Recurrent infections differ from first infections in that the blisters are usually smaller in size and more closely grouped. They also tend to be of shorter duration than the initial infection, usually 5-10 days. Generally the affected person feels quite well. Itching or burning can precede by an hour or two the development of small, closely grouped blisters on a red base. These then produce shallow ulcers, on the glans or shaft of the penis in men and on the labia, vagina or cervix in women.
Recurrences can cause distressingly painful symptoms.
In other individuals the lesions can be unnoticed. Lesions normally heal in 7-10 days without scarring. Recurrences tend to be in the same region, but not always at the identical site. Symptoms include fever, rectal pain, watery discharge, and autonomic nerve dysfunction that may result in difficulty passing urine. Meningitis occasionally occurs.