It is important to know that herpes, whether oral or genital, does not strike all at once. There is a progression — at one point you may not feel pain yet, but as the days or weeks go by, the pain increases until it becomes unbearable.
Distinguishing herpes symptoms is important, but knowing the stage of the infection is crucial. Not only does it give you a perspective on how the virus is affecting your body, but detecting the infection as early as possible allows you to treat it at once without increasing your risk for further complications and pain.
Stages of Oral Herpes
If you’re infected with the herpes simplex 1 virus, or HSV-1, you have oral herpes.1 There are six known stages of this disease:2
During this stage, the herpes virus comes into contact with the skin, causing a tightening or tingling sensation. The skin will also start to redden. After one to two days, the skin will become irritated or itchy, and there will be pain in the affected area/s.
2. Inflammation and Swelling
Unfortunately, most herpes patients are unable to notice that they’re already in the first stage and fail to have the infection treated. This makes them prone to a herpes outbreak. This stage is usually characterized with the patient having inflamed and swollen skin.
3. Formation of Blisters
Fluid-filled cold sores or fever blisters3 that are either red, white or clear, begin to form on the swollen area and stay for about two days. They may appear in clusters or groups or develop separately. Be careful, as they can be sensitive to the touch.
The sores will burst and the fluid will begin to discharge, leading to the formation of wet ulcers. Just like cold sores, these ulcers are very sensitive. They’re reddish and resemble a small cut. Although these ulcers generally disappear after a day, they’re one of the most painful stages of oral herpes.
5. Crusting or Scabbing
The healing process of the sores begins. Herpes patients will see a crust developing above the wet blister, which will then harden into a scab. In two to three days, new skin will form under the scab. This process will lead to the cracking and bleeding of the scab, as well as pain, itchiness, or dryness.
6. Complete Healing
In a few days, the scab that forms on a herpes blister will fall off and reveal fresh and virus-free skin underneath. Don’t pull the scab off before the wound is completely healed, as it might scar instead.
Stages of Genital Herpes
Genital herpes caused by the herpes simplex 2 (HSV-2) virus4 is also characterized by having six known stages, which are:5
The herpes virus becomes active in the skin, constantly moving towards the surface of the skin to cause an outbreak. People with genital herpes are considered to be highly contagious during this stage.
Tingling or itching in the affected area and pain on the buttocks and legs can be felt at this point. Some patients may also feel pain while urinating, and female patients may notice some vaginal discharge. Viral shedding, wherein the herpes virus residing in your skin can be easily transferred to others, also happens at this period.
2. Skin Redness
Portions of the skin affected by the virus will turn red and become very sensitive. Plus, the areas where the outbreak is happening may also rise up, as the virus makes its way to the skin’s surface. This will last for one to four days, with patients being very contagious at this stage as well.
3. Formation of Lesions
The very first lesions or herpes sores6 appear. Genital herpes patients see these around the genitals, either individually or in clusters. These blisters contain virus-filled fluid, and grow to become very painful. This stage lasts for two to six days, and patients are advised to wear loose and comfortable clothing and avoid doing activities that may irritate the skin during this timeframe.
4. Development of Lesions
The virus reaches its tipping point as these lesions continue to grow — the infection is at its most contagious during this stage. Eventually, the sores will crack open and release the fluid built up inside. The sores may stay open for one to four days.
Herpes patients should make sure that the areas with the sores are dry and clean. Apart from loose and comfortable clothing, herpes patients are recommended to wear cotton underwear to reduce irritation. Sexual contact is also prohibited, and touching of the affected areas should only be done when needed.
Once all the fluid has drained, the lesions will become dry and a scab will emerge. Some blisters, however, do not turn into scabs, but just disappear slightly until they’re no longer visible. Scabs stay on the skin for a couple of days. Patients are advised to refrain from touching or picking at the scabs to avoid scarring.
6. Complete Healing
You will know these sores have healed when the scab falls off or the lesion has faded on the skin. The sores may appear red, but will eventually fade as you recover. Healing time lasts for around three to seven days. In order to prevent the spread of the infection, sexual intercourse is not advised during this period.