How Do I Know if I Have Herpes or Something Else?
Genital herpes can resemble several other diseases and skin conditions. Here’s how to tell if you have the virus.
If you have blisters or sores on or around your genital region, rectum, or mouth, it could be a sign of genital herpes.
Genital herpes is a common and incurable sexually transmitted disease (STD). It’s so prevalent in the United States that about 12 percent of people ages 14 to 49 have it, according to the Centers for Disease Control and Prevention (CDC). More American women than men have herpes, possibly because the disease is somewhat easier to pass from men to women than from women to men, notes the CDC.
Herpes is caused by the herpes simplex virus (HSV). There are two types of herpes viruses: herpes simplex 1 (HSV-1) and herpes simplex 2 (HSV-2). Both viruses are transmitted by close contact with an infected person. HSV-1, or oral herpes, is usually associated with cold sores or fever blisters around the mouth, and it is often transmitted through nonsexual contact with infected saliva. HSV-2 most often affects the genital area.
However, an increasing number of genital herpes cases are being caused by HSV-1, not HSV-2. That is partly because a person who has oral herpes caused by HSV-1 can spread it to their partner’s genitals during oral sex. You can also get genital herpes by having vaginal or anal sex with someone who has the virus, per the CDC.
Most people who have herpes are asymptomatic, or they have symptoms that are so mild that they may not even notice them, according to the CDC.
What Does Genital Herpes Look Like?
When herpes symptoms do occur, lesions usually appear as small, painful blisters on or around the genitals, rectum, or mouth, per the CDC. On average, the initial herpes outbreak will occur four days after exposure, with a range of 2 to 12 days. The blisters break and leave painful ulcers or sores that may take two to four weeks to heal.
During the first outbreak, herpes lesions often last longer and are more contagious. Other symptoms may include a fever, body aches, swollen lymph nodes, and/or a headache.
According to Planned Parenthood, additional symptoms of genital herpes may include difficulty urinating or burning when you urinate, as well as itching.
Recurrent outbreaks of genital herpes are common, notes the CDC. Many people can sense a recurrent outbreak coming on hours to days before the lesions appear, with symptoms that may include genital pain, or tingling or shooting pains in the legs, hips, or buttocks. Recurrent outbreaks are usually shorter and less severe than the initial one, and they may decrease in frequency over time. They are also much less frequent with a genital HSV-1 infection than a genital HSV-2 infection.
Sometimes people mistake herpes for a pimple, ingrown hair, or the flu, notes Planned Parenthood. And since most of the time there are no symptoms, many people don’t know they have herpes.
On the plus side, this underscores how mild the symptoms of herpes can be. On the minus side, it helps explain how and why the infection is so widespread: If you don’t know you have it, you are unlikely to take steps to avoid spreading it. And herpes can be transmitted from one person to another even when there are no symptoms, per the CDC. Also, having herpes raises the risk of getting HIV, the CDC notes.
How to Treat and Prevent Herpes
Once you have herpes, you’ll always have it. There’s no cure for herpes. But there are medicines that can prevent or shorten the outbreaks, as well as make it less likely that you will pass it on to intimate partners, notes the CDC. Still, if you have herpes, whether you take medication or not, you should tell anyone you have sex with, so that they know the risk.
Using latex condoms correctly every time you have sex can reduce your risk of transmitting or becoming infected with genital herpes, but condoms do not offer 100 percent protection.
If you have herpes, you should avoid having sex while you have lesions or other symptoms of the virus (though you can still spread the infection even if you’re asymptomatic).
Symptoms of genital herpes can be mild or severe. Your doctor or healthcare provider may diagnose herpes just by looking at any sores that you have, or by taking a sample from a sore and testing it, per the CDC.
If you are pregnant, you can pass on herpes to your fetus during pregnancy, or to your infant during childbirth or just afterward. Herpes in newborns is a serious, sometimes fatal condition, according to the CDC. If you are pregnant or planning to become pregnant, it’s important to tell your doctor if you have a history of genital herpes.
Oral Herpes Can Cause Sores or Blisters Around the Mouth
HSV-1 is a common cause of oral herpes, which can lead to cold sores or fever blisters around the mouth. Most people with oral herpes do not have any symptoms, according to the CDC. Children and young adults typically get the infection from nonsexual contact with saliva. Oral herpes caused by HSV-1 can also spread from the mouth to the genitals through oral sex, causing genital herpes.
Fifty percent to 80 percent of U.S. adults have oral herpes, according to Johns Hopkins Medicine. Once you are infected with oral herpes, you will have the virus for the rest of your life. While some people never develop any symptoms, others will have recurrent outbreaks.
The first outbreak of oral herpes is usually the worst. In addition to sores on and around the lips and throughout the mouth, it may cause severe flu-like symptoms, including swollen lymph nodes and a headache, per Johns Hopkins. However, some people have no symptoms at all.
Some people with oral herpes never have any additional outbreaks after the initial one. If they do, the recurring infections are usually much milder, and the sores typically appear on the edges of the lips. Recurrent outbreaks are more common in the first year after the first outbreak of oral herpes.
The most common signs and symptoms of a recurring oral herpes infection include:
- Redness, swelling, heat/pain, or itching in the area where the infection will occur
- Painful, fluid-filled blisters on the lips or under the nose, which then leak fluid and turn into sores
- Sores that crust over and heal after about four to six days
Oral herpes typically spreads from people with an active outbreak or sore. It can be transmitted during intimate contact (such as kissing or oral sex) with someone who has the virus. To protect yourself from getting oral herpes, avoid physical contact with a person’s sores during an outbreak.
Oral herpes can be mistaken for many other infections, including allergic reactions. Your healthcare provider may diagnose oral herpes based on the location and appearance of your blisters, and confirm the diagnosis with lab tests.
Treatments for oral herpes include:
- Antiviral oral medications, such as acyclovir, famciclovir, and valacyclovir
- Antiviral topical ointments, such as acyclovir and penciclovir
- Over-the-counter topical anesthetics or anti-inflammatory agents
Are Canker Sores Caused by the Herpes Virus?
Canker sores, also called aphthous ulcers, are not caused by the herpes virus or any other virus. Canker sores typically appear as small, shallow lesions on the soft tissues in your mouth or at the base of your gums, according to the Mayo Clinic. They usually have a white or yellow center and a red border, and they typically occur on or under the tongue, inside the cheeks or lips, on the gums, or on the roof or back of the mouth.
Unlike cold sores, canker sores occur only inside the mouth, and they are not contagious.
Minor canker sores, which are the most common kind, are usually small and oval shaped with a red edge, and they heal in one to two weeks, without leaving scars, per the Mayo Clinic.
Major canker sores, which are less common, are larger and deeper than minor ones. They are typically round with defined borders, but they may have irregular edges when they are very large. Major canker sores can be very painful, and they may take up to six weeks to heal. They may also leave scars.
Herpetiform canker sores are uncommon. They are the size of a pinpoint and often occur in clusters of 10 to 100 sores, but they may merge into one large ulcer. These sores have irregular edges, and they heal without scarring in one to two weeks.
According to the Mayo Clinic, canker sores may be triggered by a variety of factors, including:
- A minor injury to your mouth from dental work, brushing your teeth too aggressively, sports accidents, or an accidental cheek bite
- Toothpastes and mouth rinses that contain sodium lauryl sulfate
- Food sensitivities
- A diet that is low in vitamin B-12, zinc, folate (folic acid), or iron
- An allergic reaction to bacteria in your mouth
- Hormonal fluctuations during menstruation
- Emotional stress
Some conditions and diseases may also cause canker sores. These include:
- Celiac disease
- Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis
- Behcet’s disease
- A faulty immune system
Anyone can develop canker sores, but they’re more common in teens, young adults, and females. People with recurrent canker sores often have a family history of them.
Your doctor or dentist can diagnose canker sores just by looking at them. Treatment usually isn’t necessary for minor ones, but a canker sore that is large or particularly painful can make it hard to eat and talk. Your doctor may suggest that you use an alcohol-free mouth rinse or topical treatment to ease the pain of a canker sore. Gargling with salt water may also help. If the sore lasts longer than 10 to 14 days, you should see a doctor or dentist.
Contact Dermatitis Can Be Mistaken for Herpes
Contact dermatitis is a skin condition that can cause an itchy rash, cracked, dry, or scaly skin, bumps and blisters, leathery patches, or swelling, burning, or tenderness, according to the Mayo Clinic. It’s not an STD, but when it appears in the mouth or genital area, it may be mistaken for herpes.
However, unlike herpes, contact dermatitis can happen anywhere on the skin and is caused by direct contact with an irritant or an allergen. It is not caused by a virus.
Contact dermatitis usually occurs within days of exposure to an irritant or allergen. Common causes include poison ivy and reactions to medication, cosmetics, detergents, and jewelry. The skin rash from contact dermatitis usually goes away in two to four weeks.
The best way to prevent contact dermatitis is to identify what’s causing it and avoid touching that item or substance again. Allergy testing can help identify the cause.
While contact dermatitis is generally not a serious condition, it can be itchy and uncomfortable. When the rash is present, try using cool, wet compresses or anti-itch creams to soothe it. Antihistamine pills can help reduce the itchiness. Avoid scratching the area: Doing so can make symptoms worse and could open the door to a bacterial or fungal infection. If your itching is severe, you should see your primary care provider or a dermatologist for topical steroid medication.
Is That Spot a Pimple or a Cold Sore?
Acne is most common in teens and young adults, but people of all ages can and do get it, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Among teenagers, it is more common in boys. Among adults, it is more common in women. For most people, acne tends to clear up by the time they reach their thirties, but some people in their forties and fifties still have it.
Acne occurs when hair follicles under the skin become clogged with oil (sebum) or dead skin cells, causing lesions commonly known as pimples or zits. Acne usually occurs on the face but can also appear on the back, chest, and shoulders.
Acne can cause inflammation, swelling, redness, heat, or pain. Different types of acne include:
- Whiteheads: Clogged follicles that stay beneath the skin and cause a white bump.
- Blackheads: Clogged follicles that appear black and reach the surface of the skin.
- Papules: Lesions that are inflamed and usually appear as small, pink bumps on the skin.
- Pustules or pimples: Papules topped off by white or yellow pus-filled lesions that may be red at the base.
- Nodules: Large, painful, solid lesions that are deep within the skin.
- Severe nodular acne (also called cystic acne): Deep, painful lesions that are filled with pus.
Hormones, stress, medications, and diet are among the factors that may trigger acne outbreaks or make them worse.
Acne is not contagious. Topical and oral medication can help heal pimples, stop new ones from forming, and prevent scars. To avoid scarring, don’t squeeze or pop pimples.
Scabies Rash Can Occur on the Genitals
Scabies is caused by tiny eight-legged bugs (called human itch mites) that burrow into the skin to live, feed, and lay their eggs, according to the American Academy of Dermatology Association (AAD). There are millions of cases of scabies worldwide each year.
Scabies can develop anywhere on the skin, but the mites most commonly burrow into the hands, arms (particularly the elbows and wrists), and skin that’s usually covered by clothing or jewelry, including the buttocks, belt line, penis, and skin around the nipples.
If you’ve never had scabies before, it can take two to six weeks to develop symptoms after the mites move in, according to the AAD. If you’ve had scabies before, the itching usually begins within one to four days.
Signs and symptoms of scabies include:
- Itching, mostly at night.
- A rash that causes small bumps that often form a line. The bumps can resemble hives, tiny bites, knots under the skin, or pimples. Scaly patches that look like eczema may also appear.
- Sores, caused by scratching the rash, which can become infected.
- Thick crusts on the skin that form when a person develops a severe type of scabies called crusted scabies or Norwegian scabies.
People usually get scabies from direct skin-to-skin contact with an infected person. Adults can get scabies through sexual contact. You can also get scabies from infested items such as bedding, clothes, and furniture, but this is less common.
A dermatologist can often diagnose scabies just by looking at the rash, and they can confirm that diagnosis by removing some skin and looking at it under a microscope.
Scabies is easily treatable with prescription medication. In addition to the person diagnosed with scabies, everyone who has had close contact with that person must receive treatment. The skin should heal within four weeks.
Additionally, any infested bedding, linens, towels, and clothing used during the three days before receiving treatment should be washed in hot water and dried in a hot dryer, dry cleaned, or sealed in a plastic bag for at least 72 hours, according to the CDC.
How to Tell if It’s a Yeast Infection or Herpes
Vaginal yeast infections are very common — up to 75 percent of women will experience this fungal infection in their lifetime, and many will have more than one, according to the Mayo Clinic.
Most vaginal yeast infections are caused by the fungus candida albicans. The vagina naturally contains a balanced mix of yeast, which includes candida, and bacteria. But an overgrowth of candida or penetration of the fungus into deeper vaginal cell layers can cause a yeast infection, notes the Mayo Clinic.
Symptoms of a yeast infection include:
- Itching and irritation in the vagina and vulva
- A burning sensation, particularly during intercourse or urination
- Redness and swelling of the vulva
- Vaginal pain and soreness
- Vaginal rash
- Thick, white, odorless vaginal discharge that looks like cottage cheese
- Watery vaginal discharge
While a vaginal yeast infection isn’t considered a sexually transmitted infection (STI) and is not contagious, there is an increased risk of getting a vaginal yeast infection when you first start having regular sex. Sexual contact can sometimes cause a yeast infection, if you have a bad reaction to another person’s natural genital yeast and bacteria, according to Planned Parenthood. Infections may also be linked to oral sex, notes the Mayo Clinic.
Antibiotics, pregnancy, diabetes, an impaired immune system, certain oral contraceptives, and hormone therapy can also cause an overgrowth of fungus, which can lead to a yeast infection.
In addition to performing a pelvic exam, your health care provider may send a sample of vaginal fluid for testing to determine the type of fungus causing the yeast infection. Antifungal medication is commonly prescribed, and the inflection typically clears up within a week or sooner.
Yeast infections can occur in men, too, on the penis or scrotum, but this is uncommon, per Planned Parenthood.
Chlamydia Can Cause Burning During Urination
Chlamydia is the most commonly reported bacterial STI in the United States, according to the CDC.
You can get chlamydia by having vaginal, anal, or oral sex with someone who has the infection. Sexually active young people have a higher risk of getting chlamydia. Gay and bisexual men are also at risk, because the infection can be transmitted through oral and anal sex.
Chlamydia often has no symptoms, but if symptoms do occur, they may not appear until several weeks after having sex with an infected partner, notes the CDC.
Women who have symptoms of chlamydia may notice abnormal vaginal discharge, and as with herpes, they may experience a burning sensation when urinating.
Men who have symptoms of chlamydia may notice a discharge from their penis, a burning sensation when urinating, and pain and swelling in one or both testicles.
Both men and women can also get chlamydia in their rectum, which can happen as a result of having anal sex with someone who has the infection, or due to spreading from another infected site (such as the vagina). Chlamydia in the rectum often causes no symptoms, but it can lead to rectal pain, discharge, and bleeding.
In women, untreated chlamydia can cause pelvic inflammatory disease (PID), which can lead to infertility, ectopic pregnancy, and other complications. The infection may also be transmitted to an infant during childbirth.
In men, chlamydia doesn’t usually cause chronic health problems, but it can cause a fever and pain in the tubes attached to the testicles, which can lead to infertility (in rare cases).
Untreated chlamydia may also increase your chances of getting or giving someone else HIV, per the CDC.
Your healthcare provider can diagnose chlamydia with lab tests. Treatment with antibiotics can easily heal the infection and could reduce your chances of having complications later, but it won’t undo any permanent damage caused by the disease. Avoid having sex again until you and all sexual partners complete treatment.
Because it's common to have repeat infections with chlamydia, you should get tested again about three months after receiving treatment, even if your sexual partner or partners receive treatment.
Women who are sexually active should get tested for chlamydia annually if they are younger than 25 years old, or if they are 25 years or older with risk factors, such as new or multiple sex partners, or a partner who has an STI. Men who have sex with men should be tested at least annually and potentially more frequently if they are at increased risk. Men who have sex with women should be screened based on risk factors, according to the CDC. Pregnant women should also be tested for chlamydia.
Syphilis Can Also Cause Sores on the Genitals and Mouth
Like herpes, syphilis is an STI that can cause sores in the genital area and the mouth. But despite these similarities, the two infections differ in their causes — syphilis is caused by bacteria and herpes by a virus. The health risks they pose are different, too.
You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex, according to the CDC. Syphilis sores in the vagina, anus, mouth, or under the foreskin of the penis can be difficult to see, so you may not notice that a sexual partner has the infection.
There are four stages of syphilis. During the first (primary) stage, you may or may not notice a single sore or multiple sores that typically occur in, on, or around the penis, vagina, anus, rectum, lips, and mouth. The sores are usually firm, round, and painless, lasting three to six weeks. While the sores will heal with or without treatment, you must receive treatment to prevent the infection from moving to the secondary stage.
During the secondary stage, you may have rashes and/or sores in your mouth, vagina, or anus. The rash can appear when your primary sore is healing or several weeks after the sore has healed. It can be on the palms of your hands and/or the bottoms of your feet and appear rough, red, or reddish-brown. The rash usually isn’t itchy, and you may not even notice it. Other symptoms may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. These symptoms will go away with or without treatment, but you must receive treatment to prevent your infection from progressing to the latent and possibly tertiary stages of syphilis.
During the latent stage of syphilis, there are no visible signs or symptoms, but the infection can still be transmitted to others through sexual contact. Most people with untreated syphilis don't develop tertiary syphilis, but when this stage does occur, it can affect many different organ systems, and sometimes it even results in death.
Healthcare providers typically use blood tests to diagnose syphilis, per the CDC. Syphilis is curable with antibiotics, but treatment might not undo some of the damage that the infection can cause. You may get syphilis again if infected sexual partners don't receive treatment.
You should get tested regularly for syphilis if you are sexually active and are a gay or bisexual man; have HIV; are taking pre-exposure prophylaxis (PrEP) for HIV prevention; or have a partner who has tested positive for syphilis. You should also get tested for syphilis if you are pregnant.
How to Know if It’s Gonorrhea or Genital Herpes
Gonorrhea is a bacterial STI that can affect the genitals, rectum, and throat, according to the CDC. The infection is very common, especially among young people ages 15 to 24 years old.
You can get gonorrhea by having vaginal, anal, or oral sex with an infected partner. The infection often has no symptoms, but it can cause serious health problems, even if you are asymptomatic.
Most women with gonorrhea don't have any symptoms, and if they do, they are often mild and can be mistaken for a bladder or vaginal infection, per the CDC. Symptoms of gonorrhea in women may include:
- Pain or a burning sensation when urinating
- Increased vaginal discharge
- Vaginal bleeding between periods
Symptoms of gonorrhea in men may include:
- A burning sensation when urinating
- A white, yellow, or green discharge from the penis
- Less commonly, painful or swollen testicles
Rectal infections in men and women may cause no symptoms or cause symptoms including:
- Anal itching
- Painful bowel movements
In women, untreated gonorrhea can cause PID, notes the CDC. In men, gonorrhea can cause a painful condition in the tubes attached to the testicles and in rare cases, lead to infertility.
Untreated gonorrhea can also spread to your blood or joints, which can be life-threatening, but this is also rare. Having untreated gonorrhea may also increase your chances of getting or giving HIV.
Healthcare providers typically collect a urine sample to diagnose gonorrhea. Your provider may also use swabs to collect samples from your throat and/or rectum.
Treatment with antibiotics can cure gonorrhea, but drug-resistant strains of the infection are on the rise. You should return to your healthcare provider if your symptoms continue for more than a few days after you receive treatment.
Avoid resuming sexual activity until you and your partner or partners have completed treatment and all symptoms have cleared up. It’s important to get retested about three months after treatment of your first gonorrhea infection.
If you are a sexually active gay or bisexual man, you should get tested for gonorrhea at least once a year. If you are a sexually active woman, you should get tested for gonorrhea annually if you are younger than 25 years old, or 25 years or older with risk factors, such as new or multiple sex partners, or a sex partner who has an STI
If you are pregnant, talk to your healthcare provider about getting tested for gonorrhea, because the infection can cause serious health problems for your infant.
Monkeypox Can Cause a Rash on the Genitals
Monkeypox is a rare disease caused by the monkeypox virus, according to the CDC. The monkeypox virus belongs to the same family of viruses as variola virus, the virus that causes smallpox. While monkeypox symptoms are similar to smallpox symptoms, they are less severe, and monkeypox is rarely fatal.
Monkeypox can cause a rash that can look like pimples or blisters at first. The rash may be painful or itchy, and it may occur on or near the genitals or anus. It may also occur on other body parts, like the hands, feet, chest, face, or mouth.
Additional symptoms of monkeypox can include:
- Muscle aches and backache
- Swollen lymph nodes
- Respiratory symptoms, such as coughing, nasal congestion, or sore throat
Monkeypox symptoms usually appear within three weeks of exposure to the virus, per the CDC. The illness typically lasts two to four weeks. Some people get a rash first, followed by other symptoms, while others get flu-like symptoms first and then develop a rash one to four days later. Still others will only get a rash and no other symptoms.
In 2022, there was an outbreak of monkeypox in several countries that don’t normally report monkeypox, including the United States.
Monkeypox can spread during close, personal, often skin-to-skin contact with a person who has the infection, notes the CDC. This can happen during direct contact with the monkeypox rash, scabs, or body fluids, or due to contact with respiratory secretions. Direct contact can happen during intimate physical contact, including oral, anal, or vaginal sex or touching the genitals or anus of a person infected with monkeypox. It can also occur during hugging, massage, or kissing, or any prolonged face-to-face contact.
You can also get monkeypox by touching fabrics (such as clothing, bedding, or towels) that have been used by an infected person, or by touching objects during sex that were used by any infected person, such as fetish gear or sex toys.
You can also get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.
Pregnant women can also spread monkeypox to their fetus.
Monkeypox can spread from the onset of symptoms until the rash has fully healed and a new layer of skin has formed. This can take several weeks; sexual contact and/or intimacy should be avoided during this time. It is not known whether monkeypox can spread through semen or vaginal fluids.
The CDC recommends vaccination for people who have been exposed to monkeypox, as well as people who have an increased risk of being exposed to monkeypox, including:
- People who have been identified as a contact of a person who has monkeypox
- People who may have been exposed to monkeypox, such as people who have a sexual partner who has been diagnosed with monkeypox in the past two weeks, or people who had multiple sexual partners in the past two weeks in an area with a known monkeypox outbreak
- People whose jobs may expose them to monkeypox
Antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox infections.
How to Reduce Your Risk of Getting an STD
The only way to completely avoid STDs and STIs, including herpes, is to not have vaginal, anal, or oral sex. If you are sexually active, you can reduce your risk by being in a long-term, mutually monogamous relationship with a partner who has been tested for STDs, and by using condoms correctly every time you have sex.
If you have any symptoms of genital herpes or any other STD, see your doctor or go to a sexual health clinic. Your doctor will know what tests to give you to detect any STDs you may have. And if you’re sexually active, get screened regularly and always practice safe sex.
Additional reporting by Cathy Cassata and Ingrid Strauch.