Herpes outbreaks usually last for about one to two weeks, though the first outbreak after infection may last longer. The symptoms typically go away on their own without treatment. However, there are at-home remedies and prescription treatments which may help to ease symptoms and shorten the length of outbreaks. Herpes outbreaks may continue to occur, but many people find that they become shorter and less severe over time.
Types of Herpes
There are two types of herpes, both of which stem from the herpes simplex virus (HSV):
- Herpes simplex virus type 1 (HSV-1): This form of the virus usually causes oral herpes. The main symptom of HSV-1 is cold sores.
- Herpes simplex virus type 2 (HSV-2): This form of the virus usually causes genital herpes. The main symptom of HSV-2 is genital sores.
Some people with herpes never experience symptoms. However, they are still capable of transmitting the virus to others.
Onset of First Outbreak
The first outbreak of oral herpes usually develops within about one to three weeks after infection. This initial outbreak may last for up to three weeks.
With genital herpes, the first outbreak usually occurs within about two to 20 days. Similar to oral herpes, the initial outbreak may last as long as three weeks.
Herpes Outbreak Symptoms
Generally, the first outbreak of herpes is more severe than recurrences that follow. Though sores are the most noticeable sign of infection, there are a number of other symptoms of herpes that typically occur only during the first outbreak, including flu-like symptoms such as:
- Muscle aches.
- Swollen lymph nodes in the neck.
Herpes sores progress through a series of defined stages as they develop. The following is an approximate timeline for the first outbreak of oral or genital herpes after infection:
- Warning signs: About 12 to 24 hours before an outbreak, itching, burning, or tingling sensations are felt where the cold sores are about to appear.
- Blister formation: On day one of the outbreak, blisters appear as fluid-filled red bumps that are painful to the touch.
- Sore formation: The blisters rupture and the fluid inside (which is usually clear or yellowish in color) oozes out. The resulting sores continue to weep for a day or so.
- Scab formation: On about day four or five of the outbreak, the sores start to crust over. The scabs that form may crack or bleed as the sores heal.
- Skin healing: The scabs eventually fall off around day six or seven (it’s best to let this happen naturally rather than picking at the skin). The skin underneath will still be a bit pink or reddish. Over the next one to two weeks, the area where the cold sore appeared will heal completely and return to its normal tone.
Differences Between Oral and Genital Herpes Outbreaks
The location of the sores is the main difference between the two types of herpes. Oral herpes sores generally develop on the mouth and lips, usually at the border of the lip where it meets the skin of the face.
Genital herpes sores can occur in a wider variety of locations depending on where the virus entered the body. These locations may include:
- For women and men:
- For women only:
- Vaginal area
- External genitals
- For men only:
There are also a few additional herpes outbreak symptoms which are only associated with genital infections, such as:
- Vaginal discharge in women.
- Blisters or ulcers on the cervix in women.
- Pain when urinating.
- Difficulty emptying the bladder.
- Decreased appetite.
After the initial outbreak is over, the symptoms are likely to return. Most people with herpes have several outbreaks each year. However, over time, those outbreaks may become less frequent, especially if you take antiviral medication for herpes. For example, sores may last for only about a week and feel less painful than during the first outbreak.
Tips for Managing Herpes Symptoms
The symptoms of herpes can be painful and uncomfortable. Fortunately, there are a few things you can easily do at home to help ease these symptoms, including:
- Apply an ice pack or warm compress to the affected area.
- Take over-the-counter pain relievers, such as acetaminophen.
- Keep the affected area clean and dry to reduce the risk of infection.
- Avoid tight clothing that may irritate genital sores.
- Don’t pop blisters or pick at scabs that form over the sores.
- Ask your healthcare provider to recommend a painkilling cream.
Taking proper care of your skin and overall health while experiencing an outbreak can help to prevent complications like infection and assist in faster healing for your sores. Keep in mind that you are especially contagious during an outbreak, so it’s best to avoid intimate contact, such as kissing or sex, until the sores heal.
Herpes Treatment Options
While there is no cure for herpes, there are treatment options available for people with frequent outbreaks.
If you want to minimize your outbreaks, make an appointment with your healthcare provider. They can take a swab from a sore or do a blood test to confirm if the herpes virus is the cause of your outbreaks.
Herpes treatment involves taking antiviral medicine. There are antiviral creams and ointments which may be applied to provide relief for burning, itching, or tingling associated with herpes blisters. During an outbreak, a shot of intravenous medication or oral pills may be recommended to help shorten the duration of symptoms.
For those with frequent outbreaks, doctors may prescribe a daily antiviral medication, also known as suppressive therapy. These medications can make outbreaks less severe and less frequent while also reducing the risk of transmission to others. Some of the prescription antiviral medicines used to treat both oral and genital herpes are:
- Valacyclovir (Valtrex)
- Famciclovir (Famvir)
- Acyclovir (Zorivax and Sitavig)
If you’ve been previously diagnosed with herpes, the medical team at Nurx can prescribe oral or genital herpes treatment online and deliver the medication to your door with free shipping. To request herpes treatment from Nurx, get started here.
Herpes Simplex, MedlinePlus, October 2019.
Genital Herpes – CDC Fact Sheet (Detailed), Centers for Disease Control and Prevention, January 2017.