What are the main symptoms of herpes?

Hey, when the topic of herpes comes up, many people might feel a bit nervous or uninformed. Actually, it's quite common, and once we clarify it, it won't seem so mysterious. Think of it as a recurring "minor skin issue" that usually doesn't have a significant impact on overall health.

The symptoms of herpes can vary depending on whether it's a primary infection or a recurrence, and where on the body it appears.

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The Most Typical Symptom Progression (Like a Cycle)

Whether it appears on the mouth or other areas, a typical outbreak generally follows this pattern:

1. Prodromal Stage (It's about to appear!)

   • One or two days before blisters appear, a specific area of the skin might feel burning, itchy, or tingly. Some people describe it as a crawling sensation. This is a sign that the virus is becoming active.

2. Blister Stage (It's bubbling up!)

   • Next, the itchy or tingly spot will turn red, and then a cluster or multiple clusters of small blisters, ranging from pinhead to rice-grain size, will emerge. These blisters are filled with clear fluid and look shiny. They usually appear grouped together.

3. Ulcer Stage (The blisters have burst!)

   • After a few days, these small blisters will break open on their own, forming one or more shallow, small ulcers or erosions. At this point, it can be a bit painful and is also highly contagious.

4. Crusting and Healing Stage (Almost healed!)

   • The ulcerated area will slowly dry out, forming a yellowish-brown scab. After the scab falls off, the skin will return to normal, usually without leaving scars. The entire process, from start to complete healing, takes about 1 to 2 weeks.

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Differentiated by Location and Type

There are mainly two types of herpes viruses, and they prefer different locations:

• Oral Herpes (Usually caused by HSV-1 virus)

  • Location: Most commonly found on the lips, corners of the mouth, around the nose, chin, or cheeks. This is what we often refer to as "cold sores" or "fever blisters."
  • Sensation: The process is as described above, starting with itching and pain, progressing to blistering, breaking, and scabbing.

• Genital Herpes (Usually caused by HSV-2 virus)

  • Location: Primarily occurs in the genital area, around the anus, on the buttocks, or inner thighs.
  • Sensation: The symptom progression is similar to oral herpes, also involving burning pain, blistering, breaking, and healing. Due to the specific location, it might be accompanied by painful urination.
  • Note: Due to diverse lifestyles, HSV-1 can now also cause genital herpes, and vice versa. Therefore, the location doesn't entirely determine the virus type.

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Primary Infection vs. Recurrence

• Primary Infection (First Outbreak)

  • This is usually the most severe episode. There might be more blisters, a larger affected area, and more intense pain.
  • In addition to skin symptoms, it may also be accompanied by some systemic symptoms, similar to having a bad flu, such as:
    • Fever
    • Headache
    • Muscle aches, fatigue
    • Swollen local lymph nodes (e.g., lymph nodes in the neck or groin might feel swollen and painful)

• Recurrence

  • After infection, the virus "lies dormant" in the nerves. When your immune system is weakened (e.g., due to stress, lack of sleep, illness, menstruation in women, etc.), it may reactivate and cause another outbreak.
  • The good news is that recurrences are usually much milder than the first time. There are fewer blisters, healing is faster, and there are generally no systemic symptoms like fever or headache. Many people can clearly feel the tingling or itching of the prodromal stage before a recurrence, allowing them to prepare in advance.

In Summary

Overall, the core characteristic of herpes is "recurrent small blisters." If you suspect you have similar symptoms, the best course of action is to see a doctor for examination and diagnosis. Self-diagnosing or indiscriminately using ointments is not a good idea.