Phases and symptoms of genital herpes: how are crises?

Most of the time, the individual does not know that he was infected by the genital herpes virus , because it is common that the disease does not show signs or symptoms. In fact, most people who become infected with the Herpes simplex virus do not develop the disease, remaining asymptomatic and unaware of the infection.

There are studies that suggest that up to 90% of infected patients do not develop symptoms.

In some cases, the signs go unnoticed or are mistaken for other diseases or conditions, such as insect bites, yeast infection ( candidiasis , for example), ringworm, acne, pimples and ingrown hairs.

Bearing in mind that the signs of genital herpes can vary greatly from person to person, it is important that each individual seeks to consult with the doctor to investigate them.

Thus, it will be possible to remove the doubt and start treatment as soon as possible, regardless of the clinical condition.

The time that symptoms can take to appear is also different for each patient. It may take a few days after contact with the virus, months or years, as well as it may never wake up.

The most well-known symptoms of this disease are the sores that appear in the genital region. These wounds, also called vesicles or ulcers, cause irregularities in the patient’s skin.

The appearance of these lesions resembles small pimples or blisters on the skin, which sometimes have a liquid inside. They can take 2 to 4 weeks to heal completely.

Some characteristics that may be present in these herpes outbreak periods include:

  • Peels that form when the ulcers heal;
  • Pains and irritation that appear 2 to 10 days after contagion;
  • Red spots and small whitish blisters that usually appear days after infection;
  • Ulcers in the genital region, which can bleed and cause pain when urinating;
  • Small clusters of blisters and wounds;
    Tingling, itching and burning around the genitals (they are common slightly before an outbreak);
  • Burning when urinating if the blisters are close to the urethra;
  • Burning and pain when defecating, if the lesions are close to the anus;
  • Groin languages.

These symptoms can happen in the penis, scrotum, thighs and urethra, in addition to the vagina, vulva and cervix. They can also appear in the mouth, buttocks and anus.

In the first days after the infection, the infected person may show symptoms very similar to those of the  flu  – as it is also a viral infection – such as:

  • Reduced appetite;
  • Fever;
  • General malaise;
  • Muscle pains in the lower back, buttocks, thighs or knees;
  • Tiredness.

Primary genital herpes

Primary infection is the name given the  first time that genital herpes lesions appear after the patient has been infected . It can last from 2 to 3 weeks, being, generally, the most difficult and painful phase of the infection.

The symptoms of genital herpes tend to develop within 3 to 7 days after intercourse responsible for the infection, but in some cases it can take up to 2 weeks.

Normally, blisters appear on the genitals, which then rupture, forming ulcers. In primary infection, these lesions tend to be very painful, and there may also be itching (itching) in the area.

In addition to the typical herpes lesion, the primary infection usually comes with other symptoms, such as fever , malaise and body aches.

Lymph nodes (lymph nodes) may appear in the groin area and, if the ulcers are close to the exit of the urethra, there may be severe pain when urinating.

In men, genital herpes sores usually appear on or near the penis.

In women, lesions may be visible outside the vagina, but they usually occur inside the vagina, such as the cervix, where they are hidden.

As for internal injuries, the only signs of illness may be vaginal discharge and / or discomfort during sexual intercourse.

Lesions of genital herpes can also appear anywhere in the perineum and around the anus of patients who have anal sex.

Recurrent genital herpes

After primary infection, the genital herpes lesions disappear, remaining silent for several months or years. In most patients, the infection recurs from time to time and, in some cases, more than once a year, due to changes in the immune system.

Once in the body, following through a nerve in the affected area, the genital herpes virus installs itself in a nervous ganglion, close to the spine, where it remains in a latent state.

Reactivation occurs when the virus multiplies in the neural ganglion and the viral particles migrate through the nerve to the site of the primary infection on the skin or mucous membranes (oral or genital).

After the initial outbreak, the person affected by the disease may develop antibodies that keep the infection inactive indefinitely and thus never get to reactivate.

Other people, at certain times, have new outbreaks of the infection, which represent a viral reactivation, with milder symptoms than those of the initial infection.

The factors that trigger this reactivation vary from person to person. Among them are physical exhaustion, other infectious processes, menstruation, excessive alcohol intake, intense sun exposure, conditions that weaken the immune system and   emotional stress .

Friction or repeated trauma at the injury site, such as during sexual intercourse, can also lead to reactivations in some people.

However, there are cases of recurrences in which it is not possible to identify any triggering factor.

90% of patients experience their first recurrence within 18 months of primary infection, with some having more than 10 recurrences within one year.

Crisis returns are frequent in those who have had a prolonged primary infection, with initial herpes lesions lasting more than 1 month. Over the years, crises become weaker and less frequent.

A few days before the lesions appear, the patient may experience some alarm symptoms, such as itching of the labia majora, tingling, burning, numbness in the penis and tingling in the genital region.

In this way, many patients are able to identify that a new outbreak of genital herpes is on the way and thus are able to prepare for the treatment and care of the lesions.

In other cases, the patient may not develop symptoms of primary infection soon after the contamination, only presenting ulcers years later, after some event that reduces his immunity.

In these cases, despite being the first appearance of wounds, the disease behaves more like a recurrence than as a primary infection, being shorter and less painful. Symptoms such as fever and malaise are also not common.

In these situations it is very difficult to establish precisely when the patient was infected and who infected him.