What Does Herpes Look Like?

One in six people in the United States has, knowingly or unknowingly, had a herpes infection at least once. While only one-third of those affected with this sexually transmitted infection show any symptoms, even those who do are unable to successfully identify it like herpes. Why is that?

Herpes brings with it a rash that resembles quite a lot of different conditions – another sexually transmitted disease such as warts or syphilis, ingrown hairs, bacterial vaginosis, yeast infections (thrush), hemorrhoids, bug bites, irritation caused by shaving, and quite commonly, pimples.

You would not want to mistake something serious like herpes with something very routine like acne (pimples). Therefore, it is important to understand what can be mistaken for herpes and what herpes really looks like.

Pimples vs Herpes Blisters – Why do they happen?

Before we delve into what herpes looks like, let’s first take a look at why it happens. It is a sexually transmitted disease, caused by skin-to-skin contact (including kissing, oral sex, vaginal sex, and anal sex) with the infected area of someone who has the Herpes Simplex Virus (HSV).

HSV comes in two forms, of which HSV-1 presents itself as blisters on the mouth (oral region), including cold sores and fever blisters, and is thus associated with oral herpes. Meanwhile, HSV-2 affects the genital region and causes genital herpes. This does not mean that anyone with blisters on their mouth must have been infected with HSV-1, as they could very well have inherited HSV-2 from an infected partner’s genitalia via oral sex.

On the other hand, pimples are linked to hygiene issues. They arise when dirt or oil clogs up the pores (oil glands or sebaceous glands) on the skin, increasing the likelihood of bacterial infection and inflammation. The pores may also be clogged by other conditions such as folliculitis (fungal infection in a hair follicle) or contact dermatitis (skin contact with an allergen).

Identifying the sores

Pimples and herpes rashes appear as small, red bumps full of pus on the skin of your mouth or genital region. Both also may itch, but there are considerable differences between the nature, pus, and location of the two, which is what allows you to never mistake pimples for herpes.

Nature

Herpes looks like white, yellow, or red translucent sores or bumps, filled with a clear liquid, whereas pimples are pink or red and are not see-through. While pimples may appear individually as well as in clusters but in recognizable patterns, herpes sores are primarily observed in a bunch.

Pimples are perfectly round and feel firm and hard if you touch them. They itch but they are not painful unless you especially apply pressure to them. On the other hand, herpes sores are extremely painful red ulcers, lying on skin that has also become itchy, reddish, inflamed, and sensitive.

Herpes rashes occur in recurrent cycles of about 2 weeks, which include their appearance, growth, and crusting before eventually bursting to leave behind an ulcer-like sore and scrabs. The bursting is very painful itself. This cycle keeps repeating until there is medical intervention, and before the appearance of the next sore, there is a painful and sensitive itching sensation. The first occurrence is the most painful one.

If you feel like your sores keep appearing and then disappearing, it is most likely herpes because pimples follow no such cycle. They can appear anytime and clear up quickly on their own, the time of fading depending upon the amount of pus stored within.

Discharge

Besides knowing what herpes looks like, it is also crucial to understand what herpes discharge looks like and how that differs from that of pimples. As established above, herpes sores are filled with a clear liquid, but pimples store thick, white pus inside.

In both circumstances, the pus leaks upon the skin if the blister is burst, squeezed, or scratched, enhancing the risk of secondary infections. This is why it is strictly advised to not burst any sore or pimple.

Bursting either of them can also mean a discharge of blood. While the sores are themselves not full of blood, bursting of the skin underneath will cause bleeding.

Location

Since pimples are caused by clogged-up pores, they are located within the pores themselves. This means that they are embedded into the deep layers of the skin, as opposed to herpes sores which lie externally on the surface of the skin. Pimples only expand above the skin if they accumulate enough pus to do so.

Herpes sores appear on the mouth region, as well as the genital region which not only includes the genitalia (penis and vagina) but also areas such as the rectum, buttocks, cervix (in women), and thighs. On the other hand, pimples can appear anywhere.

It is more likely for pimples to appear in areas where sweat and dirt can accumulate, such as where you wear tight clothing, for instance, tight underwear, bra, jockstraps, etc. Their occurrence increases during summers because your whole body may sweat then.

Other symptoms

To not mistake pimples for herpes, it also helps to consider whether the sores are isolated or are accompanied by other symptoms which include:

• Very high fever
• Joint pain and achiness
• Fatigue
• Headaches
• Pain and a tingling sensation in the legs
• Enlarged lymph nodes
• Vaginal or penile discharge – this herpes discharge looks like a thick, clear, white/cloudy liquid

How do you know for sure?

If the nature, location, and other characteristics of your sores are not enough for you to draw a confident conclusion, medical testing is the only way to have a definitive answer. This can mean any one of the following tests:

• Laboratory testing (Culture Test): A swab of the fluid sample from the blister is obtained within 48 hours of the appearance of the first symptoms to test for the viral culture.
• Blood Test (Antibody Test): Conducted a couple of weeks after the initial symptoms, this searches for any antibodies produced against HSV-1 or HSV-2.
• Polymerase Chain Reaction (PCR Test): The most expensive of all, it looks for HSV’s genetic material

Pimples test negative for all these tests.

What do I do now?

Once you successfully identify the nature of your sores, which should be an easy task now that you know what herpes looks like, the management is not that complex either. Since pimples are a hygiene issue, it only means a more thorough cleaning with effective products such as acne ointments, antibacterial soap and creams, oil ointments for inflammation, and patting with a warm, wet cloth a few times a day.

See Also: Raising Awareness About Hemophilia and Bleeding Disorders

On the contrary, if you have even a little doubt that your sores may be herpes, you should visit your primary care physician and get an anti-viral prescription. Herpes may be incurable but anti-viral is more than enough to stop it from affecting your quality of life at all. Early identification is the key to a better life.

Genital Herpes | Johns Hopkins Medicine

Genital herpes is a sexually transmitted infection that can cause blisters and open sores (lesions) in the genital area, but it can also be asymptomatic, meaning a person does not show symptoms.

Genital Herpes Overview

In the United States, about 1 in every 6 people ages 14 to 49 have genital herpes.

While there is no cure for herpes, the severity of the virus varies over the course of an infected person’s lifetime. In fact, some people with the disease do not experience any symptoms for extended periods. They may still shed the virus, though, even when no symptoms are present.

What are the different types of herpes?

There are two types of herpes simplex virus: HSV I and HSV II. HSV I commonly causes oral herpes, or cold sores. This virus can show up as an upper respiratory tract infection during early childhood. HSV II is the cause of most cases of genital herpes. However, it is possible for HSV I to cause genital herpes and HSV II to cause oral herpes.

Clinicians cannot tell the difference between the two types by physical examination alone, but there are differences between the two viruses. For example, genital herpes caused by HSV II is much more likely to recur. This diagnosis can be helpful in establishing a health care plan.

What causes genital herpes?

You can catch genital herpes by having vaginal, anal or oral sex with someone who has the disease.

Where does the herpes virus live in the body?

The herpes simplex viruses are latent, meaning they can live in the body without causing symptoms. After the initial infection, the virus gets into the nerve roots and spreads to the sensory nerve ganglia, the junctions where nerves from different parts of the body come together. For the genital area, the ganglia are adjacent to the spinal cord in the lower back. For orofacial herpes (cold sores), the ganglia are located behind the cheek bone.

How common is genital herpes?

According to the Centers for Disease Control and Prevention, approximately 40 million to 50 million adults in the United States have genital herpes. HSV II infection is more common in women and in people who have had more than five sexual partners. Most people with HSV II do not know they have it, because it does not always cause symptoms.

What does genital herpes look like?

While some people with genital herpes will never have any symptoms, other people can develop symptoms within a few weeks of being infected.

Most people notice a group or cluster of blisters or ulcers (lesions). These lesions burn and can be painful. They can appear on the buttocks, anus or thighs, on the vulva or vagina in women, and on the penis or scrotum in men.

Often, before the lesions appear, patients describe a prodrome, characterized by a tingling or burning sensation in the area where the lesions will develop that can be noticed during urination, along with itching or discomfort in the genital area.

You can also have the following symptoms:

• Blisters on the mouth or lips
• Fever, headache or pain in the joints
• Trouble urinating

The symptoms of genital herpes often go away and come back as recurring outbreaks. For most people, the first outbreak is the worst, and can last from two to three weeks. Future flare-ups are often less severe and do not last as long. Still, some people shed the virus regularly. The following triggers can make outbreaks more likely to occur:

• Viral or bacterial infections
• Menstrual periods
• Stress

Recurrent genital herpes is most common in the first year after the initial infection and decreases as time goes on.

In many cases, anti-herpes medicine can help patients. When a person experiences a prodrome and suspects a recurrence is going to happen, they begin taking anti-herpes medications that lessen symptoms and shorten the time of the outbreak.

What if I don’t have lesions?

Most people with genital herpes don’t have lesions. Many people don’t realize they have genital herpes until a blood test reveals they have antibodies to the virus.

How does genital herpes spread?

Herpes can be spread when an infected person has lesions — blisters and open sores — on their body or when you do not have any symptoms. Taking antiviral medicine can help you reduce the risk of spreading genital herpes to your sexual partners. You can also:

• Inform your sexual partner that you have genital herpes.
• Use a condom every time you have sex.
• Refrain from having sex when you have symptoms.
• Abstain from performing oral sex if you have blisters or open sores around your mouth.

Do condoms help prevent the spread of genital herpes?

Yes. To prevent transmission of herpes, we recommend that condoms be used 100% of the time. Many patients will shed the virus and be contagious when they don’t have symptoms. Studies have shown that asymptomatic shedding occurs between 1% and 3% of the time in patients with HSV II genital infections. Many new herpes infections occur from partners who are shedding the virus asymptomatically, so condoms are highly recommended.

Condoms may not be an attractive option for monogamous couples or for couples who desire to become pregnant. Couples may opt to have serological tests to determine if either partner has an asymptomatic infection. In close monogamous relationships, the risks of transmission can be weighed against other relationship issues, such as intimacy and pregnancy.

If you have genital herpes already, can it be spread to other parts of the body, such as the arms or legs?

No. Genital herpes cannot be transmitted to another part of your body such as your arm, leg or hand after the first infection occurs. If you have genital HSV II, you will not get HSV II at another site in your body. The immune system produces antibodies that protect other parts of your body from infection. However, there are cases where a person has multiple site infections from the same virus. This is usually acquired at the time of the first infection. For example, if someone has never had herpes but then has oral and genital sex with an infected partner, they can acquire the infection at both sites.

Can genital herpes be transmitted by oral sex?

Yes: Genital herpes (types I or II) can be transmitted by oral sex. A person with herpes who is shedding the virus can be contagious even if they don’t have lesions or symptoms, which is why the population of patients with genital herpes caused by HSV I is thought to be increasing.

I have cold sores in my mouth. Can I still get genital herpes?

Yes. Cold sores are usually caused by HSV I. People who have HSV I are susceptible to becoming infected with HSV II, the common cause of genital herpes.

How is genital herpes diagnosed?

If you have blisters in your genital region, your physician can order a test to determine if you have genital herpes. Your physician may take a sample of cells from the fluid inside the blister or order a blood test.

I had lesions when I was evaluated, but my culture was negative. Does this mean that I don’t have herpes?

Not necessarily. Although lesions can be caused by something other than herpes, false negative herpes tests can occur if the samples are not taken appropriately, if there is a long transport time between the clinic and the laboratory, or if cultures were taken late in the course of the lesions. Lesions that occur early in the course of a herpes outbreak are much more likely to have positive cultures than cultures taken after the lesions crust over.

Can genital herpes be treated?

Your physician can prescribe different medications to help reduce your symptoms and speed up the healing of an outbreak. These medicines work best when you start them soon after an outbreak occurs.

To reduce pain during an outbreak:

• Sit in warm water in a portable bath or bathtub for about 20 minutes. Avoid bubble baths.
• Keep your genital area clean and dry, and avoid tight clothes.
• Take over-the-counter medications, such as acetaminophen or ibuprofen. Avoid aspirin.

Let your physician know if you are worried about your genital herpes. He or she can recommend a support group to help you cope with the virus.

Can I be treated to prevent genital herpes transmission to my partner?

Yes. A large study showed that if one partner has herpes and the other partner is uninfected, treating the infected partner with suppressive therapy can prevent transmission of symptomatic herpes in over 90% of cases. This is an option for couples who are interested in having unprotected sex or who are planning to become pregnant.

If you are entering into a new relationship and are aware that you have herpes simplex infection, you owe it to your partner to notify them before having sex.

Can treatment help prevent multiple genital herpes outbreaks?

Suppressive therapy can address frequent outbreaks. Taking a small dose of anti-herpes medication every day can reduce the number of outbreaks by over 90%. You can take suppressive therapy for long periods of time, or gradually taper off.

Are there any side effects from genital herpes medications?

The medications used to treat herpes have extremely low side effects. There are no major complications associated with these medications.

Is there any resistance to genital herpes medication?

Resistance to drugs that treat genital herpes — even after 20 years of use — is very rare. Herpes medications may not work as well in patients who are very immunosuppressed and have been treated with these drugs for a long time. Each individual’s response to treatment may vary. In some cases, patients may need more drugs to suppress their viral outbreaks than others.

Genital Herpes and Pregnancy

It is important to avoid contracting herpes during pregnancy. A first episode during pregnancy can create a greater risk of transmission to a newborn.

Fortunately, it is rare for women with genital herpes to infect their babies. If you know that you have genital herpes before becoming pregnant, your physician will monitor your condition throughout your pregnancy. If you have an active outbreak at the time of delivery, a C-section may be recommended. Depending on individual diagnosis, though, the American Congress of Obstetricians and Gynecologists endorses suppressive therapy to reduce the frequency of C-section.

Is genital herpes related to shingles?

Shingles, also called herpes zoster, is caused by the varicella zoster virus (VZV), which causes chickenpox earlier in life. The natural history of varicella zoster infection is similar to genital herpes infection in that VZV also becomes latent in the sensory nerve roots. Later in life the virus may exit, causing shingles.

Recurrences in shingles cause blister lesions in a single area of skin called a dermatome. Shingles is not a sexually transmitted infection and is independent from genital herpes.

Is genital herpes infection related to HIV?

Herpes and HIV are caused by different viruses. But patients infected with these viruses are more likely to transmit either disease to their sexual partners. Patients with herpes are more vulnerable to HIV infection. People newly diagnosed with herpes should be tested for HIV infection and other sexually transmitted infections.

Patients who are infected with both herpes and HIV also may have a higher concentration of HIV viruses in their body because of the interaction between the herpes virus and the HIV virus. When HIV damages a person’s immune system, the person may be more likely to shed herpes simplex virus asymptomatically.

Types of herpes – Features of herpesvirus infections

Herpesvirus infections often occur in latent (hidden) or chronic forms. The absence of specific symptoms in such cases for a long time forced experts to adhere to the opinion that the incidence of this virus was low. However, the development of laboratory diagnostics and the emergence of new methods of blood testing for herpes made early diagnosis possible, which showed a much greater prevalence of this infection: about 90% of the world’s population is infected with one type or another of the herpes virus.

Subfamily one: alpha viruses (Alphaherpesvirinae)

This group includes the following types of herpes infection:

• HSV*-1
  The main causative agent of herpes infection. It is transmitted by airborne droplets or through contact with an infected person.
• HSV*-2 or genital herpes
  Refers to diseases transmitted through sexual contact.
• Varicella zoster virus
  It provokes two different diseases: chickenpox – a primary infection obtained from an external source; shingles – secondary, arising from reinfection (re-infection) with a latent virus hiding in the central nervous system (CNS).

*HSV is the herpes simplex virus.

Second subfamily: beta viruses (Betaherpesvirinae)

A representative of this group is cytomegalovirus (CMV), one of the main causative agents of congenital viral infections affecting the central nervous system. A feature of this virus is its ability to repeatedly reactivate and stay in the body for life after the initial infection. Given this factor, it is important to take care of the prevention of an infectious disease in a timely manner. During pregnancy, it is necessary to undergo a CMV diagnosis, even in the absence of factors contributing to infection. With a positive test result, it is important to start treatment for cytomegalovirus as soon as possible to prevent its transmission to the fetus.

Beta viruses include two more types of herpes:

• 6A
  Sudden exanthema, characterized by an acute febrile state and a patchy pink rash. It develops rapidly and ends with spontaneous recovery.
• 6B
  The predominant number of patients diagnosed with 6B are young children, since it is during this period that infection with this virus usually occurs. The nature of the effect of 6V on human health is not fully known today. The development of acute respiratory infections in children associated with this type of herpes is expected.

Subfamily three: gamma viruses (Gammaherpesvirinae)

In the group of gamma viruses are pathogenic pathogens for humans. These include the Epstein-Barr virus (EBV), which provokes the development of the following diseases:

• Infectious mononucleosis, an acute form of Epstein-Barr infection;
• Burkitt’s lymphoma is a malignant tumor;
• Nasopharyngeal carcinoma is a poorly differentiated epithelial malignancy.

The herpesvirus associated with Kaposi’s sarcoma also belongs to the group of gamma viruses. The formation of this rare tumor is most susceptible to patients with HIV infection in the AIDS stage. The selection of effective antiretroviral therapy for HIV helps patients slow down the development of a malignant neoplasm, strengthening their immunity.

All gamma viruses have a high oncogenic risk – they provoke oncological diseases.

Types of herpes by types

Each type of herpes virus infection belongs to a specific type:

• HSV-1 – type 1;
• HSV-2 – type 2;
• Smallpox and lichen virus – herpes type 3;
• Epstein-Barr virus – type 4;
• Cytomegalovirus – type 5;
• 6A – herpes type 6;
• 6B – herpes type 7;
• Herpes virus associated with Kaposi’s sarcoma – type 8.

H-Clinic specialists against infections

Each herpesvirus infection has a number of features that must be considered when drawing up a treatment plan. It is important to foresee the possible individual reactions of the patient to the presence of infection, to assess the state of his health, in particular, HIV status. In the case of pregnant women and patients planning pregnancy, safe antiretroviral therapy is selected, the main goal of which is to prevent transmission of the infection to the fetus or minimize the negative consequences of the infectious process for the health of the child.

In the infectious diseases clinic H-Clinic, you can get the help of qualified infectious disease specialists and specialists in related areas who will draw up an individual plan for the prevention, diagnosis and treatment of herpes infection for you. You can find out more and make an appointment with a doctor by calling the clinic in Moscow +7 (495) 191-11-29.

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Primary appointment (examination, consultation) with an infectious disease specialist

4000 ₽

Reception (examination, consultation) of an infectious disease specialist, primary doctor of medical sciences, senior researcher, ch. doctor

7 000 ₽

Appointment (examination, consultation) with an infectious disease specialist primary, family

7,000 ₽

Appointment (examination, consultation) with an infectious disease specialist at home (outside the Moscow Ring Road)

20 000 ₽

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2,000 ₽

PrEP consultation. Pre-exposure prophylaxis of HIV infection (30 min.)

3 000 ₽

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Herpes zoster – what is it? : useful news on panoramamed.ru

Not all skin rashes are skin diseases, more often they indicate problems inside the body. Such diseases include herpes zoster – an insidious disease, which is described by the dermatologist of the Panorama Med Medical Center Svetlana Urvantseva.

– Svetlana Vasilievna, does herpes zoster have anything to do with the “cold” on the lips?

– Nothing! This is a special type of herpes that does not affect the skin, but the nerves. And the disease is caused by the familiar chickenpox virus, which has mutated in the body of a person who has already had chickenpox. As you know, chickenpox is a childhood disease that almost all people endure, acquiring immunity. But the chickenpox virus itself does not leave our body, but lives in it in an inactive, dormant form. Under certain conditions, when we meet again with a virus carrier, this virus reactivates and takes the form of herpes zoster.

– What are the conditions?

– Herpes develops in an organism weakened by other diseases, the elderly are especially susceptible to the disease. The disease is also a marker of diabetes mellitus, HIV infection and oncology, so doctors often refer such patients for additional examination. Children rarely get herpes zoster.

– How does the disease begin and with what symptoms does it occur?

– The herpes zoster virus attacks the nerves and penetrates the nerve fibers to the skin, causing pain or burning and a rash in the form of bubbles grouped in small groups. Bubbles eventually turn into sores, which dry up with the formation of crusts. It happens that pain precedes the appearance of blisters. Sometimes pain accompanies the patient for a long time even after the external manifestations of the disease have passed. And it exhausts a person very much and, which is typical, is not removed by analgesics. Rashes are localized along the nerves, depending on which nerve is affected by herpes. Rashes and pain may, for example, appear in the lumbar or intercostal region of the skin. Herpes on the face is most severe when the trigeminal nerve is affected, because the virus can cause damage to the eye. Then ophthalmologists are involved in the treatment.

– Today, many consider themselves the best doctors and quickly find cures for any disease on the Internet and in pharmacies. What is the risk?

– First of all, because they may “not recognize” herpes and be treated for another disease. And a long-term illness threatens with long-term, exhausting pain.