Signs of herpes in men include genital lesions or sores that will appear about six to eight days after infection. Specifically, first signs of genital herpes in men appear as reddish, painful bumps, or papules along the penis, and for women on the vulva. They may also appear on the thighs or buttocks, in the vagina, or on the cervix. These papules turn into groups of small blisters that are filled with fluid containing infectious viral particles. The blisters are attacked by the body’s immune system (white blood cells). They fill with pus, burst, and become extremely painful, shallow sores or ulcers surrounded by a red ring.
People are especially infectious during such outbreaks, because the ulcers shed millions of viral particles. Other symptoms and signs of herpes in men and women may include headaches and muscle aches, swollen lymph glands, fever, burning urination, and a vaginal discharge. The blisters crust over and heal in one to three weeks. Internal sores in the vagina or the cervix may take 10 days longer than external (labial) sores to heal. Physicians thus advise infected women to avoid unprotected intercourse for at least 10 days after the healing of external sores.
Although the symptoms and signs of herpes in men disappear, the disease does not. The virus remains in the body permanently burrowing into nerve cells in the base of the spine, where may lie dormant for years or for a lifetime. The infected person is least contagious during this dormant stage. For reasons that remain unclear, the virus becomes reactivated and gives rise to recurrences in most cases.
Recurrences may be related to infections (such as a cold), stress, fatigue, depression, exposure to the sun, and hormonal changes such as those that occur during pregnancy or menstruation. Signs of herpes in men or recurrences, tend to occur within 3 to 12 months of the initial episode and to affect the same part of the body.
About 50% of people with recurrent herpes experience prodromal symptoms before an active outbreak. These warning signs of herpes in men and women may include feelings of burning, itching, pain, tingling, or tenderness in the affected area. These warning signs may be accompanied by sharp pains in the lower extremities, groin, or buttocks. Women and men with herpes may be more infectious when prodromal symptoms appear. They are advised to avoid unprotected sex until the flare-up subsides.
The oral signs of herpes in men and women include sores or blisters on the lips, the inside of the mouth, the tongue, or the throat. Fever and feelings of sickness may occur. The gums may swell and redden. The sores heal over in about two weeks, and the virus retreats into nerve cells at the base of the neck, where it lies dormant between flare-ups. About 90% of people with oral herpes experience recurrences. About half of them have five or more recurrences during the first two years after the initial outbreak.