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Symptoms and Diagnosis


Dr. Mayzik
Most people infected with herpes simplex virus, or HSV, have no symptoms or very mild symptoms that go unnoticed. In some cases, symptoms may be mistaken for another skin condition. Dr. Alvarado, can you tell us about these symptoms?

Dr. Alvarado
Definitely, Dr. Mayzik. The typical symptom of a herpes infection is an "outbreak" or episode of herpes lesions. These lesions appear as one or more vesicles, or small blisters, on or around the genitals, rectum, or mouth. Vesicles can develop two to 12 days after exposure to HSV. These small blisters break and leave painful ulcers, or sores, that may take two to four weeks to heal.

Other symptoms that may occur during this time include:

  • Fever
  • Body aches
  • Swollen lymph nodes, and
  • Headache

Once a person has contracted HSV, the virus never leaves their body, even if they receive treatment. After the first outbreak, however, HSV may become inactive for a time. When the virus reactivates, it can cause recurrent outbreaks. Recurrent outbreaks are typically shorter in duration and less severe than the first outbreak of genital herpes. In addition, the number of symptomatic recurrent outbreaks may decrease over time.

Different diagnostic tests are used depending on whether symptoms are present or not. Nucleic acid amplification tests, or NAATs, and viral culture tests can be used for diagnosis when a person has symptoms. These tests are highly accurate and can differentiate between HSV-1 and HSV-2. Blood tests can be done for people who have no symptoms, but some blood tests may provide less definitive or even false results.