Herpes generally starts as small red bumps, often with a clear head like a small bubble or blister. The blisters later burst, leaving small, and usually very painful, open sores. Eventually the sores crust over and heal without leaving scars. Many people have pain, burning, or itching in the area, which can start before the sores appear.Two important points to remember:
A large number of those with herpes either have no symptoms, or such mild symptoms that they never know they are infected.
There are other diseases, some of which are sexually transmitted, that can also cause small sores.
The best way to tell if you have herpes is to get tested within the first 48 hours of any suspicious rash or bumps. Simple medical examination can diagnose herpes when the appearance is classic, but all herpes infections don’t look the same. This means examination isn’t always reliable. Not all sores are herpes, but you won’t know until you’re tested - so if you have sores, get them checked! Go early, preferably within 48 hours; once the sores are open the virus starts to die, so tests may not be accurate.Right now there is no perfect test for herpes. There are several tests available; each has advantages and disadvantages.
Testing from swabs of the sores:
Viral cultures are very accurate when they are positive for herpes, but at times they will falsely say that herpes is not present. Cultures are most accurate early in the outbreak, while the sores still look like small blisters. Cultures take seven to ten days for results.
The FA or fluorescent antibody test is slightly less accurate at finding positive results, and has the same problem as a culture with false negatives. It is faster than a culture, giving a result within 2 or 3 days. Like cultures, this test is most accurate early in the outbreak.
Another test, PCR, is extremely accurate but also extremely expensive. Currently, doctors use this test in the rare cases of life threatening infections that could be caused by herpes. This type of severe infection mainly happens in people with damaged immune systems, such as those undergoing cancer chemotherapy.
Blood tests
There are two kinds, type specific, and nonspecific. A nonspecific test isn’t very helpful, since it will show positive for either type: HSV-1, a common infection from childhood, and HSV-2. Type-specific tests report which type of HSV is present. Most newer tests are type specific. Blood tests are very accurate, but only after 12 to16 weeks of infection.