Herpes: What Does Herpes Look Like?

Herpes is a very common infection caused by HSV-1 and HSV-2. Approximately a third of the world’s population aged 0–49 have oral herpes, and half a billion have genital herpes. According to the Centers for Disease Control and Prevention (CDC), many with herpes are unaware they have an infection, with an estimated 87.4% aged 14–49 going undiagnosed.¹ ²

Herpes can cause cold sores around your mouth and painful blisters around your genitals. While we don’t yet have a cure for this infection, you can take steps to avoid your risk of contracting or spreading the highly contagious virus. Let’s find out more.

What is herpes?

Herpes is a viral infection that is highly contagious and usually spread through direct skin-to-skin contact. Herpes simplex virus causes herpes infections. There are two types of the virus: HSV-1 and HSV-2. HSV-1 typically causes cold sores, while HSV-2 typically causes genital herpes. 

Other herpesviruses, such as the varicella-zoster virus, can cause different infections in humans, such as chickenpox and shingles.

What does herpes feel like?

Herpes outbreaks may make your skin feel sensitive and swollen. You may experience aches in the muscles surrounding the infected area. 

The symptoms of herpes may not be visible, so you may not realize you have it if the symptoms are mild. That is one of the reasons it is so easy to transmit the virus.

Herpes simplex 1 (HSV-1)

HSV-1 may not result in symptoms at all, but it can lead to cold sores around the mouth and lips or possibly a sore inside the mouth. These sores may hurt when you eat, tingle, sting, or burn. During the initial outbreak, you will likely experience flu-like symptoms. Cold sores typically heal in a few weeks, although you may have another outbreak a few weeks later. You may also go years before having another one. 

Herpes simplex 2 (HSV-2)

One of the most obvious signs of genital herpes caused by HSV-2 is clusters of small blisters. They can come up in various areas, including on and around the: 

• Vulva

• Vagina

• Cervix

• Testicles

• Penis

• Buttocks

• Anus

• Thighs

Blisters can break and turn into sores that cause itchiness, pain in the genital area, and difficulty urinating.

During your first herpes outbreak, you may feel like you're coming down with the flu. You may notice symptoms like: 

• Headaches

• Feeling tired

• A fever

• Swollen glands in your throat, in your armpits, and near your groin

Genital herpes can develop from HSV-1, which may be passed from the mouth to the genitals during oral sex. An HSV-1 infection can mimic an HSV-2 infection, and you can experience multiple symptoms at once.

What are the causes and risk factors?

The herpes simplex virus can be transmitted through skin-to-skin contact and vaginal, oral, or anal sex. It's also possible to get an infection from an object contaminated by someone with the disease that comes in contact with your skin. 

Risk factors include:

• Unprotected sex, although a condom/dental dam may not cover all sores

• Sexual activity with multiple partners

• Having sex with someone who isn’t taking antivirals to limit outbreaks

• Being in a certain population group:

  • Women who have sex with men: HSV spreads more easily from men to women than from women to men.

  • Men who have sex with men

  • People with a history of sexually transmitted diseases

  • Older adults

  • Black people in the US

If you’re concerned about your herpes risk, speak to your doctor for advice. 

What are the symptoms of herpes?

The symptoms of herpes can include: 

• Blisters or a rash on or near the mouth or genitals

• Swollen glands in the groin area

• A fever over 101 degrees Fahrenheit

• Flu-like symptoms

It's not always possible to identify that someone has herpes just by looking at them, but these symptoms may indicate an infection is present.

Cold sores often come with their own symptoms, including: 

• Pain around the infected area Tingling sensations before developing into blisters

• Redness on or around the lips or face

• Fever

• Sore throat

• Headaches

Pimples vs. herpes blisters: Why do they happen?

Pimples and herpes blisters may look similar, but they form because of different causes. Pimples form when excess sebum combines with dead skin cells to clog pores. They can appear on any part of the body and aren't contagious.

Herpes blisters are white, yellow, or red translucent sores or bumps filled with a clear liquid, while pimples are opaque with a yellow or white head. 

How is herpes diagnosed?

Herpes can be difficult to diagnose because not everyone with it will experience symptoms. Current tests are most accurate when symptoms are present. A doctor can diagnose herpes simply by examining the blisters or sores and confirming it by performing a swab test of sores that have not fully healed.

Doctors rarely use blood tests because they have limitations. Speak to your healthcare provider about whether a blood test would be useful to confirm your diagnosis.

How is herpes treated?

Treatments that reduce the severity, frequency, and duration of outbreaks include antivirals like valacyclovir, acyclovir, or famciclovir. 

You can apply topical numbing agents like lidocaine cream or benzocaine gel during an outbreak to ease the pain.

How to prevent herpes from spreading

Even if you have no visible symptoms, it's important to take precautions by practicing safe sex and always using protection during sex, including oral sex.

During an outbreak, it’s vital to do everything you can to avoid spreading the virus. That means:

• Avoid kissing and oral sex to prevent spreading the virus during an oral herpes outbreak

• Abstain from sex during a genital herpes outbreak

• Avoid touching open sores to reduce the risk of spreading them to other parts of the body

• Never pop the sores

• Avoid peeling scabs, as this prolongs the healing process

• Wash your hands with soap and water before and after applying an ointment to your sore

• Don’t share any products you use on your lips or sores during a flare-up

• Don’t share towels, dishes, or cutlery

• Don’t kiss infants: Neonatal herpes infection in babies can be deadly

How to prevent an outbreak

While there is no known cure for herpes, you can prevent an outbreak. You can take antiviral medications like acyclovir and learn about your triggers. 

While scientists aren’t exactly sure what can trigger an outbreak, these can cause flare-ups:

• Stress

• Menstruation (periods)

• Another infection or illness, such as a cold

• Fever

• Sunlight exposure

• Tiredness

• Injury to the area

• Hot or cold temperatures

If you suffer from recurrent outbreaks of genital herpes, your doctor may suggest taking an antiviral every day to prevent future outbreaks and transmission. These drugs prevent HSV from multiplying in your body's cells. 

When to see a doctor

Call your doctor if:

• You're pregnant

• You have a high fever

• You’re vomiting

• The sores aren’t healing

It's important to see your physician if you're concerned about herpes and need some clarification on the infection. 

Your doctor will want to confirm you have symptoms of herpes rather than an infectious disease like chickenpox. While there’s no cure, your doctor may prescribe acyclovir to control the outbreak.

The lowdown

HSV-1 and HSV-2 are two similar herpes simplex viruses that cause herpes. Outbreaks may lead to flu-like symptoms, including chills, fever, body aches, and headaches. While there isn't currently a cure for this virus, medications can manage symptoms and reduce outbreaks. Speak to your doctor for diagnosis and their recommendations for treatment. 

Frequently asked questions

How do I know if I have herpes?

The only way to know for sure is to ask your doctor or healthcare professional. Your doctor may be able to tell from looking at the blisters. They can also check by swabbing the existing sores or ordering a blood test, although testing is not always required.

What does an outbreak look like?

An outbreak of cold sores or genital herpes usually looks like a cluster of fluid-filled blisters that can burst and crust over.

What causes an outbreak?

There isn't one specific cause for an outbreak after contracting HSV. Outbreaks are unpredictable, but contributory factors include stress, lack of sleep, or other illnesses that cause a weakened immune system.