What are the symptoms of a herpes simplex infection?

The symptoms of an HSV infection vary according to the specific type of infection:

Oral herpes. Blisters on your lips or around your mouth. Skin may tingle, itch or burn up to 48 hours before blisters appear.

Genital herpes. Blisters on and around your genitals. Symptoms in the 48 hours leading up to blisters appearing include fever, headache, swollen lymph nodes and itching or tingling in your genital area.

Herpes gladiatorum. Blisters anywhere on your skin but usually your hands, face, ears or chest.

Herpetic whitlow. Blisters on your fingers, discolored skin around your fingernail, swelling in your finger.

Herpes keratitis (eye herpes). Eye pain or irritation, feeling like there’s something in your eye, sensitivity to light, blisters on your eyelids or around your eyes.

HSV encephalitis. Headache, fever, focal seizures, changes in speech or behavior.

Herpes meningitis. Headache, fever, sensitivity to light.

You catch HSV through direct contact with someone who has an HSV infection. This means part of your body needs to touch someone else’s:

Someone with HSV doesn’t transmit (or “shed”) the virus from every part of their body. They only shed it from the area that’s infected. Usually, that’s the part of their body where HSV first entered.

For example, someone with genital herpes can transmit the virus through the skin, mucosa and bodily fluids in their genital area only. They won’t spread HSV through their saliva — the exception, of course, is if they also have oral herpes (we’ll return to this later).

Similarly, if your partner has oral herpes but not genital herpes, then you don’t have to worry about getting HSV from contact with their genitals. You’d only be at risk of catching HSV through contact with your partner’s mouth or saliva.

If your partner has both oral and genital herpes, then it’s possible you could catch HSV from contact with their mouth area or their genital area. But exactly how the virus affects you would depend on which part of your body made that contact. This deserves a closer look.

HSV usually spreads in the following ways:

Type of contactHow HSV spreads
Genital-to-genital contact   HSV spreads from one person’s genital area to another person’s genital area (giving them genital herpes).  
Oral-to-oral contact   HSV spreads from one person’s mouth to another person’s mouth (giving them oral herpes).  
Oral-to-genital contact   HSV spreads from one person’s mouth to another person’s genitals (giving them genital herpes).  
Genital-to-oral contact   HSV spreads from one person’s genitals to another person’s mouth (giving them oral herpes).  
Skin-to-sore contact   It’s less common but possible to spread HSV by touching an oral or genital sore or other infected areas.  
Type of contact
Genital-to-genital contact  
How HSV spreads  
HSV spreads from one person’s genital area to another person’s genital area (giving them genital herpes).  
Oral-to-oral contact  
How HSV spreads  
HSV spreads from one person’s mouth to another person’s mouth (giving them oral herpes).  
Oral-to-genital contact  
How HSV spreads  
HSV spreads from one person’s mouth to another person’s genitals (giving them genital herpes).  
Genital-to-oral contact  
How HSV spreads  
HSV spreads from one person’s genitals to another person’s mouth (giving them oral herpes).  
Skin-to-sore contact  
How HSV spreads  
It’s less common but possible to spread HSV by touching an oral or genital sore or other infected areas.  

The incubation period for herpes simplex infections ranges from one to 26 days but is typically six to eight days. This is how long it takes for you to develop symptoms after first getting infected with HSV.

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Some people get infected but don’t develop symptoms right away. Instead, symptoms may not appear for months or even years until the virus reactivates.

Triggers that may cause an oral or genital herpes outbreak include:

Potential triggers specific to oral herpes include:

Sun exposure.

Upper respiratory infection.

Trauma to your mouth area.

Outbreaks can also occur randomly without any obvious trigger.

An HSV infection has three stages:

Primary infection.

Latency.

Reactivation.

A “primary infection” is what happens after HSV enters your body. The virus travels to nearby nerve cells, where it starts replicating. When HSV enters your mouth, it typically infects your trigeminal nerves. When it enters your genital area, it typically infects your sacral plexus (a network of nerves in your pelvis).

HSV then travels through your nerves to nearby skin or mucosa. By this point, your immune system recognizes there’s an invader, and it starts sending out immune cells. This leads to inflammation and the formation of blisters on your skin. You may also notice swollen lymph nodes in that area (for example, underneath your jaw or along your groin).

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For some people, a primary infection causes no symptoms and they’re unaware they’re infected with HSV.

Within a few weeks, your immune system clears up the primary infection, but HSV stays in the nerve cells it first infected. Healthcare providers refer to this as latency. It means the virus is present in your nerve cells but mostly inactive (you might hear this described as the virus being “asleep”).

During latency, most of the infected cells are sleeping, but a few are awake at any given time. Usually, this doesn’t cause an outbreak. Sometimes, infected cells “wake up” and cause enough of a stir that your immune system notices. This is HSV reactivation.

Reactivation is when infected cells wake up and trigger an immune response. There are a few possibilities at this point: