Because it so contagious, HSV causes a primary infection in most people who are exposed to the virus.
However, only about 20% of people who are infected with HSV actually develop visible blisters or sores.
Repeat (recurrent) herpes simplex virus infections are often milder than the primary infection, though they look alike.
Shortly after exposure to the virus, a newly infected person may develop fluid-filled blisters (vesicles) or pus-filled bumps (pustules), occurring singly or in a group.
These vesicles and pustules are usually quite fragile, so many people never notice them but instead see tiny open sores (ulcers).
Herpes simplex virus infections occur in people of all races, of all ages, and of both sexes.
However, the 2 groups most commonly infected with HSV-2 include newborns, who contract it from their infected mothers during birth, and sexually active teenagers and adults, who contract it from their sexual partners.
The lymph nodes in the groin may or may not be swollen.
In severe cases of primary HSV-2 infection, people may develop fever, headache, neck stiffness, sensitivity to bright lights, muscle pain, painful urination, and discharge from the vagina or urethra.
Many people with recurrent sacral herpes infections report that the skin lesions are preceded by sensations of burning, itching, or tingling (prodrome).
About 24 hours after the prodrome symptoms begin, the actual lesions appear as one or more small blisters or open sores, which eventually become scabbed over.
These recurrent herpes simplex virus infections may develop frequently (every few weeks), or they may never develop.
Recurrent infections tend to be milder than primary infections and generally occur in the same location as the primary infection.
Nevertheless, the virus remains in the body, hibernating in nerve cells.