Sexual Health STIs Herpes How Long Can Herpes Be Dormant? By Christine Zink, MD Christine Zink, MD LinkedIn Dr. Christine Zink, MD, is a board-certified emergency medicine physician with expertise in global medicine. She utilizes 15 years of clinical experience in her medical writing. Learn about our editorial process Published on October 17, 2022 Medically reviewed by Chioma Ndubisi, MD Medically reviewed by Chioma Ndubisi, MD Chioma Ndubisi, MD, is a board-certified OB/GYN who specializes in sexual and reproductive health in New York, New York. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Incubation Period Dormancy Period Symptoms Outbreaks What to Expect Frequently Asked Questions Herpes is a common contagious viral infection that can cause cold sores around the mouth or small, burning blisters and ulcers in the genital area. Once contracted, the herpes virus does not leave the body, even with treatment. The herpes virus remains dormant in a part of a nerve called the ganglion. Certain life events or reactions can lead to the reactivation of the virus and recurrent ulcers around the mouth or genital region. This article discusses the difference between a herpes incubation period and a dormancy period. It will go into the symptoms of a herpes outbreak and what you can expect from a lifelong infection with the virus. Westend61 / Getty Images Herpes Incubation Period Herpes is an infection with herpes simplex virus-1 (HSV-1) or herpes simplex virus-2 (HSV-2). HSV-1 is more often associated with oral herpes, also known as cold sores, but the virus can spread to the genital area. HSV-2 leads to genital herpes. The viruses are transmitted through saliva, genital secretions, mucosa (such as the oral, vaginal, and anal linings), skin contact, and from a pregnant person to a fetus or newborn. Activities leading to transmission can include kissing and sex (including oral sex). When a person contracts a herpes virus, it moves from the skin or mucosal membrane to a part of a sensory nerve in the spinal cord called the ganglia. Shortly after that, a person develops symptoms of an initial herpes outbreak. The incubation period is the time between acquiring the virus and developing symptoms. For a herpes infection, this period usually lasts around four days but can be as long as 12 days. The first episodes of blisters and ulcers may last a few weeks before fully healing. This first outbreak is usually the worst (there are more ulcers, and it lasts longer). Herpes Dormancy Period After the first outbreak of herpes, the lesions heal, and the virus remains dormant in the sensory nerve ganglia. This means that a person still holds the virus in the body but does not have active disease with skin lesions or other symptoms. The duration of the dormancy period is different for each individual. Some people will have an initial herpes outbreak and never have an episode with symptoms again. In contrast, other people have frequent episodes of symptoms several times a year. Specific triggers appear to be related to an outbreak in some individuals. They include: Recent sexual intercourseStressRecent infectionRecent surgeryPregnancy or menstruationA weakened immune system There is no way to know whether a specific individual will have more frequent outbreaks. However, people with human immunodeficiency virus (HIV) or other problems with immunity seem to have more frequent attacks. People with HIV also seem to have more severe episodes of herpes. Herpes Symptoms Most people with herpes do not develop any symptoms or have very mild blisters that can be mistaken for pimples. When significant symptoms develop, herpes is characterized by painful blisters and ulcers around the mouth or genital region. People can also develop blisters in the anal area. People with genital herpes may also have swelling of lymph nodes in the groin. Increased Risk for Other Sexually Transmitted Infections Herpes is a sexually-transmitted infection. People with a sexually transmitted infection are at increased risk for other sexually transmitted infections, so it is crucial to be tested for all of them. Other symptoms associated with herpes include: Tingling in the genital areaShooting pain down the thighsFeverHeadacheFatigueMuscle aches Herpes Outbreak If a person contracts a herpes virus, there is a high likelihood they will not even know it. Most do not develop symptoms. However, if a person does develop symptoms, it is usually shortly after contracting the virus. The first outbreak is typically the worst. People who develop recurrent attacks of herpes can often feel a prodrome, meaning they have mild symptoms that indicate a herpes attack is coming on. Prodrome symptoms often include fatigue and tingling or itching in the genital area. The prodrome is excellent time for a person to start preventive antiviral therapy to prevent the ulcers from developing or to shorten the duration of symptoms. Options for the treatment and prevention of herpes include Zovirax (acyclovir), Famvir (famciclovir), and Valtrex (valaciclovir). Herpes Outbreak Prevention Daily oral medication can reduce outbreaks in people with frequent outbreaks. It can also reduce the risk of transmission to a partner who had not contracted herpes. What to Expect A person will never be able to get rid of HSV-1 or HSV-2 or be cured of the infection. Each individual is different in how often they will have recurrent outbreaks. However, most people do not have recurrent lesions very often. When they do, the episodes become shorter in duration and less severe. When you live you herpes, you face the psychological burden of having a lifelong disease that a person can transmit to a partner. Complications Some people can develop rare complications from infection with herpes, particularly in newborns or people with weakened immune systems and HIV infection. Complications include: Encephalitis (inflammation of the brain) Meningitis (inflammation of the linings around the brain) Hepatitis (inflammation of the liver) Pelvic inflammatory disease (inflammation of the female reproductive organs in the pelvis) Pneumonitis (inflammation of the lungs) Summary Herpes is a common contagious viral infection that leads to cold sores around the mouth and ulcers in the genital region. Once a person contracts HSV-1 or HSV-2, they have a lifelong infection. Most people are unaware of herpes infection because they never develop symptoms. If a person develops symptoms, it usually occurs within four to 12 days. Over a lifetime, a person might have recurrent outbreaks, but these outbreaks become less severe and less frequent. The virus remains dormant inside sensory nerves when people are without symptoms, but they are still contagious even without symptoms. It is important to use a condom during sex to avoid infection with herpes. A Word From Verywell Infection with herpes can be painful, embarrassing, and psychologically distressing due to the lifelong nature of the illness. It is possible to reduce the number and the severity of the outbreaks by taking antiviral medication that keeps the virus dormant. However, a person can still spread the virus even when symptoms are not present. The best protection to prevent transmission is using a condom during sex. Frequently Asked Questions How long can you have herpes without knowing? Most people infected with the herpes virus do not develop symptoms or have such mild symptoms they are never aware that they have the disease. People who become symptomatic develop symptoms of a first outbreak about four days after contracting the virus. Is herpes still contagious after 10 years? Over time people have fewer herpes outbreaks, which means they develop open sores that spread the virus less frequently. However, the virus can still be passed to another person when sores are not present. A person with herpes can still give the virus to somebody else years after infection. How do you keep herpes dormant? Most people may never know that they are infected with a herpes virus, and often people do not have frequent outbreaks. However, people with frequent herpes outbreaks can keep the virus dormant or prevent an attack by taking suppressive antiviral medication.Sometimes a healthcare provider will recommend taking the medicine when prodromal symptoms begin or taking the antiviral medication daily. Will you still test positive for herpes during the incubation period? The preferred test to confirm a herpes diagnosis is sampling an active ulcer. Since people do not have open sores during the incubation period, it is impossible to sample a lesion. Blood tests are available to look for antibodies against the virus, but these tests are highly inaccurate, with false-positive results. Additionally, people typically do not develop antibodies to the virus until weeks or months after exposure. 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. Genital herpes -- CDC fact sheet. Groves MJ. Genital herpes: a review. Am Fam Physician. 2016;93(11):928-34. MedlinePlus. Herpes - oral. MedlinePlus. Genital herpes - self care. Centers for Disease Control and Prevention. Genital herpes-sexually transmitted infection treatment guidelines, 2021. Pratt LA, Xu F, McQuillan GM, Robitz R. The association of depression, risky sexual behaviours and herpes simplex virus type 2 in adults in NHANES, 2005-2008. Sex Transm Infect. 2012;88(1):40-4. doi:10.1136/sextrans-2011-050138 Centers for Disease Control and Prevention. Genital herpes. By Christine Zink, MD Dr. Christine Zink, MD, is a board-certified emergency medicine with expertise in the wilderness and global medicine. She completed her medical training at Weill Cornell Medical College and residency in emergency medicine at New York-Presbyterian Hospital. She utilizes 15-years of clinical experience in her medical writing. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit