Do Genital Herpes sores change during different stages?

Experiencing the symptoms of an STI can be very stressful. It can be extra stressful when those symptoms change over time. And the symptoms experienced during a Herpes infection are no exception.

In this blog, we’ll plot out what a Herpes sore might look like, and how this might change over time. Keep reading to find out more.

If you’re concerned about a recent sexual encounter, get tested as soon as possible with Better2Know.

What is Herpes?

Herpes is a sexually transmitted infection caused by the Herpes Simplex Virus (HSV), which comes in two main types: Herpes Simplex Virus Type 1 (HSV-1) and Herpes Simplex Virus Type 2 (HSV-2). HSV-1 is primarily associated with oral herpes, leading to cold sores or fever blisters around the mouth and lips. Most people get HSV-1 through kissing, but you can also get it through oral sex if your partner has a genital-based HSV-1 infection.

HSV-2, on the other hand, is predominantly linked to Genital Herpes and is usually transmitted through sexual contact. This virus causes outbreaks of blisters and sores in the genital and anal areas, which can be painful and uncomfortable. Like HSV-1, HSV-2 infections can be asymptomatic, meaning many people may carry the virus without showing any signs. Most people get Genital Herpes infections through unprotected sex, such as vaginal sex, anal sex, oral sex, and sharing sex toys.

Both HSV-1 and HSV-2 are lifelong infections, as the virus remains dormant in the body and can reactivate, causing recurrent outbreaks. While there is no cure, antiviral medications can help manage symptoms and reduce the frequency of outbreaks.

What do Genital Herpes sores look like?

What a Herpes sore might look like will depend on the different stages of an infection.

Prodromal symptoms

The prodromal phase of Genital Herpes is when vague or nonspecific symptoms appear before the more characteristic signs of the infection.

These early symptoms often resemble the flu and can develop a few hours to a day before the actual outbreak. You might experience:

• Tingling, burning, or itching sensations around the site of infection
• Fatigue
• Headache
• Low-grade fever
• Muscle aches

During the primary infection, these prodromal symptoms may or may not occur, and if they do, you might not realise anything is wrong until the blisters develop. For future outbreaks, prodromal symptoms can serve as a warning sign that an outbreak is imminent, allowing you to start treatment early when it is most effective.

Blistering

During the primary infection, HSV rapidly replicates in squamous epithelial cells on the skin’s surface. As more viruses are produced, some move down to the spinal nerve roots where they become embedded, while those near the surface trigger an extreme inflammatory response. This inflammation causes fluid leakage from affected tissues along with systemic symptoms.

During this phase, you may develop:

• Clusters of tiny, painful fluid-filled blisters on the genitals, redness and heat on surrounding tissue
• Swollen lymph nodes, especially in the groin
• Generalized body aches
• Fever

Genital Herpes blisters are generally small, usually no more than 3 millimetres in size, and this blistering phase typically lasts from one to three days.

Rupturing

As the virus continues to replicate and the immune system fully kicks in to fight the infection, the blisters become larger as they fill with fluid, cellular debris, and dead immune cells. Unlike some blistering skin conditions where blisters emerge, those caused by HSV tend to be nearer to the surface and covered with a thinner layer of tissue, making them more prone to rupture.

Symptoms of this stage include:

• Spontaneous rupture of blisters, often on their own or when abraded by clothing
• A clear or yellowish fluid discharge
• Red, cave-like sores, and significant pain, especially when touched.

The pain can be heightened when passing urine or during sex. This phase can also last from one to three days.

Crusting and healing

As the blisters rupture and the fluid dries, a crust forms around the perimeter of the sore. This crusting helps with healing by preventing bacteria from entering the exposed tissues.

On moist tissues, like those in the vagina or anus, crusting may be minimal and take longer to heal. The crusting can cause itching, and using a cold compress or over-the-counter anti-inflammatory drugs can ease symptoms and help prevent scratching.

As healing progresses, the crusts will fall off, leaving no scars. Without treatment, Genital Herpes symptoms typically go away after two to four weeks, depending on the severity of the outbreak.

Latency

Genital Herpes doesn’t go away after the initial infection. It remains in your body for life.

During the latency stage, the virus embeds itself in nerve cells called ganglia, which serve as relay stations in the nervous system. Once embedded, the virus can remain dormant for weeks, months, or even years. The duration of latency can vary, with flare-ups occurring frequently after the primary infection but gradually tapering off as the immune system better recognizes and responds to early reactivation.

Over time, the replication capacity of HSV tends to decrease, and in some people, flare-ups may stop altogether. This is especially true for Genital Herpes caused by HSV-1, where the concentration of the virus in the sacral ganglia is lower and less prone to reactivation.

Does the appearance of the sores change over time?

Over the course of several Genital Herpes outbreaks, the appearance of sores can change significantly. Initially, during the first outbreak, the sores tend to be more severe, with larger, painful blisters that take longer to heal.

In subsequent Genital Herpes outbreaks, the sores generally become less severe. The blisters may be smaller and less painful, and the healing process is typically faster. The prodromal symptoms, such as tingling and itching, may still occur but are often less intense. Over time, the frequency and severity of outbreaks tend to decrease as the body becomes more adept at managing the virus.

Despite these changes, it’s important to note that Herpes sores can still vary widely from person to person and outbreak to outbreak. Factors such as stress, illness, and overall health can influence the appearance and severity of sores.

What should I do if I think I have Herpes?

If you think you have Herpes, it’s important to get tested. You may have a Herpes infection if you’re experiencing the following symptoms.

Symptoms of Oral Herpes:

• Painful blisters or sores on the lips, gums, tongue, or inside the mouth
• Tingling or burning sensation on the lips before the outbreak
• Fever and general discomfort during an outbreak
• Sore throat and swollen lymph nodes
• Difficulty swallowing or eating
• Headache and body aches

Symptoms of Genital Herpes:

• Pain or itching around the genitals
• Small bumps or blisters around the genitals, anus, or mouth
• Painful ulcers that form when blisters rupture and ooze or bleed
• Scabs that form as the ulcers heal
• Painful urination
• Discharge from the urethra or vagina
• Fever, headache, and body aches during the first outbreak
• Swollen lymph nodes in the groin

Final thoughts

Better2Know is here to help if you have any sexual health concerns. Book your appointment at a sexual health clinic near you if you’re concerned about any aspect of your sexual health.

Don’t leave your sexual health to chance. Book an appointment at a sexual health clinic near you.