Symptoms of Type 1 Genital Herpes
There are two types of herpes viruses–herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) 1. While HSV-1 primarily causes sores (fever blisters) to develop on the mouth or face, it is estimated that 30 percent of all genital herpes infections are caused by HSV-1 12. These cases are sometimes transmitted through genital-to-genital contact, but more often through oral to genital contact. Like those with HSV-2 infections, approximately two-thirds experience no symptoms and are not aware they have herpes 1.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Early Symptoms
Early signs of a type 1 genital herpes infection usually appear within two to three weeks of exposure to a partner who has the virus 2. The early symptoms of an oncoming herpes outbreak include itchiness, tingling or pain in the genital or anal area 2. Some people may experience some swelling and unusual redness in the affected area, as well. For women, the symptoms may develop in the vaginal area, cervix, anus, or external genitals and buttocks. Men can develop symptoms externally on the penis, scrotum, buttocks or thighs, or inside the urethra or anus.
- Early signs of a type 1 genital herpes infection usually appear within two to three weeks of exposure to a partner who has the virus 2.
- For women, the symptoms may develop in the vaginal area, cervix, anus, or external genitals and buttocks.
Symptoms of Blisters
Signs of Herpes on the Penis
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Soon after the first signs of tingling and pain, one or more small red bumps appear. These bumps become ulcerated blisters filled with liquid. The blisters then open, leaving them feeling wet, raw and often quite painful to the touch. They may ooze fluid or a reddish, bloody liquid. Men and women may experience burning during urination if the sores are in a location that comes into contact with the urine stream. Redness, swelling, pain and tenderness in the area persist in the region of the outbreak while the sores are open, and women may also experience a vaginal discharge.
- Soon after the first signs of tingling and pain, one or more small red bumps appear.
Flu-Like Symptoms
The first genital herpes outbreak may also sometimes be accompanied by flu-like symptoms, including muscle aches, fever, headache, and swollen lymph nodes in the groin area 2. In some cases, a second crop of sores may appear along with continued flu-like symptoms.
Healing Symptoms
First Outbreak Symptoms of Mouth Herpes
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Herpes sores will eventually stop oozing and will develop a dry crust or scab where the wet ulceration once was. New skin forms beneath the scab, and eventually the crust falls off to complete the healing process. Though the new skin may be slightly tender and redder in appearance than the surrounding skin, other painful symptoms will have subsided.
After the herpes sores have healed, it is possible that genital herpes outbreaks may recur 2. However, genital HSV-2 outbreaks recur ten times more often than genital HSV-1. Research studies have shown the average number of recurring outbreaks in those with HSV-1 genital to be between zero and one. Thus, many people with HSV-1 genital herpes may never have another outbreak after the initial outbreak, and those who do may experience relatively minor symptoms compared to the first outbreak 12.
- Herpes sores will eventually stop oozing and will develop a dry crust or scab where the wet ulceration once was.
Undetectable Symptoms
Many people do not know they have type 1 genital herpes because they do not notice overt symptoms 2. However, even in the absence of symptoms, HSV-1 can “shed” itself through the skin’s surface and increase the likelihood of passing it on through oral-to-genital or genital-to-genital contact. This is commonly known as viral shedding 3.
Genital herpes caused by HSV-1 produces much less viral shedding than genital herpes caused by HSV-2 23. Only about 25 percent of people with genital HSV- 1 shed any virus in the absence of symptoms, compared to 55 percent of people with HSV-2 1. Over time, rates of viral shedding decrease even further 3. Nevertheless, using latex condoms and avoiding sexual contact several days before and after an outbreak can help to minimize the risk of passing on the virus.
Related Articles
References
- Herpes: The Truth about HSV-1 and HSV-2
- CDC: Genital Herpes Fact Sheet
- Herpes Cold Sores: Viral Shedding
- Delmonte S, Sidoti F, Ribero S, Dal Conte I, Curtoni A, Ciccarese G, Stroppiana E, Stella ML, Costa C, Cavallo R, Rebora A, Drago F. Recurrent herpes labialis and HSV-1 herpes genitalis: which is the link? G Ital Dermatol Venereol. 2017 Feb 8. doi: 10.23736/S0392-0488.17.05563-8.
- Opstelten W, Neven AK, Eekhof J. Treatment and prevention of herpes labialis. Can Fam Physician. 2008;54(12):1683–1687.
- Delmonte S, Sidoti F, Ribero S, et al. Recurrent herpes labialis and HSV-1 herpes genitalis: which is the link? G Ital Dermatol Venereol. 2017. doi:10.23736/S0392-0488.17.05563-8
- Glinšek biškup U, Uršič T, Petrovec M. Laboratory diagnosis and epidemiology of herpes simplex 1 and 2 genital infections. Acta Dermatovenerol Alp Pannonica Adriat. 2015;24(2):31-5. doi:10.15570/actaapa.2015.9
- Centers for Disease Control and Prevention. Prevalence of Herpes Simplex Virus Type 1 and Type 2 in Persons Aged 14–49: United States, 2015–2016. Updated February 7, 2018.
- Embil JA, Manuel FR, Mcfarlane ES. Concurrent oral and genital infection with an identical strain of herpes simplex virus type 1. Restriction endonuclease analysis. Sex Transm Dis. 1981;8(2):70-2.
- Stanaway JD, Wald A, Martin ET, Gottlieb SL, Magaret AS. Case-crossover analysis of condom use and herpes simplex virus type 2 acquisition. Sex Transm Dis. 2012;39(5):388–393. doi:10.1097/OLQ.0b013e318248aa8a
- Bonnar PE. Suppressive valacyclovir therapy to reduce genital herpes transmission: good public health policy? Mcgill J Med. 2009;12(1):39–46.
- Cunningham SD, Kerrigan DL, Jennings JM, Ellen JM. Relationships between perceived STD-related stigma, STD-related shame and STD screening among a household sample of adolescents. Perspect Sex Reprod Health. 2009;41(4):225–230. doi:10.1363/4122509
- Embil JA, Manuel FR, McFarlane ES.Concurrent oral and genital infection withan identical strain of herpes simplex virus type 1. Restriction endonucleaseanalysis.Sex Transm Dis. 1981 Apr-Jun;8(2):70-2.
- Glinšek Biškup U, Uršič T, Petrovec M. Laboratory diagnosis and epidemiology of herpes simplex 1 and 2 genital infections. Acta Dermatovenerol Alp Pannonica Adriat. 2015;24(2):31-5
- Lafferty WE, Coombs RW, Benedetti J, Critchlow C, Corey L.Recurrences afteroral and genital herpes simplex virus infection. Influence of site of infectionand viral type. N Engl J Med. 1987 Jun 4;316(23):1444-9.
- Ramchandani M, Kong M, Tronstein E, Selke S, Mikhaylova A, Magaret A, Huang ML, Johnston C, Corey L, Wald A. Herpes Simplex Virus Type 1 Shedding in Tears and Nasal and Oral Mucosa of Healthy Adults. Sex Transm Dis. 2016 Dec;43(12):756-760.
- Ryder N, Jin F, McNulty AM, Grulich AE, Donovan B. Increasing role of herpes simplex virus type 1 in first-episode anogenital herpes in heterosexual women and younger men who have sex with men, 1992-2006. Sex Transm Infect. 2009 Oct;85(6):416-9. doi: 10.1136/sti.2008.033902.
- Delmonte S, Sidoti F, Ribero S, Dal Conte I, Curtoni A, Ciccarese G, Stroppiana E, Stella ML, Costa C, Cavallo R, Rebora A, Drago F. Recurrent herpes labialis and HSV-1 herpes genitalis: which is the link? G Ital Dermatol Venereol. 2017 Feb 8. doi: 10.23736/S0392-0488.17.05563-8.
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Based in New York City, Tricia Mangan began her writing career in 2001. She has co-authored a National Cancer Institute report and a number of research articles that have appeared in medical journals. Tricia holds a Master of Arts in clinical psychology from Stony Brook University and boasts diverse clinical, research and teaching experience.