What Does A Herpes Rash Look Like?

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Herpes is a common virus spread through vaginal, anal, or oral sex. Around half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection. 

There are two strains of the herpes simplex virus, HSV-1 and HSV-2.  

HSV-1 is transmitted through oral-to-oral contact - spread through kissing, sharing cutlery, and oral care items such as toothbrushes with an infected person. It causes sores around the mouth and lips which are commonly known as cold sores.

HSV-2 is a sexually transmitted infection which causes sores around the genital area or rectum. It is passed on through vaginal, anal, and oral sex.  

Lesions do not have to be present for both strains to spread. Many people are asymptomatic and do not show symptoms or have very mild symptoms, even if they have a herpes infection. 

 

What is a herpes rash?  

The herpes rash is one of the main and most common symptoms of the HSV virus. The first sign of an oncoming rash is a tingling, burning, or an itching sensation in the affected area. These symptoms usually occur a day or so before a rash appears. Rashes are usually in clusters, which are painful to touch.  

The rash is caused by white blood cell activity in the infected area. When the virus infects the skin, it prompts the cells to break down. Further inflammation and irritation including redness, blisters and itching of the skin can also happen whilst the body begins to fight the infection. 

 

What does it look like? 

The herpes rash looks like clusters of small, fluid filled blisters. They tend to be painful and can appear as white, yellow, or red translucent sores or bumps, filled with a clear liquid.  

Herpes sores can be overlooked when symptoms first appear, because they can be similar to other common skin conditions.  

The appearance of herpes sores cannot solely signify whether an outbreak is caused by HSV-1 or HSV-2. A herpes test can help to identify which strain of the virus you have. You are able to get tested at a local sexual health clinic

Man sitting on sofa having found out what genital herpes is
Man sitting on sofa having found out what genital herpes is
Man sitting on sofa having found out what genital herpes is
Man sitting on sofa having found out what genital herpes is


Where on the body do you get a herpes rash? 

The herpes rash commonly appears around the mouth and genitalia, including the penis, vagina, rectum, buttocks, cervix, and thighs. It is not always isolated to these areas and can occur anywhere on the body. The site at which a rash occurs will depend on where and how the infection is contracted.

Genital herpes rash 

The genital herpes rash can appear on the vagina, groin, buttocks, and inner thigh areas. Men may develop a rash on the penis or under the foreskin. A rash around the anus and buttocks is also possible. In addition to a rash, genital herpes can cause a fever, headache, and muscle aches. You may also experience fatigue, swollen lymph nodes (specifically in the groin), pain, and difficulty when urinating.  

Oral herpes rash 

A cold sore is a key symptom of oral herpes. These small blisters are sometimes referred to as fever sores, and appear in or around the lips and mouth. They are usually tender, painful, and tingly, and occasionally develop on the face or tongue. Each outbreak lasts between two to three weeks. 

Herpes rash on the face

Groups of fluid-filled blisters appearing on red swollen areas of the skin, or the mucous membranes, can be an indication that herpes rash on the face is present. Sores may appear on the neck, cheeks and nose and could be mistaken for spots; however, there is a clear difference in appearance. Herpes sores are white, yellow, or red translucent bumps which are filled with a clear liquid. They often appear in honeycomb like clusters, whereas pimples are pink filled with white pus, and appear sporadically around the face.

Herpes rash on the finger 

Herpetic whitlow is a painful infection of the finger, caused by the herpes simplex virus 1 (HSV-1). Small blisters form on the hand and fingers, usually around the fleshy area of the fingertips. Symptoms of herpetic whitlow include swelling, pain, blisters, sores, and a change in the skin tone on your finger. 

Herpes rash on the body

A herpes rash on the body is often referred to as a herpes skin rash. It looks like a small cluster of fluid filled bubbles, and can occur anywhere on the body. The sores usually burst, leaving ulcers with raised edges. These then crust over and can cause scarring on the skin which usually heals after a few weeks. If you have contracted oral or genital herpes, it will not spread to other parts of your body. The immune system will produce antibodies to protect other areas from infection.

 

Is it usually mild or severe?  

The first episode of genital herpes tends to be more severe than recurrent outbreaks. With time, infections are shorter in duration and are generally less painful, with most people experiencing a mild herpes rash in comparison to the first outbreak.

 

How long does it last? 

A flare-up causing a herpes rash usually lasts between one to three weeks and sores can take up to four weeks to heal. The first outbreak usually lasts longer than subsequent outbreaks.  

 

Is a herpes rash contagious?  

Yes, a herpes rash is highly contagious. HSV-1 predominantly affects the mouth, and is spread through close contact activity, such as kissing. It is also possible to spread HSV-1 from the mouth to the genitals through oral sex. HSV-2 primarily affects the genitals, and is spread through sexual activity, where there is close contact between genitals. It is also possible to transmit HSV-2 from the genitals to the mouth during oral sex.

 

Herpes is most contagious during an outbreak, starting from a few days before the tingling first appears, all the way through to when sores heal. Herpes is still contagious for a few weeks after sores have healed. Although the risk of transmission is lower when the virus is not active and symptoms are not present, some people may be asymptomatic and will therefore be contagious without knowing. Medication can be taken to help lower viral shedding and reduce the chances of an outbreak.

 

Herpes rash diagnosis 

A visual diagnosis by a healthcare professional, accompanied by a test, is usually required to diagnose herpes. For a test to be accurate, you will need to swab the fluid from blisters. The CDC (Centers for Disease Control and Prevention) reports that false positive test results, those showing positive when you do not actually have the virus, are possible when testing for HSV-1 and HSV-2, so it is recommended that testing is done only with people who show symptoms. A herpes blood test can help determine if an infection is present, it will not be able to inform you who gave you the infection.  

 

Herpes rash treatment 

There is no cure for genital herpes. Aciclovir and Valaciclovir are antiviral medicines used to treat and suppress the herpes simplex virus. They can be taken during the onset of an outbreak, to help reduce the length and severity of an outbreak. They can also be taken over a long period of time, to help reduce the chances of a flare-up, in those that experience frequent outbreaks.

Aciclovir 400mg

Treatment of an outbreak 

1 tablet to be taken three times a day for 5 days 

Suppression treatment 

1 tablet to be taken twice a day 


 

Valaciclovir 500mg

Treatment of an outbreak 

1 tablet to be taken twice a day for 5 days 

Suppression treatment 

1 tablet to be taken daily 

 

Can other rashes look like herpes? 

Yes, other rashes can be mistaken for herpes. A test or a visual examination from a doctor or pharmacist can help to identify herpes sores. 

Contact dermatitis 

Contact dermatitis causes red, itchy, blisters like herpes lesions on the skin. It usually occurs after contact with an irritant such as medication, plants, jewelry, and cosmetics. They can recur just like herpes.

Pimples 

Pimples can have a similar appearance to sores brought on by herpes on the face. However, herpes spots usually appear in clusters, are more painful, and will usually appear after tingling to the area. Herpes spots are also usually more aggressive than pimples.  

Scabies 

A herpes rash on the body and scabies can cause skin irritation. Herpes on the thigh or herpes on the arm, could be mistaken for scabies, as it tends to affect the legs, arms, and hands. A common symptom of scabies is severe itching that occurs mainly at night. This is a telltale sign of scabies. Scabies pimples are also not likely to appear in bunched clusters, and unlike herpes, the rash is not likely to fill with fluid and burst.

Jock itch 

Jock itch is a fungal infection, causing a red and itchy rash in warm and moist areas of the body. It is common in athletes or people who sweat a lot and often affects the groin and inner thighs. Herpes is itchy and can feel like a burning sensation on the skin which can also occur in Jock Itch, although the rash which shows with Jock Itch tends to have a distinctive ring shape.  

Genital warts 

Genital warts are a common sexually transmitted infection. Small, flesh-colored bumps affect the moist tissues of the genital area and have a cauliflower-like appearance. They primarily effect the vagina and penis but like the herpes rash, they can also develop in the mouth or throat.  

Shaving rash 

Shaving rash is a form of irritant contact dermatitis, which occurs when the skin is irritated by shaving. It can look like herpes on legs because the symptoms are similar. Redness, itching and tenderness usually occur in the affected area, however shaving rash is usually a temporary condition which clears over time.  

Shingles 

Shingles may be confused with the HSV rash because it causes a tingling or painful feeling in an area of skin with a rash will appear a few days later. The shingles rash differs to the herpes virus because it usually only affects one side of the body.  

Other STIs 

Gonorrhea, chlamydia and syphilis can all cause genital sores which can look and feel like herpes lesions on skin, so it is important to get tested by a medical professional as soon as symptoms show.  


Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.