A genital herpes outbreak can start out mild but become more severe. You may experience itchy bumps or painful blisters, depending on the stage of your outbreak.

Genital herpes is a sexually transmitted infection (STI) that results from the herpes simplex virus (HSV). It’s most commonly transmitted through sexual contact, whether oral, anal, or genital sex.

Genital herpes is usually caused by the HSV-2 strain of herpes. The first herpes outbreak may not happen for years after transmission.

But you’re not alone.

About 1 in 6 U.S. people have experienced a herpes infection. Around 776,000 new cases of HSV-2 are reported every year.

There’s plenty that can be done to treat the symptoms and manage outbreaks so that life isn’t ever disrupted by it.

Both HSV-1 and HSV-2 can cause oral and genital herpes, but we’ll be focusing mainly on genital HSV-2.

Early symptoms tend to happen around 2 to 12 days after infection. There are two phases, latent and prodrome.

  • Latent phase: Infection has occurred, but there are no symptoms.
  • Prodrome (outbreak) phase: At first, the symptoms of a genital herpes outbreak are typically mild. As the outbreak progresses, the symptoms become more severe. The sores will typically heal within 3 to 7 days.

What to expect

You may feel a light itchiness or tingling around your genitals or notice some tiny, firm red or white bumps that are uneven or jagged in shape.

These bumps may also be itchy or painful. If you scratch them, they can open up and ooze white, cloudy fluid. This can leave painful ulcers behind that can be irritated by clothing or other materials than come into contact with your skin.

These blisters can show up anywhere around the genitals and the surrounding areas, including the:

  • vulva
  • vaginal opening
  • cervix
  • butt
  • upper thighs
  • anus
  • urethra

The first outbreak may also come along with symptoms that are like those of the flu virus, including:

The first outbreak is usually the most severe. Blisters may be extremely itchy or painful, and sores may appear in many areas around the genitals.

But every outbreak after that is typically less severe. The pain or itchiness won’t be as intense, the sores won’t take quite as long to heal, and you probably won’t experience the same flu-like symptoms that happened during the first outbreak.

The symptoms of genital herpes look different at each stage of an outbreak. They may start mild, but become more noticeable and severe as the outbreak worsens.

Genital herpes symptoms don’t look the same for every person. You may even notice differences in your sores from outbreak to outbreak.

Here are some examples of what genital herpes looks like for people with vulvas at each stage.

Genital herpes is spread through unprotected oral, anal, or genital sex with someone who has an infection. It’s commonly transmitted when a person has sex with someone who has an active outbreak consisting of open, oozing sores.

However, the absence of a visible outbreak does not mean the herpes virus can’t still be transmitted. The virus can also be present and transmissible on unbroken skin that looks normal to the eye. Unfortunately, though condoms are helpful, any contact with uncovered skin may still transmit the virus.

If you start to feel the prodromal symptoms preceding an outbreak such as itching. tingling, or burning, avoid sexual contact until the scabs have gone away and wash your hands with soap and water after any contact with the area.

Once the virus has made contact, it spreads in the body through mucous membranes. These are thin layers of tissue found around openings in the body like your nose, mouth, and genitals.

Then, the virus invades the cells in your body with the DNA or RNA material that makes them up. This allows them to essentially become a part of your cell and replicate themselves whenever your cells do.

Here are a few ways a doctor may diagnose genital herpes:

  • Physical examination: A doctor will look at any physical symptoms and check your overall health for any other signs of genital herpes, such as lymph node swelling or a fever.
  • Blood test: A sample of blood is taken and sent to a laboratory for testing. This test can show the levels of antibodies in your bloodstream for fighting off an HSV infection. These levels are higher when there’s been a previous herpes infection or if there’s a current outbreak.
  • Virus culture: A small sample is taken from the fluid oozing from a sore, or from the area of infection if there isn’t an open sore. They’ll send the sample to a laboratory to be analyzed for the presence of HSV-2 viral material to confirm a diagnosis.
  • Polymerase chain reaction (PCR) test: First, a blood sample or tissue sample is taken from an open sore. Then, a PCR test is done at a laboratory with DNA from your sample to check for the presence of viral material in your blood — this is known as the viral load. This test can confirm an HSV diagnosis and tell the difference between HSV-1 and HSV-2.

Genital herpes can’t be completely cured. But there are plenty of treatments for the symptoms of an outbreak and to help keep outbreaks from happening — or at least to reduce how many a person has throughout their life.

Antiviral medications are the most common form of treatment for genital herpes infections.

Antiviral treatments can stop the virus from multiplying inside the body, lowering the chances that the infection will spread and cause an outbreak. They can also help prevent transmitting the virus to sexual partners.

Some common antiviral treatments for genital herpes include:

A doctor may only recommend antiviral treatments if a person starts to see symptoms of an outbreak. But they may need to take daily antiviral medication if they have outbreaks often, especially if they’re severe.

A doctor may recommend pain medications like ibuprofen (Advil) to help reduce any pain or discomfort before and during an outbreak.

An ice pack wrapped in a clean towel and placed on the genitals can help to reduce inflammation during an outbreak.

Below are some methods to make sure herpes isn’t transmitted or contracted from another person:

  • Get tested regularly to make sure there’s no HSV infection, especially if you’re sexually active. Make sure partners are tested before having sex.
  • Communicate frankly with your partner. If they have been exposed to HSV, are they feeling any signs of a potential outbreak, even if they have no visible sores?
  • Have partners wear a condom or other protective barrier when having sex. This can help protect the genital area from fluid carrying the herpes virus in a partner’s genitals. Keep in mind that a person with a penis doesn’t need to ejaculate to pass the virus to their partners — touching tissue infected with the virus with the mouth, genitals, or anus can cause exposure to the virus. Remember also that condoms themselves do not prevent transmission from uncovered parts of the body.
  • Limit the number of sexual partners to reduce the chances of exposure to the virus unknowingly from a new partner or a partner that may be having sex with other partners.
  • Don’t use douches or scented products for your vagina. Douching can disrupt the balance of healthy bacteria in the vagina and increase the susceptibility to both viral and bacterial infections.

You are not alone. Tens of millions of other people are going through the exact same thing.

Try talking to someone you’re close to about your experiences with genital herpes.

Having a friendly ear, especially someone who may also be going through the same thing, can make the pain and discomfort that much easier. They may even be able to provide some tips on how to best manage symptoms.

If you’re not comfortable talking with a friend, try finding a genital herpes support group. This can be a traditional meet-up group in your city, or an online community on places like Facebook or Reddit for people to talk openly, and sometimes anonymously, about their experiences.

Genital herpes is one of the more common STIs. Symptoms are not always immediately noticeable, so it’s important to see a doctor and get tested right away if you think you may have contracted an infection and want to avoid transmitting it.

Even though there’s no cure, antiviral treatments can keep the number of outbreaks and severity of symptoms to a minimum.

Just remember that a person can still transmit genital herpes to someone even when not having an outbreak, so practice safe sex at all times to make sure the virus doesn’t spread.