Herpes Signs and Symptoms ~ Incubation ~ Prodrome


First Signs of an Outbreak: Prodrome

The first signs of a Herpes infection are usually a tingling, itching, and/or burning sensation at the site of infection.  These “pre-outbreak” signs and symptoms are called prodrome.  Prodrome usually precedes the appearance of blisters or lesions by 30 minutes to a couple of days.  In genital herpes, sometimes shooting pains, numbness, achiness, or other sensations are felt in the genitals, back, buttocks, or thighs.  When ANY of these symptoms are present, it means the virus is active, and risk of transmission is high.  Additional secondary symptoms may include an onset of fever, headaches, soreness in the genital area, swelling of lymph nodes, malaise, irritability, and listlessness.

Redness, Blisters

These symptoms may be accompanied or followed by a tenderness and redness in the infected area manifesting usually as a bump or cluster of vesicles (blisters) on the skin that rupture to form lesions or sores.  The blister phase of a herpes outbreak may pass so quickly as to be unnoticed – it may seem that one as gone directly from tingling to lesion.  Unlike many other STDs, Herpes lesions are usually painful, sore, or tender to the touch.  Blisters usually form in a localized area and sometimes will appear as a cluster of bumps or blisters, from a few to many, or they may take the appearance of forming a short irregular row effect.  Blisters may be as small as a pinprick, or as large as a pea.  As with many aspects of HSV infection, these symptoms may vary in manifestation and severity with each individual, and from outbreak to outbreak.

Lesions or Sores

In first episodes or primary occurrences lesions can last from 7 to 12 days, followed by a crusting or scabbing.  Healing of eruptive sites usually occurs within 10 – 21 days, when crusts or scabs will form.  (Softer skin surfaces, such as mucous membranes of the female genitals and vulva, may not exhibit typical sores or scabbing as with classic “cold sores.”)  An onset of a new series of lesions is common within the first or second week of a primary outbreak.  Healing time for initial outbreaks is generally about 3 weeks.  Recurrent episodes generally exhibit the same or similar symptomology, but are usually less severe, less extensive, less painful, and of shorter duration than first episodes.

People who have had prior exposure to HSV-1 before contracting HSV-2 may generally, but not always, experience less noticeable symptoms.  (For example, a person who has had HSV-1 “cold sores” their whole life, and then acquires genital HSV-2 as an adult.)

All symptoms listed above are not always noted.  A significant percentage of people who contract HSV exhibit mild or hardly noticeable symptoms.  Many others may misdiagnose symptoms as rashes, sweat bumps, “jock itch,” irritations, etc.  Some people go their whole adult lives with Herpes and never realize it!

HerpeSite highly advises anyone who may suspect any possible exposures to HSV, to immediately consult with a knowledgeable Health care professional.  The sooner a person gets in for examination and testing, the better and more accurate their diagnosis and treatment will be.  In general, one may have a better consultation with doctors who specialize in the fields of dermatology, urology, gynecology, or infectious diseases.  It may be good to call around and ask if the physician you are considering has knowledge and experience with HSV.  Most nurses and receptionists will be able to indicate, to some degree, their familiarity with Herpes.


Incubation is the time between exposure to the virus and symptoms developing.  The time between infection and the appearance of symptoms for Herpes falls between 2-7 days in most cases.  Most transmissions will become evident within the span of 2 days to 3 weeks.  However, HSV may be contracted and remain unnoticed or unrecognized for a longer time.  Incubation time may also depend on a person’s immunity or pre-existing exposure to HSV-1.

Psychological Effects of Genital Herpes

Because of the stigma, fear, and misinformation about Genital Herpes, the psychological effects that accompany an HSV infection are as substantial as the physical.  Symptoms for primary infections range from confusion, denial, anger, hostility, withdrawal, and severe depression to guilt, shame, fear, a sense of immeasurable loss, resentment, and retaliation.  Many people with Herpes become socially isolated.  For many, the fear of transmitting the virus to another or fear of discussing the infection with a potential partner can lead to avoidance of relationships.

There is a real and very deep social stigma attached to genital Herpes.  Many people after discovering they’ve acquired herpes are very much at a loss as to how to cope, feeling very lost and alone.  There can be a sense of betrayal if the person they acquired it from knew and didn’t tell them.  People who contract HSV may at some point or another begin to face deep intimacy hesitancy, feelings of vulnerability, a sense of being “dirtied or disgraced,” or a general state of “unworthy of being loved.”  A survey conducted by the American Social Health Association in the mid-90s found that 28% of people who contract genital Herpes have considered suicide as a result.  These feelings usually ease with time, management of outbreaks, and acceptance. Discussion with a close friend, family member, support group, or professional counselor can also be very helpful in alleviating these feelings.

We believe that the stigma of Genital Herpes is unfounded, unfair, and unsubstantiated.

Herpes is a virus that can be a pain in the butt, but it’s no more horrifying or disgraceful than “cold sores” simply because it happens to be on the sexual organs rather than on the face.  Yet it’s continually talked about in the media, on TV, in books and magazines, and even by some medical professionals, as being somehow “bad” and that people who get genital herpes are somehow immoral, slutty, unclean, or otherwise of bad character… when nothing could be further from the truth!  IT’S JUST A VIRUS!  We’ll talk more about this on our blog and twitter as we go along.  See also our Herpes Overview Page here for a more extensive discussion of our thoughts on herpes stigma and the media.

Developing and maintaining an empowered mindset, as well as taking care of the body’s general health and nutrition, is key to successfully dealing with HSV, both physically and emotionally.  See the Support and Reading pages here at HerpeSite for additional references for social, psychological, and physical support.