In the early phase of a recurring episode, many people feel an itching, tingling or painful feeling in the area where the lesions will develop. This can include pain in the buttocks, back of legs or even lower back. The prodrome often happens a day or two before an outbreak. How often a person gets a herpes outbreak depends upon the HSV type and how long the infection has resided in the body. Herpes triggers are poorly understood by scientists and appear to be highly individual.
Research shows that lengthy exposure to strong sunlight can trigger oral herpes.
Triggers for genital herpes include surgical trauma and excessive friction in the genital area. With time, people begin to recognize what will trigger an outbreak in their own bodies. The average number of recurrences or outbreaks is four to five. People with HSV-2 can also expect to have unrecognized outbreaks. These unrecognized outbreaks probably occur less often than symptomatic outbreaks, but account for about one-third of all reactivation.