A Complete Medical Guide to Herpes: Symptoms, Diagnosis, & Treatment (with Pictures)

• Cold sores, genital sores, fever, and fatigue are all sign of herpes, though some people don’t have any noticeable symptoms.
• The Herpes Simplex Virus (HSV) has two major strains: HSV-1 and HSV-2. HSV-1 is often linked with cold sores, and HSV-2 is often linked with genital herpes.
• Visit your doctor to get tested if you suspect that you might have herpes.
• Take antiviral medications prescribed by your doctor to help manage your herpes symptoms.

Identifying Oral and Genital Herpes

Cold sores are the most common symptom of oral herpes. Also known as fever blisters, cold sores resemble blisters (or a group of blisters) inside or outside of your mouth. They often feel itchy or uncomfortable, and hang around for a week to 10 days.

Genital blisters are a common sign of genital herpes. People with genital herpes often notice single (or multiple) sores near their genitals and butt. Unlike cold sores, genital blisters often hang around for 2-4 weeks, where they open up, drain, crust over, and heal.

Genital herpes can sometimes cause fever and fatigue during your first outbreak. Herpes typically makes itself known with “outbreaks,” or flare-ups of noticeable symptoms (like blisters). During your very first outbreak of genital herpes, you might feel feverish, achey all over, nauseous, and extra tired. Painful urination, swollen lymph nodes, and a tingling sensation are other common signs of a herpes outbreak. Herpes breakouts often flare up again and agin, but the signs and symptoms are slightly different. During future breakouts, you might experience back pain, knee pain, buttocks pain, and upper leg pain, and you might notice an uncomfortable tingling sensation around where the herpes originated. Thankfully, repeated herpes outbreaks only hang around for a week or less.

Certain people don’t notice any genital herpes symptoms. HSV can be completely dormant in the body without creating any noticeable flare-ups, like blisters, fever, aches, or painful urination. In some cases, people can even misdiagnose herpes as a different skin issue. Genital herpes can sometimes be confused for an ingrown hair or zit. If you notice any symptoms similar to this, see your doctor right away.

Understanding and Diagnosing Herpes

Herpes is caused by the Herpes Simplex Virus (HSV). HSV is classified in 2 categories: HSV-1 (oral herpes) and HSV-2 (genital herpes). HSV-1 typically leads to cold sores, while HSV-2 usually leads to genital blisters. HSV-1 is especially common—according to one study, over 60% of Americans have it. Genital herpes can also be caused by HSV-1, although it’s less common. HSV typically takes at least 2 days to show obvious symptoms. In some cases, it takes up to 10 days for symptoms to appear.

Herpes gets spread by direct contact with someone who has the virus. Skin and saliva are both fair game—HSV-1 in particular spreads quickly through activities like sharing a drink or snack, using someone’s lip balm, kissing, or borrowing a person’s razor. HSV-2 tends to be spread through all kinds of sexual intimacy, including vaginal, oral, and anal sex. Using a contaminated sex toy can also spread HSV-2.

Herpes outbreaks stick around for anywhere from 1-4 weeks. Cold sores (caused by HSV-1) only stick around for 7-10 days, while an initial genital herpes outbreak can stick around from 2-4 weeks. Future genital herpes flare-ups don’t last as long, and go away within 3-7 days. Medical treatments can help you manage your symptoms, but herpes will ultimately clear up and temporarily go away on its own.

The herpes virus never goes away but it often stays dormant. HSV always exists in your nerve cells, even if it isn’t creating any symptoms. In today’s society, herpes diagnoses are painted in a far worse light than they actually are. While the virus never leaves your body, it isn’t life-threatening or dangerous. People with herpes can live just as full and fulfilling lives as people who don’t have it! Different health issues and life events can cause herpes to flare up again, like a menstrual cycle, fever, or stressful experience.

Get tested by your doctor to confirm if you have herpes. During the appointment, your doctor takes either a blood sample or a sample from your blister for testing. Through this testing, your doctor can let you know if you have herpes or not, and what your treatment options are.

Treating and Preventing Herpes

Take an antiviral medication prescribed by your doctor to manage your herpes. No medicine out there can totally cure herpes, but antiviral medications help make your symptoms less severe. These medications can also help keep your flare-ups to a minimum, and prevent the chance of spreading herpes to other people. Valacyclovir (Valtrex), acyclovir (Zovirax and Sitavig), and famciclovir (Famvir) are common medications used to treat herpes. These are only available via prescription, though, so talk to your doctor about your options.

Ease your symptoms with at-home remedies. Treat cold sores with topical OTC creams like docosanol (Abreva) or benzocaine (Orajel)—if they’re especially painful, place a towel-wrapped ice pack over the blister for a few minutes at a time. To treat genital herpes, using an ice pack can also be helpful, as well as applying a 1-2% lidocaine cream to the sores or taking a warm bath. Take NSAIDs like ibuprofen, aspirin, or naproxen if you’re dealing with a lot of pain. Some people have found success treating their herpes with natural remedies. Always talk with your doctor before trying any of these, though.

Practice safe sex to prevent catching herpes or giving it to someone else. While abstinence is the only way to completely protect yourself from herpes, using a condom or dental dam can definitely reduce your risk of catching it. Always talk to your partner about using protection before you get intimate so you both can stay as safe and healthy as possible. Keep in mind that herpes can be spread through skin contact. Even if you or your partner wears a condom, you can still potentially pick up herpes from other parts of your skin making contact.

Avoid getting intimate if you or your partner is having an outbreak. Herpes outbreaks usually make themselves known with body aches and sores. If you or your partner have herpes and/or notice any of these symptoms, wait to get intimate until you both feel healthy again.

Avoid sharing snacks, drinks, and other personal items. HSV-1 is easily spread through saliva—especially if you’re sharing with someone who has an active cold sore. For the sake of your own health, keep your food, beverages, and personal items to yourself. At the very least, wait for the person’s cold sore to completely heal before up before you share food and other personal items with them. They’re much less likely to spread HSV at this point.

Discuss your sexual health and history with any new partners. Herpes is nothing to be ashamed of—tons of people have caught it at some point, so you’re definitely not alone. What matters most is being transparent with your partner so you can plan to be intimate in a safe and responsible way.