For many people, the first outbreak of genital herpes is the worst and longest-lasting.
Continue reading to learn more about what a first outbreak of genital herpes is like, including symptoms and treatment.
Genital Herpes Symptoms
Not everyone with genital herpes has detectable symptoms. Those who do will usually notice small, red, itchy, and fluid-filled blisters around the genitals and rectum. These blisters can also be internal, along the urethra or vagina, for example. They eventually rupture and crust over, leaving behind painful ulcers.
Other symptoms you may experience include:
Itching or burning around the genitals or anusPain in the leg, buttocks, and groinPain during urinationUnexplained or unusual vaginal or penile discharge
How Is the First Outbreak Different?
The first outbreak of genital herpes is the most severe because your body hasn’t previously encountered the virus and has no immune response. You’ll likely have more sores, pain, itchiness, and burning during your first outbreak than during future outbreaks. The first outbreak is also the longest, with symptoms sticking around for two to four weeks.
Some people experience additional whole-body symptoms during their first outbreak, including:
FeverBody achesSwollen lymph nodesHeadache
After the first outbreak, the virus lays dormant in your nerve cells. When it reappears, your body can mount an immune response, fighting the virus. Because of that, subsequent outbreaks of genital herpes are less severe, and most people experience fewer outbreaks over time.
What to Expect
The symptoms of genital herpes appear two to 12 days after exposure to the virus, in most cases.
A healthcare provider can diagnose genital herpes by swabbing the lesions to check for the virus. Once you’ve been diagnosed with genital herpes, your healthcare provider will likely start you on prescription medication to get the outbreak under control.
Treatment
The first outbreak of genital herpes is treated with oral antiviral medications. When you visit your healthcare provider, you’ll likely get a seven to 10 day prescription of one of the following medicines:
Zovirax (acyclovir), taken three times a day Famvir (famciclovir), taken three times a day Valtrex (valacyclovir), taken twice daily
Over-the-Counter (OTC) Relief
In addition to prescription antivirals, OTC options can help keep you comfortable during your first outbreak, including:
Numbing gels containing lidocaine Pain relievers, including Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil or Motrin (ibuprofen) or Aleve (naproxen) Hydrocortisone cream to fight itch
Home Remedies
Even with antiviral medications and topical creams to relieve itching and pain, you’ll still likely be uncomfortable during your first outbreak. Scratching can increase the risk of secondary infection. Instead of scratching, apply a cold compress to the area.
Although it’s difficult, managing your stress is important. Stress can make outbreaks worse.
Summary
Genital herpes is a common STI. If you’ve been exposed, you may experience your first outbreak within two to 12 days. Although some people never notice symptoms, for most people, the first outbreak is the worst. Prescription antivirals and over-the-counter medications can help manage your symptoms, which will likely last two to four weeks. While you have lesions, abstain from sex, since the risk of passing herpes is highest during the first outbreak.
A Word From Verywell
Experiencing your first genital herpes outbreak can take an emotional toll. It’s important to remember that genital herpes is very common and is nothing to be ashamed of. Getting treatment quickly can reduce your risk of passing on the virus and help you feel better fast.
