Is It a Rash or Is It Herpes?

Herpes lesions often look wet and may form a crust once they rupture. Other types of rashes, such as those from irritants or tinea cruris (jock itch), usually present differently.

When someone develops an inflamed, painful skin eruption, they may worry it’s caused by herpes. To help distinguish between them, this article compares the visual signs and symptoms of herpes with those of several frequent skin rashes.

Rash symptoms vs. herpes symptoms

Herpes

If you notice fluid-filled, “wet-appearing” blisters around your mouth or genital area, you likely have a herpesvirus infection. When these blisters are broken, they commonly form a crust.

There are two main herpes viruses:

• HSV-1 (Herpes simplex virus type 1) typically causes cold sores or fever blisters around the mouth and lips.
• HSV-2 (Herpes simplex virus type 2) usually causes sores in the genital region.

Many people infected with herpes never develop noticeable symptoms, but common signs include:

• fluid-filled blisters
• tingling, burning, or itching of the skin before lesions appear
• flu-like symptoms
• pain or discomfort when urinating

Rashes

A rash represents skin inflammation that can arise from numerous causes, from contact with irritants to systemic illness. Rashes are often characterized by:

• redness
• swelling
• itchiness
• scaling or flaking

The features of specific rashes usually differ from herpes, although they may develop in similar body areas. Common conditions that can cause a rash include:

Dermatitis

Dermatitis produces red, itchy, often flaky skin. It’s commonly categorized as contact dermatitis or atopic dermatitis.

Contact dermatitis develops after the skin encounters an irritant, like a fragrance or chemical. The rash appears where contact occurred and may include blisters. A rash from poison ivy is an example of contact dermatitis.

Atopic dermatitis, also called eczema, is an allergic-type rash. It typically causes thickened, scaly, red patches across different parts of the body.

Unlike herpes, dermatitis can show up anywhere on the skin. Contact dermatitis usually improves once the offending substance is removed and the area is cleansed gently. Managing atopic dermatitis focuses on moisturizing and avoiding triggers such as very hot showers or extreme cold.

Shingles

Shingles is a painful skin condition caused by reactivation of the varicella-zoster virus, the same virus that causes chickenpox. Although shingles can produce itchy, fluid-filled blisters like herpes, those blisters generally appear in a single stripe or limited area on one side of the face, neck, or torso, accompanied by an angry-looking rash.

• Treatment for shingles. There’s no cure, but antiviral medications such as acyclovir (Zovirax) or valacyclovir (Valtrex) may be prescribed to shorten the duration and lessen complications. Your provider may also recommend pain relief, for example topical lidocaine.

Jock itch

Jock itch is a fungal infection that typically looks like a red rash with small blisters along the edge. These blisters generally don’t crust over as herpes blisters do. Herpes lesions often affect the penis, while jock itch usually affects the inner thighs and groin area but not the penis itself.

• Treatment for jock itch. Jock itch is commonly managed with two to four weeks of cleansing with an antifungal shampoo and applying a topical antifungal cream.

Scabies

Scabies is a contagious skin infestation caused by the Sarcoptes scabiei mite, which burrows into skin to deposit eggs. While herpes is usually localized to the mouth and genitals, scabies can affect any area of the body. A scabies infestation appears as redness or a rash, often with tiny pimples, bumps, or blisters. Scratching may lead to sores.

• Treatment for scabies. Your provider is likely to prescribe a scabicide lotion or cream to eliminate the mites and their eggs.

Genital warts

Genital warts, caused by the human papillomavirus (HPV), are generally flesh-colored growths that can look like cauliflower, whereas herpes produces fluid-filled blisters.

• Treatment for genital warts. In addition to prescription topical treatments, clinicians may recommend cryotherapy (freezing) or laser removal. Because HPV has no cure, treatments may not prevent recurrences.

Razor burn

Shaving pubic hair can irritate the skin and create ingrown hairs, producing red bumps that may be mistaken for herpes lesions. Razor burn is more like an acneiform rash. Ingrown hairs often resemble pimples with a central yellow spot, while herpes sores are more typically fluid-filled blisters containing clear liquid.

• Treatment for razor burn. People treat razor burn with OTC topical hydrocortisone creams or home remedies such as witch hazel or tea tree oil.

Shop for hydrocortisone.

Shop for witch hazel.

Shop for tea tree oil.

Consult with your doctor

Certain rashes need medical evaluation. Make an appointment with your clinician if:

• the discomfort is severe enough to disrupt sleep or daily activities
• you suspect herpes or another sexually transmitted infection
• you believe the skin may be infected
• self-care measures haven’t helped

Outlook

If you suspect your rash might be herpes, examine its appearance and symptoms and compare them with typical herpes signs and other common rashes. Regardless of your observations, it’s sensible to consult your healthcare provider, who can recommend appropriate treatments for various skin inflammations.