Symptoms of the first attack usually appear less than 7 days after sexual contact. Initially, red painful inflammatory area appears commonly on the clitoris, labia, vestibule, vagina, perineum and cervix. Multiple vesicles appear which progress into multiple shallow ulcers and ultimately heal up spontaneously by crusting. It takes about three weeks to complete the process. Inguinal lymphadenopathy occurs. Constitutional symptoms include fever, malaise and headache. There may be vulval burning, pruritus, dysuria or retention of urine.