What To Expect from the First Genital Herpes Outbreak

The Symptoms You Should Be Looking Out For

Close up of man wearing pyjama bottoms, woman in background
Cultura RM/Annie Engel/Getty Images

Genital herpes is a common sexually transmitted infection (STI) marked by genital pain and sores.Most people who are infected with the herpes simplex virus do not have symptoms. But of those who do develop symptoms, the first outbreak of genital herpes is worse than future recurrences. 

Genital Herpes and the Herpes Simplex Virus

In the past, genital herpes was caused mainly by the herpes simplex virus type 2 (HSV-2).

But now, new genital herpes infections can be caused by both the herpes simplex virus type 1 (HSV-1) and HSV-2. Most people who get a primary outbreak do so between three days to two weeks after initial exposure. This exposure occurs when the virus comes in contact with broken skin or the lining of the mouth, vagina, or anus.

The First Genital Herpes Outbreak

Seventy-nine percent of people get general symptoms with the first outbreak of genital herpes. These symptoms usually resolve themselves within a week. Common symptoms include:

Some who have contracted genital herpes also get a rash, which presents as a cluster of vesicles on a red base. In moist areas such as the vagina, herpes may cause ulcerations instead of blisters.

In women, the first outbreak of genital herpes can occur on the vulva, cervix, vagina, urethra, anus, buttocks, or thighs.

Men usually get an outbreak on the tip of the penis or the shaft, but rarely around the base. Men who have sex with men may also get blisters in or around the anus.

The rash in men is usually mild: only six to 10 blisters. The blisters in both men and women can be painful. These blisters also contain a large number of viral particles, so they should be considered highly contagious.

Women and the First Genital Herpes Outbreak

Women are four times more likely to be infected with HSV-2 than men. For some reason, it also hits women harder, and brings with it more complications during the first infection than it does with men. If a woman gets a herpes outbreak on the cervix or in the vagina and not externally, she may develop vaginal discharge, pelvic pain, or burning with urination. With the first outbreak, some women may also get a second round of blisters or ulcers in the second week.

How Long the First Genital Herpes Outbreak Lasts

The first herpes infection usually lasts for two to three weeks, but skin pain can last for one to six weeks. The blisters eventually dry out and crust over. When the crusts fall off, the area is usually not contagious anymore.

There is evidence that some people have low levels of the virus present even when they do not have symptoms.

In order to avoid transmitting the virus to your sexual partners, practice safe sex, or abstain from sex entirely during an outbreak.

Further Reading


CDC. "Sexually Transmitted Diseases Treatment Guidelines, 2006." Morbidity and Mortality Weekly Report. 55(2006): 16-20.

Habif, Thomas. "Warts, Herpes Simplex, and Other Viral Infections" Clinical Dermatology, 4th Edition. Ed. Thomas Habif, MD. New York: Mosby, 2004. 381-388.

Yeung-Yue, Kimberly. "Herpes simplex viruses 1 and 2." Dermatologic Clinics 20(2002): 1-21.

Continue Reading