Herpes: signs, symptoms and complications


Both herpes simplex viruses (HSV) can cause ulcers. HSV type 1, which is usually spread by kissing or sharing objects such as toothbrushes, usually causes sores on the mouth or tongue ( herpes ). HSV type 2 sores are usually found in the genital area, as this type of herpes is transmitted sexually. However, there may be no symptoms of infection or the ulcers may come and go .

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Frequent symptoms

There are some similarities between the symptoms of HSV 1 and HSV 2:

  • Severity: Herpes and genital herpes often cause more noticeable and widespread symptoms during the first infection. As a general rule, relapses are easier.
  • Asymptomatic Intervals: Herpes and genital herpes are caused by viruses that penetrate the skin and enter the nerves, where they lie dormant (inactive) before reappearing. These asymptomatic intervals can last for weeks, months, or even years.
  • Warning signs of reactivation: Pain, tingling, or burning may occur before a recurrent episode of herpes. It is associated with inflammation and irritation of the nerves in the infected area. These warning signs of another outbreak (often called prodromal symptoms) mean that you are highly infectious, even if you don't have visible ulcers.

In the vast majority of cases, HSV types 1 and 2 cause superficial skin symptoms in certain areas mentioned. In rare cases, the most severe symptoms can affect other parts of the body.

The main difference between the symptoms of the two types of herpes virus is where the sores occur.

Herpes (HSV 1)

Herpes can appear on the outside of the mouth or lips, inside the mouth, or on the tongue. HSV 1 symptoms include:

  • Open, blistered, or crusted sores
  • Pain when chewing, swallowing or speaking.
  • Itchy sores and the area around them

Symptoms can last three to 10 days, and recurring ulcers usually affect the same area.

Genital herpes (HSV 2)

Typical symptoms of genital herpes include:

  • Small, fluid-filled, often clumping, internal and external blisters and ulcers
  • Itching or burning around the genitals or anus
  • Pain in the legs, buttocks, or genital area.
  • Pain when urinating
  • Unexplained discharge from the penis
  • Unusual vaginal discharge

Symptoms disappear in 10 to 21 days. Recurrent seizures usually affect the same area, but are less serious .

In men, the infection can affect the penis, anus, buttocks, and / or thighs. In women, ulcers can occur in the vagina, cervix, urethra (the tube through which urine passes), the area around the buttocks, the anus, and / or the thighs.

Women may be more susceptible to genital herpes infections, primarily because the female genital area is more likely to be hydrated by body fluids, allowing the virus to penetrate the skin more easily.

Women tend to have a higher rate of complications during the first outbreak of genital herpes.

Less common symptoms

In general, herpes simplex infections cause sporadic relapses of ulcers, often with a prior trigger, such as a cold or fever, and sometimes without any triggers.

The infection can cause other symptoms, although less common. This includes:

  • Severe pain in the area of the ulcers: Ulcers can cause severe pain, usually as a result of repeated abrasion. For example, HSV type 1 can appear on the tongue near the teeth, which can cause additional irritation. HSV type 2 can occur near an area that is constantly rubbed by clothing or an area that is aggravated by walking or sitting, which can make symptoms worse.
  • Painful and enlarged lymph nodes : The glands in your neck, armpits, or groin may become enlarged or painful if you have an active herpes infection.
  • Flu-like symptoms. The infection can cause fever and general flu symptoms, such as muscle aches and fatigue. This may be due to the body's immune system response to an HSV infection.

Symptoms in other areas of the body.

HSV type 1 can occur in the genital area and HSV type 2 can occur in the mouth or in the mouth. Any of these cases is usually the result of transmission through oral sex .

You can't always tell what type of herpes virus you have by looking at it, since the sores caused by both viruses look the same.

HSV 1 can also affect other parts of the body such as the neck, arms, and trunk. Symptoms include pain, itching, blisters, or sores. It is most commonly associated with wrestling and is described as gladiatorial herpes when it occurs in this setting.


In most cases, herpes only causes superficial sores. Herpes can cause serious complications that affect other parts of the body, but this is rare.

As a general rule, herpes complications most often occur in two situations: when a child is born with herpes transmitted by the mother during childbirth, and when the person's immune system is not working properly (as with HIV infection).

Disseminated herpes

Disseminated herpes occurs when a herpes virus infection spreads from the initial site of infection. For example, type 2 herpes sores can recur and affect multiple areas of the vagina; Herpes simplex virus type 1 sores can recur and affect multiple areas of the tongue.

Common cold sores can be more serious because the herpes virus can spread to other parts of the body, including the brain.

Ophthalmic herpes

Herpes infection can affect the eyes. This is a rare complication of HSV type 2, most often seen in newborns who may be exposed to the virus during vaginal delivery. Ophthalmic herpes can cause painful sores on the eyelid or in the eye itself.

Symptoms of ocular herpes include the following:

  • Pain in and around the eye
  • Redness, rash, or sores on the eyelids, around the eyes, or on the forehead.
  • Redness of the eyes
  • Edema and opacity of the cornea
  • Tearing
  • Blurry vision
  • Photosensitivity
  • To shoot

Hearing loss

Herpes is associated with sudden hearing loss in children and adults, as well as hearing loss in newborns. This complication can occur if the herpes virus infects the nerves that control hearing.


Encephalitis is an infection of the brain. It is a serious infection that can cause developmental delays in children or cognitive (thinking) disturbances in adults.

When to contact a healthcare provider

If you have cold sores, you don't need to make an appointment with your doctor because it will probably go away on its own in a few days. However, make an appointment for an exam if you have persistent and / or extremely painful herpes signs and symptoms, especially if they are associated with fever, swelling, bleeding, or oozing. Although cold sores are generally not a serious condition and rarely cause complications, you need to control their outbreaks.

However, if you have any signs of genital herpes, you should see your doctor for a few days before the lesions disappear.

Ulcers on or near the genitals may indicate a sexually transmitted disease or may be the result of another type of irritation. Most STDs are treatable , but it is difficult to know which one you may have, or if you have any, if you are not trained to diagnose them. Many people do not communicate with their sexual partners when it comes to the status of an STD, so it is best to get a definitive answer about the cause of your symptoms.

If you have pain or bleeding when urinating, pain during sexual activity, or if you notice that the lesions in the genital area appear inflamed, you should call your doctor, even if you have already been diagnosed with herpes and are receiving treatment.

Frequently asked questions

  • The first herpes outbreak usually begins two to 20 days after infection.

  • Yes, in men, herpes can be asymptomatic. Women can also have an asymptomatic HSV-2 infection.

  • Herpes outbreak symptoms can last from 10 to 21 days. The first outbreak is usually the most intense and can last two to four weeks.

  • Some people with herpes may experience a worsening of symptoms in the hours or days before the outbreak. Common warning signs include itching, burning, or tingling in or around the genitals.

  • No. Herpes symptoms will go away, but the virus that causes it will remain in your body and can cause outbreaks in the future.

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