In fact, “atypical symptoms” are the reason that so many people don’t know they have herpes. Their reality is nothing like the scary images that pop up when you Google image search the term. Atypical symptoms include things like nerve pain, achy muscles, itching, and tingling. Some women I talked to reported being misdiagnosed with frequent yeast infections or bacterial infections before receiving their herpes diagnosis. “With your first episode, you can have fever, fatigue, and flu-like symptoms,” says Cullins.
Herpes simplex is a viral infection caused by the herpes simplex virus. Infections are categorized based on the part of the body infected. Oral herpes involves the face or mouth. It may result in small blisters in groups often called cold sores or fever blisters or may just cause a sore throat. Genital herpes, often simply known as herpes, may have minimal symptoms or form blisters that break open and result in small ulcers. These typically heal over two to four weeks. Tingling or shooting pains may occur before the blisters appear. Herpes cycles between periods of active disease followed by periods without symptoms. The first episode is often more severe and may be associated with fever, muscle pains, swollen lymph nodes and headaches. Over time, episodes of active disease decrease in frequency and severity. Other disorders caused by herpes simplex include: herpetic whitlow when it involves the fingers, herpes of the eye, herpes infection of the brain, and neonatal herpes when it affects a newborn, among others.
Patients with genital herpes have reported that outbreaks or episodes typically diminish through the years. Early prodromal symptoms, or warning signals, that are followed by outbreaks. These prodromal symptoms often include mild tingling or shooting pains in the legs, hips and buttocks, and can last from 2 hours to 2 days. After the prodromal symptoms occur the blisters develop into painful red spots, which then evolve into yellowish, clear fluid-filled blisters after a day or two. These blisters burst or break and leave ulcers that usually heal in about 10 days. In women, blisters can develop inside the vagina and cause painful urination.
Oral herpes is a viral infection mainly of the mouth area and lips caused by a specific type of the herpes simplex virus. Oral herpes is also termed HSV-1, type 1 herpes simplex virus, or herpes labialis. The virus causes painful sores on the upper and lower lips, gums, tongue, roof of the mouth, inside the cheeks or nose, and sometimes on the face, chin, and neck. Infrequently, it may cause genital lesions. It also can cause symptoms such as swollen lymph nodes, fever, and muscle aches. People commonly refer to the infection as "cold sores."
Although the exact cause of Bell's palsy—a type of facial paralysis—is unknown, it may be related to reactivation of HSV-1. This theory has been contested, however, since HSV is detected in large numbers of individuals having never experienced facial paralysis, and higher levels of antibodies for HSV are not found in HSV-infected individuals with Bell's palsy compared to those without. Antivirals may improve the condition slightly when used together with corticosteroids in those with severe disease.
A person may show symptoms within days after contracting genital herpes, or it may take weeks, months, or years. Some people may have a severe outbreak within days after contracting the virus while others may have a first outbreak so mild that they do not notice it. Because of these possibilities, it can be difficult for people to know when and from whom they may have contracted the virus.