If you have recently been infected with genital herpes then you can expect your first outbreak to be the longest and most painful. This is because your body has not yet created antibodies to fight off the infection.

Most people with genital herpes will never know they are infected. In fact, 90% of people who carry the genital herpes virus show no symptoms or their symptoms are so mild that they are mistaken for something else like a yeast infection or jock itch. 

If you do have an outbreak you can expect it to start anywhere from 2 to 12 days after first becoming infected. However, it is important to remember that this varies greatly. Some people do not experience their initial outbreak for months or even years after first becoming infected.  

Here is a list of symptoms commonly experienced during the initial outbreak:

- Flu-like symptoms including fever, aches, and pain

- Swollen glands

- Vaginal discharge

- Swelling

- Itchy and painful skin

- Sores, lesions, and blisters (these can vary in both size and number - they can be located on the genitals, thighs, buttocks, or near the anus)

The initial genital herpes outbreak usually lasts between 2 and 12 days but can sometimes last as long as a month.

You can reduce the duration and severity of your initial outbreak by taking prescription anti-viral medication. There are currently three available options when it comes to medication – acyclovir, famciclovir (Famvir), and valacyclovir (Valtrex). All three of these medicines work in the same way reducing the ability of the herpes virus to reproduce.

According to the Centers for Disease Control and Prevention (CDC) the currently recommended regimens for these medications are as follows:

Acyclovir – 400 mg orally three times a day for 7 to 10 days

Or

Acyclovir – 200 mg orally five times a day for 7 to 10 days

Or

Famciclovir – 250 mg orally three times a day for 7 to 10 days

Or

Valacyclovir – 1000 mg orally twice a day for 7 to 10 days

Your doctor may prescribe a different dosage regimen for you if you are obese or if your symptoms last longer than 10 days.

It is important to start treatment for initial herpes infection immediately. It is recommended that treatment be started within six hours of your first symptoms. Doing this will both shorten and reduce the severity of your outbreak. In some cases this has actually stopped the outbreak completely. During the initial stages of an outbreak, the herpes virus is busy producing as many copies of itself as it can. If you start taking anti-viral medication during this time you will limit the number of viruses present which will result in fewer and smaller sores.  And it is much easier for your body to fight off a handful of small herpes blisters than it is to fight off dozens of large blisters. 

Along with treatment for initial herpes infection, obtaining laboratory confirmation is also important. Testing is most accurate if done during the initial outbreak when there are active sores present. Testing will let you know which type of genital herpes virus you are carrying. One of these virus types leads to many more recurrent outbreaks and is much more contagious than the other. Getting tested during your initial outbreak will also let you know if you have acquired this virus recently or some time ago. If you do not get tested during this first outbreak then it will no longer be possible to know when you acquired the infection.