Genital herpes is a sexually transmitted infection that can cause blisters and open sores (lesions) in the genital area, but it can also be asymptomatic, meaning a person shows no symptoms. Although there is no cure for the disease, the severity of the virus varies over the course of an infected person’s life. In fact, some people infected with herpes do not show any symptoms for long periods of time, but can still transmit the infection. There are two types of herpes simplex virus – herpes simplex I and herpes simplex II. Herpes simplex virus I usually causes oral herpes. It can present as an upper respiratory tract infection in early childhood. Herpes simplex virus II is the cause of most cases of genital herpes. Clinicians cannot tell the difference between the two types by physical examination alone, but there are differences between the two viruses. For example, genital herpes caused by herpes simplex II is much more likely to recur. Herpes simplex viruses are latent, which means they can live in the body without causing symptoms. After the initial infection, the virus enters the nerve roots and spreads to the sensory nerve ganglia, the places where nerves from different parts of the body come together. For the genital area, the ganglia are adjacent to the spinal cord in the lower back. In orofacial herpes (proceeding with the appearance of canker sores), the ganglia are located behind the cheekbones. While some people with genital herpes will never have any symptoms, other people may develop symptoms within a few weeks of being infected. Most people notice a cluster or group of blisters or sores (lesions). These lesions burn and can be painful. They can appear on the buttocks, anus or thighs, on the vulva or vagina in women and on the penis or scrotum in men. Often, before the lesions appear, patients describe a prodrome characterized by a tingling or burning sensation in the area where the lesions will develop, which can be noticed during urination, along with itching or discomfort in the genital area. You may also observe: Blisters on the lips; Fever, headache, or joint pain; Problems urinating Symptoms of genital herpes often go away and come back as recurring outbreaks. For most people, the first outbreak is the worst and can last two to three weeks. Future attacks are often less severe and do not last as long. However, some people transmit the virus regularly. Recurrent genital herpes occurs most often in the first year after the initial infection and decreases over time. In many cases, anti-herpes drugs can help patients. When a person experiences a prodrome and suspects that a relapse will occur, they start taking medications that reduce symptoms and shorten the time of the outbreak. References: Hopkins medicine