Some people will have no recurrences. The great majority of people will have three or fewer recurrences per year. Some people will have more frequent recurrences. Recurrences are often minor (single, small blisters) but must be recognized because the blisters are contagious. Most people with long term recurrences will notice a decline in the yearly number of recurrences.
For persons with recurring Herpes, certain signs, called the prodrome, indicate the beginning of a new outbreak. People may feel a tingling sensation 24-36 hours before the blisters begin to appear. Herpes virus may be transmitted through direct skin to skin contact during the prodrome. It is believed that recurrences can be triggered by stress, fatigue, poor nutrition, menstruation, sexual intercourse, or illness that reduces the efficiency of the bodies immune system. Oral Herpes cold sores may recur from sun exposure.