What are the symptoms of genital herpes?

Although most people are asymptomatic and do not experience any signs of infection, those that do have symptoms typically experience:

Painful herpetic lesions (also referred to as ulcers / blisters / sores) in the genital / rectum area.

• These lesions may break open and ooze fluid 
• They usually crust over and heal within 1-4 weeks
• The lesions may appear as a cluster in one region or individually 
• Tingling, itching, burning, or painful skin may also be present in the infected area. These symptoms can precede the emergence of herpes lesions. 
  

Swollen and tender lymph nodes in the groin area

Pain in the legs, hips, or buttocks

Flu-like symptoms including: 

• headache, 
• fever, 
• fatigue, 
• and muscle ache 
  

The first outbreak is often the most severe. Individuals who experience a primary outbreak may have repeated outbreaks, known as recurrences. In many people, especially those with HSV-1, recurrence will often decrease in frequency over time. 

The frequency and severity of recurrent outbreaks are influenced by the severity and duration of the initial outbreak, the type of herpes virus, and the host. 

Before a primary or recurrent outbreak, tingling, burning, and itching can be experienced in the area lesions will occur. During recurrent outbreaks, lesions typically occur in a similar area to where they appeared during the first outbreak.

Genital herpes symptoms can sometimes be mistaken for ingrown hairs, razor burn, jock itch, yeast infections, or allergic reactions - making diagnosis by a healthcare provider essential! ‍

HSV infection locations

In persons with a penis, genital herpes can appear around and on the penis including blisters on the base or shaft of the penis, or even on the scrotum and buttocks.

In persons with a vagina, symptoms can include blisters on the vagina, anus, and buttocks. There may also be watery discharge from the vagina.‍

Complications from HSV

Although very rare, severe complications of HSV-1 or HSV-2 infections can include blindness, meningitis (inflammation of the lining of the brain), encephalitis (inflammation of the brain), and death.

Herpes keratitis

While uncommon, HSV can spread to the eyes. This condition can result in a gritty feeling in the eye, along with discharge and pain.

Neonatal herpes 

Pregnant parents with genital herpes may also pass the infection on to their newborns, especially if they have an active outbreak during vaginal delivery. Newborns with a herpes infection are at risk of developing severe complications, including blindness, brain damage, and death. 

HSV oral infection

Blisters can appear on the mouth, face, and throat.

HSV anal infection:

Blisters, as well as pain and itching, can appear around the anus. Changes in bowel habits and proctitis (inflammation of the rectal lining) may also be experienced.

Infections of the rectum are most common in males who have sex with other males.

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Sources:

• https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm#preg