​​How Long Does a Herpes Outbreak Last?

The herpes virus family include many types of infections, including HSV-1 and HSV-2, which may be sexually transmitted.

The viruses that cause different types of herpes are similar, but not the same.

An outbreak of herpes is uncomfortable.

This article explores different types of herpes, how oral herpes and genital herpes are treated, and how to know when you should see a doctor.

What is Herpes?

Herpes is a type of infection caused by the herpes simplex virus.

HSV-1 is common and widespread across the world, affecting around 67% of the global population.

There are other types of herpes viruses that are also common and cause infections like chickenpox, shingles, and mononucleosis.

Types of Herpes

There are eight herpes viruses that infect humans.

• Herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2) cause oral herpes and genital herpes. These are the most common types of herpes infections.

• Varicella-zoster causes chickenpox and shingles.

• Cytomegalovirus is a common virus that rarely causes symptoms or complications outside of infants or immune-compromised people.

• Epstein-Barr virus causes mononucleosis. 

• Human herpesvirus 6 type A or type B causes a common childhood illness known as roseola.

• Human herpesvirus 7 causes an illness very similar to roseola.

• Kaposi’s sarcoma virus (also known as human herpesvirus 8) causes a rare type of cancer primarily in people who have HIV or AIDS.

Herpes Outbreak Symptoms

When most people refer to a herpes outbreak, they mean genital herpes or HSV-2.

However, HSV-1 can also cause genital sores, although most commonly it causes cold sores or fever blisters in or around the mouth.

Both types of the herpes simplex virus can result in outbreaks of sores that are highly contagious from direct contact with the fluid in the sores or from an infected person’s saliva.

The symptoms of a herpes simplex virus outbreak or a reactivated virus can be similar between HSV-1 and HSV-2.

Both HSV-1 and HSV-2 may lead to painful sores or blisters that form in or around the mouth, nose, chin, cheeks, eyes, genitals, anus, and inner thighs.

• HSV-1 most commonly causes cold sores around the mouth or on the face. Around 67% of the world’s population under age 50 have this virus.

• HSV-2 most commonly causes sores around the genitals, anus, or thighs. Around 13% of the world’s population under age 50 have this viral strain.

Signs of a herpes outbreak can be similar between both types of virus. They include:

• Tingling, itching, burning, or numbness 1-3 days before sore outbreaks
• Fever
• Fatigue
• Swollen lymph nodes
• Headaches or body aches

Both viruses can be asymptomatic, even when someone is contagious.

How Long Does an Oral Herpes Outbreak Last?

Oral herpes outbreaks typically resolve on their own, with or without treatment, in 1-2 weeks.

Using antiviral medication or topical creams at the first sign of an outbreak may be able to prevent or shorten the duration of an active cold sore outbreak.

How Long Does a Genital Herpes Outbreak Last?

The first outbreak of genital herpes typically lasts for an average of 20 days.

Recurrent outbreaks are typically shorter and may last around 10 days.

Using antiviral medications may be able to shorten the duration.

People who are immune compromised may experience longer outbreaks.

What Causes Recurrent Herpes Outbreaks?

Once a patient acquires a herpes virus, it stays in the body for life.

The immune system puts viruses into dormancy.

Many people get the herpes simplex virus and never experience an outbreak or symptoms.

Others will have an initial outbreak, but no recurrences.

Some people get more frequent herpes outbreaks.

HSV-1 or oral herpes causes an average of one recurring outbreak after the initial infection for between 20-50% of people who have the virus.

HSV-2 causes an average of four outbreaks in the first year for as many as 90% of people who have the virus.

Outbreaks of herpes simplex typically become less frequent, and less severe, the longer the virus is in the body.

People who have compromised immune systems may experience more frequent, or more severe, outbreaks.

Herpes Treatment Options

There is no cure for herpes viruses.

But there are antiviral treatment options that may shorten or prevent future outbreaks and help to manage pain and discomfort.

• Oral antiviral medications: Common prescription medications that can treat herpes blisters include acyclovir (Sitavig, Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex).

• Topical antiviral creams: For cold sore outbreaks, topical antiviral creams can help shorten the duration of an outbreak by approximately one day. Some are available OTC, like docosanol 10% (Abreva), benzyl alcohol (Zilactin-L), and dimethicone with sunscreen (Herpecin-L). Others require a prescription, such as penciclovir cream (Denavir) or acyclovir cream (Zovirax).

When to See a Doctor

If you experience signs of a herpes outbreak, either with cold sores around the mouth or with herpes blisters around the genitals, you should see your doctor.

If it is a first outbreak, a medical provider can give you an accurate diagnosis.

If it is a recurring outbreak, a healthcare provider may be able to prescribe medication to shorten the frequency of outbreaks.

While there is no cure for oral or genital herpes, some prescription and OTC treatments may relieve discomfort.

How K Health Can Help

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