The virus starts to multiply when it gets into the skin cells. The skin becomes red and sensitive, and soon afterward, one or more blisters or bumps appear. The blisters first open, and then heal as new skin tissue forms. During a first outbreak, the area is usually painful and may itch, burn or tingle. Flu-like symptoms are also common. These include swollen glands, headache, muscle ache or fever. Herpes may also infect the urethra, and urinating may cause a burning sensation.