At the beginning of the infection, the herpes virus escapes the immune defenses by entering the nerve endings and travelling to the ganglia, which are clusters of nerve cells. In the ganglia, the virus is inactive and it causes no harm to the body or the nerve cells. From time to time, however, the virus can be reactivated. When that happens, it travels back down the nerve to the surface of the skin. There it starts to multiply, causing another outbreak.
Recurrences usually develop near the site of the initial infection.
During a first episode, the immune system develops antibodies and other weapons against the virus. As a result, there are usually fewer sores, they heal faster, and the outbreak is less painful. The flu like symptoms of the first outbreak are seldom present. Herpes infections have different patterns in different people. A recurrence of the herpes infection may occur when latent viruses are triggered by immunosuppressive events such as emotional stress, sunlight, menses, cold or fevers, certain foods , beverages, vitamins and medications.