The initial infection
When you're infected with the herpes simplex virus for the first time, the episode is called a primary infection or initial infection. It usually happens when you're a child from close contact (eg, kissing) with a relative who has the virus. It can take 1 to 3 weeks to show any symptoms.
The first infection can be so mild you don’t notice it, but it’s usually the hardest. It lasts for 10 to 14 days. You may have the following symptoms:
- Fever (high temperature) which lasts for 3 to 5 days.
- Many sores around your mouth, nose, gums, throat and palate (roof of your mouth).
- Eating can be painful.
- Bad breath.
- Tiredness.
- Tender, enlarged lymph nodes in your neck.
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The herpes simplex virus remains hidden in your nerves for the rest of your life. It can become active again from time to time causing a cold sore. This will usually show up in the same places where you‘ve had an infection before. Cold sores don’t usually come back more than once a year, but about 5 to 10% of people get 6 or more episodes a year.
The virus can be triggered to become active by a fever (eg, a common cold), menstruation, skin damage, UV radiation (exposure to sunlight), extreme tiredness or lowered immune function.
An outbreak
An outbreak has 4 stages:
- A tingling feeling in your skin.
- Over the next 48 hours, you may notice slight swelling of the area and then a group of of fluid-filled blisters come up, which are often painful.
- Over the next few days, the blisters burst and form clusters, leaving fluid-filled sores.
- After 8 to 10 days, the sores eventually dry, scab over and heal without scarring. This stage can be irritating and painful.
You're contagious (able to pass the virus on) from the moment you first feel tingling or other signs of a cold sore coming on until the cold sores are completely covered by dry scabs.