Despite how common it is, a herpes diagnosis can be scary. There’s no cure for herpes, meaning you could be dealing with flare-ups your whole life. This could leave you with a lot of questions, like, “does herpes go away on its own?” and “how long does a herpes sore last?”
The different types and forms of herpes
Herpes infections are caused by a herpes virus, either the herpes type 1 virus (HSV-1) or the herpes type 2 virus (HSV-2). Both types of virus can cause irritating, painful blisters and flu-like symptoms during the initial outbreak. The primary difference between the two is where on the body these sores appear. HSV-1 usually causes oral herpes, while HSV-2 causes genital herpes.
Occasionally, genital herpes infections are caused by HSV-1, but usually, they’re caused by HSV-2. Genital herpes is primarily spread through sexual contact. You can contract genital herpes from direct contact with genital surfaces, skin, sores, or body fluids of an infected individual. HSV-1 can be spread genitally through oral sex.
The World Health Organization estimates that about 491 million people ages 15-49 have HSV-2 worldwide. Women are more likely to have genital herpes than men are, as it’s more easily transferred from men.
Individuals with genital herpes are at a higher risk of contracting HIV, because the HIV virus appears to replicate well within genital herpes sores. Genital herpes can also lead to complications such as bladder problems, rectal inflammation, and occasionally, meningitis.
For most people, herpes can be irritating or slightly painful. However, infants often don’t have a strong enough immune system to fight the virus, which can lead to severe complications and even death.
An infant can contract herpes in a few ways, but the most common cause of neonatal herpes is a herpes outbreak in the pregnant patient during delivery. And 90% of neonatal herpes cases are caused by the baby contracting the virus in the birth canal.
Most of the time, babies born to infected individuals are perfectly healthy. The risk for neonatal herpes increases if the pregnant patient has their first herpes infection during the last trimester of pregnancy.
If you’re pregnant and have herpes, your doctor may prescribe an antiviral treatment toward the end of your pregnancy to reduce the chance of an outbreak at the time of delivery. If you do have an outbreak when it is time to deliver, they may recommend a C-section to avoid exposure to the virus in the birth canal.
Less commonly, infants can also contract herpes in the womb or after birth. Individuals with herpes should avoid kissing newborns, especially on the mouth.
Neonatal herpes can cause skin blisters, but it can also lead to inflammation of the brain and a disseminated herpes infection. In a disseminated herpes infection, the virus spreads throughout the infant’s body and affects multiple organs. Untreated, this can be fatal.
Oral herpes is caused by HSV-1. HSV-1 is incredibly common; WHO estimates that 3.7 people under the age of 50 have HSV-1 globally. Oral herpes results in a sore or sores, often called cold sores or fever blisters, around the mouth. Your first oral herpes outbreak may also come with flu-like symptoms.
Oral herpes is spread by contact with the herpes sores or saliva of an infected individual. This can happen while kissing or by sharing things like eating utensils, drinks, or toothbrushes. The best way to avoid contracting oral herpes is by avoiding contact or sharing things like utensils with someone having an active outbreak.
How long do herpes symptoms last?
There is no firm herpes outbreak timeline. The length of time your symptoms last will depend on the strain of virus you have, your overall health, and whether it’s your first infection or a subsequent infection. Some people never experience an outbreak or symptoms of herpes.
Initial outbreak vs future outbreaks
After you’re exposed, the incubation period, or time it takes for infection to appear, can range from 2-21 days. Your first herpes infection is usually the most severe, and includes not just the typical sores but also flu-like symptoms. The first herpes infection is usually the longest, lasting on average 20 days.
After your initial herpes outbreak, future outbreaks are often shorter, possibly because your body begins building antibodies against the virus. On average, these outbreaks last about 17 days.
Only about 20-40% of people with HSV-1 develop fever blisters. They usually last 1-2 weeks and develop in stages:
- Stage 1: You may notice a tingling, itching, or burning where the sore is about to form.
- Stage 2: A couple days later, small, fluid-filled blisters form, usually on the side of the mouth. This is a fever blister or cold sore.
- Stage 3: The blister bursts and may be very painful. You are most contagious during this time.
- Stage 4: About three days later, the blisters start to scab. This is the beginning of the healing time.
- Stage 5: About 2-3 days after the scabbing starts, the scab falls off and the sore heals completely.
The genital herpes infection follows nearly the same timeline as an oral herpes infection. An outbreak typically lasts 1-2 weeks, and the length of the outbreaks may shorten as time goes on. Like oral herpes, the first sign of an outbreak is tingling, itching, or burning in the affected area, followed by sores that burst, scab over, and eventually heal.
Body aches and flu-like symptoms
Often, your first herpes outbreak includes flu-like symptoms, such as:
- Body aches
- Swollen lymph nodes
These can last the duration of your outbreak, meaning the flu-like symptoms can persist for 2-3 weeks with your initial outbreak. While flu-like symptoms can sometimes accompany subsequent outbreaks, it’s not as common.
What can you do if you’re suffering recurrent herpes outbreaks?
On average, an infected person with HSV-1 has one outbreak in the year after initial infection, while someone with HSV-2 averages four outbreaks in the following year.
Common triggers for HSV flare-ups include:
- Illness, ranging from mild colds to more severe conditions
- Menstrual periods
- Trauma to the affected area
If you’re experiencing frequent outbreaks, try to do what you can to limit triggers.
While most herpes outbreaks go away on their own, treatment options like antiviral medication can help reduce how frequently you get outbreaks, reduce your risk of transmitting the virus, and ease symptoms. Speak to your healthcare provider for more guidance.
Get tested today
Herpes simplex, as well as many sexually transmitted diseases, can lie dormant in your body without showing symptoms. Despite this, you can still infect others. If you’re sexually active and not in a long-term, monogamous relationship, it’s important that you test yourself at least once a year. MyLAB Box offers a range of STD screening tests so you can stay safe and take control of your health.