5 Signs of Herpes (Oral and Genital), First Symptoms, Pictures

There herpes virus is a large family of viruses and several of these can cause diseases in humans. Most of us refer to the herpes simplex virus (HSV) when we refer to the condition as herpes.This is a common virus and the two types are known for causing mouth (oral) and genital diseases. These two types of herpes simplex virus (HSV) are simply referred to as HSV-1 and HSV-2.

One in two American adults have oral herpes and about one in six people between the age of 14 to 49 years have genital herpes. This makes herpes one of the more common viral infections and with regards to genital herpes, it is among the more common sexually transmitted infections (STIs). There are approximately 800,000 new genital herpes cases in the United States every year.

Read more on herpes simplex infection.

How To Spot Herpes

Contrary to popular belief, herpes cannot be easily spotted with a visible sore. In fact it is estimated that most people with genital herpes do not even know they have it. Partners will be unable to spot it either and this is one of the many reasons why this infection is so easily transmitted. Even when the sores of herpes do arise, it does not last till the disease resolves. Instead it is resolves and recurs repeatedly, even over years and decades.

As a result, when a person is asymptomatic there is no way to spot oral or genital herpes. Nevertheless the virus can still be spread from one person to another during this asymptomatic period. A few days after infection there are generalized symptoms like fever, muscle aches, loss of appetite and malaise (general sense of feeling unwell). These symptoms are non-specific and a person may not associate it with a herpes infection. It does not usually recur with repeated episodes where the typical herpes sores appear.

Which Herpes Virus Causes Oral and Genital Herpes?

Of the two herpes virus, HSV-1 usually causes oral herpes and HSV-2 usually causes genital herpes. However, in a small number of cases the opposite may occur, meaning that HSV-1 causes lesions on the genitals while HSV-2 causes lesions on the mouth area. These uncommon instances are more likely to occur with genito-oral contact, where the mouth of an infected person comes into contact with the genitalia of an uninfected person and vice versa.

Is Herpes Contagious?

The herpes simplex virus is highly contagious. It is easily spread through skin-to-skin contact, through saliva and during sexual intercourse. The most contagious period is when there are open sores that are oozing. However, the virus can still be transmitted even within any sores or other symptoms. With HSV-1 the virus can be spread by sharing utensils, towels and other objects like razors. It is highly unlikely to spread HSV-2 via these routes.

When Do First Symptoms Start?

As with any infection, there is a delay from the time of the infection to the time that symptoms arise. This period is known as the incubation period. It varies among different infections. With oral herpes this incubation period may be around 3 to 6 days. In genital herpes the incubation period is around 3 to 7 days. Therefore a person is not aware that they have been infected.

The following signs and symptoms of both oral and genital herpes may not always arise immediately after the incubation period. At times there are generalized symptoms mentioned above after the primary infection, particularly with oral herpes. The sores may then arise much later and in this way a person may be unsure as to when they were initially infected.

Sores

During symptomatic episodes, sores arise at the site of infection. These are small fluid-filled blisters that arise at the outer edge of the lip in oral herpes. It may also occur on the inside of the mouth and tongue. The sores are referred to commonly as cold sores.

With genital herpes there are small red lumps or white blisters that occur on the external genitalia. It can extend into the female reproductive tract in women and even occur on the scrotum in men. These bumps and blisters eventually develop into open sores (ulcers) as discuss below.

Herpes simplex mouth

Nose herpes

hsv blister

Pain and Tenderness

Pain and tenderness are common symptoms that arise before the appearance of the sores, while the sores are present and tends to worsen once the sores burst open to form an ulcer. This pain is often accompanied by tingling and itching. Many herpes sufferers are aware of when an acute episode is about to arise, sometimes even days before, by the development of the pain and tenderness with no sores. Women often report severe pain with genital herpes.

Read more on mouth pain.

Tingling and Itching

Tingling and itching are two other common symptoms that arise prior to the appearance of the sores, along with pain and tenderness. This is known as the prodrome. It is also reported along with a burning sensation that starts in and around the mouth for 1 to 2 days before the sores appear in oral herpes. In genital herpes this arises about one week after infection and for about 1 to 2 days prior to the development of sores in recurrent outbreaks.

Ulcers

Eventually the blisters in both oral herpes and genital herpes burst to form ulcers (open sores). These ulcers may ooze fluid, crust over or bleed. Ulcers (open sores) exposed the underlying tissue. It is very tender and painful. Even the slightest pressure on the ulcer can elicit pain. It makes movement, wearing of clothes, eating, dental hygiene and other activities difficult depending on whether it is oral or genital herpes.

Scabs

Eventually the ulcers heal which can take anywhere from a few days to up to two weeks. Scabs form during this healing process and eventually fall off as the skin underneath it heals. The symptoms totally resolve and a person is asymptomatic until the next episode occurs. These outbreaks can occur several times in a year, just once a year and sometimes not occur for a few years.

References:

  1. emedicine.medscape.com/article/218580-overview
  2. atlasdermatologico.com.br

Please note that any information or feedback on this website is not intended to replace a consultation with a health care professional and will not constitute a medical diagnosis. By using this website and the comment service you agree to abide by the comment terms and conditions as outlined on this page

Ask a Doctor Online Now!

  • Karijt

    I’m not sure anything crazy is going on for sure or not, i just wanted some advice before i actually spent money at the clinic. Vaginally, i’m having a super thick, white discharge. There’s no smell to it, and i haven’t had any itching or anything of the sort there. At times, my pee is appearing to be cloudy. When i’m on my period, my blood seems to look a bit cloudy the first day instead of bright red like usual. Orally, i’ve had a sore throat for a while, white/yellow patches come and go. This morning i woke up to find my tongue was covered in yellow, i scraped it off and brused most of it off. No pain. No itching, burning, or tingling around the mouth. They were chapped for a while, not at all now. Lymph nodes are swollen. I feel like i have a hair stuck in my mouth, but there’s nothing there. Under my tongue, it feels like i have sores but i see nothing there. I also have white/yellow stuff on my tongue. Ive tried brushing it off when i brush my teeth and some comes off but not all, i am able to scrap it off but not completely without making myself gag. There is no fever. Just everything above. Help?

  • Hi Karjit. The question here is whether the vaginal symptoms and throat symptoms are related. Herpes is a possibility but so is thrush (yeast infection). Vaginal thrush is common and affects most women at some point in their life. Oral (mouth) thrush is less common. It is mainly seen in people who have HIV, uncontrolled diabetes, have used steroid drugs for a long time and so on. Most of the time oral thrush is linked to having an abnormally weakened immune system which can be caused by any of the diseases and drugs mentioned above. Of course, this is just one possibility. Given your symptoms you should be speaking to a doctor as soon as possible.