Symptoms of Genital Herpes: 8 Common Signs to Look for

Genital herpes is a sexually transmitted infection (STI) that’s much more common than most people realize. About 1 in 5 people in the U.S. have genital herpes, although the actual number is likely higher, since many people don’t know they have it. 

Genital herpes is caused by a virus (herpes simplex virus, or HSV) that lives in the body forever. And it can easily spread from person to person during oral, genital, or anal sex — even when a person doesn’t have active symptoms. 

Let’s take a closer look at eight common symptoms of genital herpes, so you’ll know what to look for and when to get tested.

Symptoms of genital herpes

The symptoms of genital herpes may be vague and hard to pinpoint before the sores appear. Here are some of the signs to watch out for.

1. Fever or chills

A fever is your body’s response to a boost in the immune system to handle viruses, like herpes. At the same time, chills can happen as your body tries to control its temperature during a fever.

2. Headache

When your body fights a virus, like genital herpes, it can cause flu-like symptoms. And headaches are common with a herpes infection. 

3. Fatigue

Fatigue is a common symptom of genital herpes as your body’s defenses kick into action. It’s more often seen as a symptom of your first outbreak, and it’s not as common with recurrent flares. You may feel tired because your body is putting a lot of energy into fighting the virus.

4. Aches and pains

The immune response to the herpes virus can cause inflammation and irritation. This occurs not only in the genital area but also throughout the body. And this can leave your body and muscles feeling achy. Again, you’re more likely to see this with your initial infection.

5. Visible sores

One of the most well-known signs of genital herpes is having sores or lesions on the genitals. These sores can be painful and look different for each person. These sores can include:

• Blisters

• Pimples

• Open sores

• Scabbing lesions

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6. Swollen genital lymph nodes

Swollen lymph nodes in the genital area are common with a herpes infection. Lymph nodes are normally pea-sized glands located throughout the body to help you fight infection. The glands in the groin might get bigger and feel sore during a genital herpes outbreak. 

7. Tingling or itching around the groin or anus

Before the sores appear, there can be tingling or itching in the private area or around the bottom. This can also sometimes feel like a burning sensation. This can be a sign that a herpes outbreak is about to happen.

8. Burning with urination

Discomfort when you urinate can be a sign of a genital herpes infection. While herpes doesn’t directly impact the urinary tract, the open sores can become irritated and hurt when urine touches them.

Quiz: Do you have a UTI or a STD/STI?

What does a genital herpes outbreak look like?

The first outbreak of genital herpes, also known as the primary outbreak, tends to be the most severe. Usually, a red patch of skin shows up with tiny bumps that feel a bit raised. These bumps turn into clear, fluid-filled bumps called “vesicles.” Later, the bumps break open and become painful sores. 

As the sores heal, they form scabs. It usually takes about 2 weeks for the scabs to go away, but sometimes it can take up to 6 weeks. During this time, you might feel itchy or uncomfortable. You may also notice some systemic symptoms, like fever, chills, or fatigue.

Taking good care of the sores and getting treatment can help them go away faster. But it’s important to know that herpes sores can come back again and again over time. Future outbreaks may be milder. Future outbreaks may have fewer sores, less-severe symptoms, and happen less often. 

Can I have genital herpes and not know it?

It’s possible to have genital herpes and not know it. That’s because not everyone with genital herpes experiences noticeable symptoms. 

There are two types of herpes: herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). HSV-2 more commonly causes genital herpes. HSV-1 usually causes oral herpes, but some cases of genital herpes are due to HSV-1. This may be the case if the virus is transmitted from the mouth to the genitals during oral sex. 

Both types may cause no symptoms or only mild symptoms. Mild cases often go unnoticed. And a single sore can be confused with an ingrown hair, razor burn, or even just minor irritation. 

If you think that you may have been exposed or infected, it’s important to know what to look out for. By knowing the signs and symptoms, you may be able to prevent transmission. 

Active sores increase the risk of transmitting the infection. But it’s important to keep in mind that it’s still possible to pass the virus to your sexual partner(s) even if you don’t have any sores. 

What other conditions can look like genital herpes?

There are several STIs that can cause bumps and sores that look a lot like genital herpes. But there are some helpful clues that may help you and your healthcare professional tell the difference:

• Syphilis sores: Unlike herpes sores, which tend to cause some discomfort, syphilis sores aren’t painful.

• Chancroid ulcers: These often appear more gray or yellow. And the fluid inside the bumps appears white (rather than clear). 

• Lymphogranuloma venereum: This generally causes painless bumps or ulcers, unlike the painful ulcers in herpes. 

• Granuloma inguinale ulcers: These are painless and tend to have a red, beefy appearance. They may bleed easily.

Genital herpes can also be mistaken for other conditions that aren’t transmitted sexually. This is especially true if someone doesn’t have the hallmark sores. Some common examples include:

• Ingrown hairs, razor bumps, or pimples

• Hemorrhoids (when the sores are around the anus)

• Urinary tract infection (UTI)

• Yeast infection, especially in women

• Vaginitis (a condition that leads to inflammation of the vagina)

The good news is that when the diagnosis is unclear, there are some simple tests that can help.

Diagnosing genital herpes

If you do have active sores, a healthcare professional may swab the area and look at the sample under the microscope. They may also send the sample to a lab to test for the presence of HSV-1 and HSV-2. 

You may also have a blood test if you don’t have active sores, but you’re worried about exposure. This can be helpful because it doesn’t need to be timed with an outbreak. Blood tests can have a few drawbacks, though:

• Some blood tests can’t differentiate between HSV-1 and HSV-2.

• If the test is positive, it doesn’t specify how long you’ve had the infection.

• It isn’t always positive right after you get the infection. So, this may mean you need to schedule a repeat test.

Talk with a healthcare professional about the type of blood test that may be best for you. They can provide useful information, and you can do it at any time — even if you don’t have symptoms.

Treatment for genital herpes

There’s no cure for genital herpes, but there are effective medications that can treat an outbreak and help prevent future outbreaks. It’s important to get treatment as early as possible during your first outbreak, since your first HSV illness can be serious and prolonged. But treatment can lessen both symptom severity and length of illness.

The medications used to treat genital HSV infections block the virus from replicating (making more virus). Important oral medications used for treating HSV include:

• Acyclovir (Zovirax) 

• Valacyclovir (Valtrex)

• Famciclovir (Famvir)

If you have frequent outbreaks, a healthcare professional may prescribe a daily regimen as a suppressive therapy. (Suppressive therapy is when you take medication daily to decrease the frequency and severity of your outbreaks.) 

If outbreaks are infrequent, you’ll probably only need to start medication at the first sign of an outbreak.

What to do if you think you may have genital herpes

If you’re worried that you may have genital herpes, don’t hesitate to reach out to a healthcare professional to schedule an appointment. If you have active sores, it’s possible to get a diagnosis of genital herpes based on appearance. But laboratory testing to confirm herpes infection is also available and recommended.

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Written by:

Cherilyn Davis, MD

Cherilyn Davis, MD, is a board-certified pediatrician in New York City. She has held local and national roles at the American Medical Women’s Association including board member of the physician division and physician chair of social media.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

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