Stages of Herpes

Herpes sores usually move through a predictable pattern. Knowing the stage helps you know when the virus is most contagious.

Oral and genital herpes

1. Prodrome (day 0 to 2): tingling, itching or burning where the sore will appear. The virus is already active, so avoid contact.
2. Redness and swelling: the skin becomes red and tender.
3. Blisters: small fluid-filled blisters form and the virus is very contagious.
4. Ulcer: blisters burst and leave painful open sores. Contact is most risky at this stage.
5. Crusting: a scab forms.
6. Healing: the scab falls off, usually without a scar. Most episodes last 1 to 3 weeks.

Between episodes

The virus lies dormant in nerves. It can still shed without symptoms.

Shingles

1. Pain phase: burning or tingling for 1 to 5 days before any rash.
2. Rash and blisters: a one-sided band of blisters.
3. Crusting: blisters dry out in 7 to 10 days.
4. Healing: over 2 to 4 weeks. Some people go on to have long-lasting nerve pain (postherpetic neuralgia).

When the stage matters

Antivirals work best when started early in the prodrome or in the first 72 hours of the rash.

Key point

Avoid kissing, sexual contact and sharing towels from the first tingling until the sore has fully healed.

Before your appointment

Note when the first symptoms began, where the sores or rash are, and any fever or pain. List past episodes, triggers, partners who should know, and any pregnancy. Bring your medicines and past reports, including HIV or STI tests. Ask about antiviral options, how to protect others and the warning signs that mean you should call 112 or 102.