeks. If you start to develop symptoms of a cold sore outbreak, especially if the outbreaks recur, talk to your doctor about the best treatment plan for your age, medical history, and lifestyle.

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