Herpes infections may be painless or slightly tender. In some people, however, the blisters or ulcers can be very tender and painful. In women, the lesions may be visible outside the vagina, but commonly occur inside the vagina where they can cause discomfort or vaginal discharge but cannot be seen except during a doctor's examination. First outbreak The first herpes outbreak is usually the most painful. And the initial episode may last longer than later outbreaks.
Some people develop other signs of herpes infection, particularly with the first episode.
Later outbreaks If the disease returns, later outbreaks generally have much less severe symptoms. Many people with recurrent disease develop pain in the area of the infection even before any blisters or ulcers can be seen. This pain is due to irritation and inflammation of the nerves leading to the infected area of skin. People who notice these symptoms should realize that these are signs that an outbreak is about to start. They are particularly contagious during this period, even though the skin still appears normal.