Painful blisters, a burning feeling and you feel fluey: a first genital herpes outbreak can hit hard. Many people are mostly shocked by the idea that it "stays". That is partly true, but the story is more nuanced than the initial fright suggests.
Our stance: with herpes the hardest part is not the first outbreak but the misunderstanding that an STI test tells you everything here. Herpes works differently from chlamydia or gonorrhoea.
What does a first outbreak feel like?
A first outbreak usually appears within a few days to two weeks after infection. Many people notice painful blisters or small sores around the genitals or anus, sometimes with a burning feeling when peeing and a general unwell feeling. Thuisarts.nl describes that the first time is often more intense than later outbreaks, which usually run milder and fade on their own.
The tricky part is that far from everyone has clear complaints. Some people have such a mild first outbreak that they do not recognise it as herpes. If you are unsure about a bump or blister on your genitals, that article helps you place the signs.
How does transmission work?
Genital herpes is caused by the herpes simplex virus and is passed on through skin-to-skin contact, even without visible blisters. That last point matters: transmission can happen in periods without complaints. The overview below sets the phases side by side as a guide.
| Phase | What happens | Can it be passed on? |
|---|---|---|
| First outbreak | Blisters, pain, sometimes fluey feeling | Yes, the chance is higher then |
| Between outbreaks | No complaints, virus stays in the body | Yes, possible even without visible blisters |
| Later outbreak | Often milder and shorter | Yes, the chance is higher then |
Condoms reduce the chance of transmission but do not rule it out fully, because not all skin is covered. This is a consideration you make together with a partner.
Why testing for herpes is different
For herpes a test is less straightforward than for many other STIs. During an outbreak a doctor can examine fluid from a blister with a PCR test, which can detect the virus directly. Without complaints that is harder, and an antibody blood test does not always give a clear answer about where or when you were infected. That is why RIVM and Soa Aids Nederland do not advise routine herpes testing in people without complaints.
In practice this means: if you have complaints now, go to your GP, who can test specifically during an outbreak and advise you. If you want a broader check on the STIs that are well suited to a self-test, a combined test for chlamydia, gonorrhoea and trichomonas can be part of that.
What can you do yourself?
A doctor can ease a first outbreak with medication, especially if you are early. Later outbreaks often pass on their own. Many people notice that outbreaks become less frequent over time. For the right approach you discuss your situation with your GP, because medication and advice are tailored to you.
Practical points during an outbreak: keep the area clean and dry, touch the blisters as little as possible and wash your hands after contact, because otherwise the virus can move to other places. Postpone intimate contact while there are blisters or sores, because the chance of transmission is higher then. These are general tips, not treatment; what works best for you is something you arrange with your GP.
Misunderstandings that cause a lot of worry
Stubborn misunderstandings surround herpes and cause more fright than necessary. We set a few of them straight. Herpes does not mean you can never have a healthy sex life again; with good agreements and sometimes medication, many people live well with it. A herpes outbreak also does not automatically mean a partner has cheated, because the virus can lie dormant in the body for years before a first outbreak. And cold sores (oral herpes) and genital herpes are related but not identical; through oral contact, transmission between mouth and genitals is possible. Our view: most of the harm with herpes lies in unnecessary shame, not in the virus itself.
With herpes a calm approach matters more than panic. The diagnosis is not a breaking point, and many people live well with it. Every result we provide is assessed by a BIG-registered doctor, and you make treatment decisions together with your GP.
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Autor
Discreettest
Dr. Naimi, lekarz wpisany do holenderskiego rejestru BIG, nadzoruje standardy medyczne naszych treści i ocen. Przeczytaj naszą politykę medyczną
