Early symptoms of herpes

herpes symptoms

The early symptoms of herpes are usually associated with the genital area. However, the blisters – or sores, or ulcers – characteristic of this infection often appear on the lips or around the mouth. Moreover, herpes outbreaks can occur anywhere on the skin. It may also happen that the virus spreads to one of both eyes; this condition is known as herpes keratitis. Oral herpes is generally caused by HSV-1 – and to a lesser extent by HSV-2 – and the first infection tends to take place between 6 months-3 years of age. Approximately 60% to 90% of people have been infected with HSV-1 by the time they reach adulthood. A bad sunburn can trigger an outbreak of oral herpes.

The earliest signs of oral herpes are flu-like symptoms (fever, swollen lymph nodes) accompanied by tingling, itching, or burning, followed by:

·         Blisters on the lips, around the mouth, and possibly also on the tongue.

·         Increased salivation and halitosis.

·         Difficulty swallowing




·         Chills

·         Muscle pain

·         Hearing loss

The blisters break into painful, open sores that develop a yellowish membrane before healing, all in the span of 3 to 14 days. The infection typically takes place in the mouth in children, and in the upper part of the throat in teenagers, accompanied by soreness. HSV-2 infections are less common and recur less often than HSV-1 infections. The majority of patients have two or three outbreaks a year, though a small number of people may experience more. Recurring infections tend to be less severe than primary infections, and are usually known as cold sores or fever blisters. They appear mostly on the external edge of the lips, seldom affecting the gums or throat. Cold sores should not be confused with canker sores, which are not related to herpes.  

Herpes can lead to a painful condition known as gingivostomatitis, in which ulcers develop on the gums and mucous membranes of the mouth. Gingivostomatitis mainly affects children aged 1 to 5, and invariably goes away in two weeks. Seldom does it lead to viral infection. Children who have this condition usually develop herpes of the fingers, an infection around the fingernail also called herpetic whitlow.

As mentioned above, herpes can spread to the eyes. The signs of herpes keratitis (eye infection) include:

·         Pain.

·         Sensitivity to light.

·         Discharge.

·         Gritty feeling in the eye.

·         Scarring of the eye


If not promptly untreated

·         Cloudy vision

·         Loss of vision

It’s important not to mistake herpes keratitis for corneal scratches. Even though the two conditions can cause the same amount of pain, the latter goes away in about 24 hours and does not display the corneal lesions commonly seen in herpetic eye infections. Approximately 50,000 Americans suffer one of two types of ocular herpes every year.



Stromal keratitis

Occurs in up to 25% of ocular herpes cases. Scarring and corneal thinning can lead to rupture of the eye’s globe. Uncommon but at the same time a leading cause of corneal blindness in the United States.


A serious complication of herpetic infection of the eye where the iris and the area surrounding it swell up.

The transmission of herpes is thought to be exclusively due to sexual contact. The fact is, though, that healthcare practitioners such as doctors, nurses and dentists are at an increased risk of the aforementioned herpetic whitlow – though they can protect themselves with latex gloves. Furthermore, wrestlers, rugby players, contact sport athletes are at risk of herpes gladiatorum, a rare form of HSV-1 that is transmitted through skin contact with sores that are exposed due to a lack of protective gear. This type of herpes affects the head or eyes.  

Recurring infections follow the same cycle of early symptoms of herpes of primary infections, and even attack the same sites.

Prodrome (itching, tingling, burning) (2 hrs-2 days) →Blister eruption→Healing (6 to 10 days)

A quarter of recurring cases stop at the prodromal phase. On occasions when the symptoms are not similar to those of the previous infection, they are replaced by fissures and scrapes in the skin, or by a general inflammation around the area. Although the symptoms of herpes may seem to come and go willy-nilly, they should be taken seriously lest they lead to complications such as:

·         Neonatal herpes. Pregnant women infected with herpes may transmit the disease to their child in utero or during delivery. Less than 0.1% of babies are born with neonatal herpes of the 25%-30% of pregnant women who have the virus. However, the risk increases when a mother with an asymptomatic infection delivers vaginally. Neonatal herpes can cause skin rash, fevers, mouth sores, eye infections, and even death if not treated.

·         Herpes encephalitis. More than 2,000 cases of encephalitis in the U.S. are a complication of herpes. Herpes encephalitis has a death rate of more than 70%, with respiratory arrest potentially occurring in the first 24 to 72 hours. Even those who recover are left impaired with neurological problems or paralysis.

·         Herpes meningitis. This is an inflammation of the membranes lining the brain and spinal cord occurring in 10% of primary genital HSV-2 cases. This condition usually resolves within a week, though it might recur.

·         Eczema herpeticum. AKA Kaposi’s varicellaform eruption, it affects patients who have skin conditions or who have a compromised immune system. Clusters of blisters appear in 7 to 10 days and are susceptible of being infected with staphylococcal or streptococcal bacteria. The blisters heal in 2 to 6 weeks with treatment, but the condition can be severe and even deadly without treatment.

Additionally, herpes can lead to miscarriage, premature labor, and inhibited fetal growth in pregnant women, and pneumonia, esophagus inflammation, destruction of adrenal glands, dissemination of herpes through the body, and liver damage in immunocompromised patients, in whom HSV-1/HSV-2 co-infection is very likely.