For each person, a herpes outbreak is different. But there are overarching similarities between herpes outbreaks. For most people, the herpes outbreak will occur in the same physical location of the original infection each time (or close to it, since for each outbreak herpes travels from the spine to the surface of the skin via nerve cells that branch off). Normally, genital herpes will show up as one, a few or a small cluster of very small blisters (see herpes pictures). For others, they can have what resemble paper cut outbreaks.
The best way to know if herpes symptoms are sneaking up on you? Pay attention to your body. People commonly report feeling a slight burning or itching. For most of the time, herpes lies dormant in the body in the sacral ganglion at the base of the spine. (For some, herpes dormancy can last forever without ever having a visible outbreak, but be aware of viral shedding!) Since herpes uses the nerve pathways to travel from the spine to the surface of the skin, some people report cramps in the back of their legs before getting a herpes outbreak. When you become more knowledgeable about your own body, you can pick up on signals of an impending outbreak. Then you can be proactive and take your anti-viral medication to hopefully avert the outbreak altogether.