Herpes or Something Else? 13 Conditions Mistaken for Herpes

Sensitive Content: Medical Images Included
This article contains medical images of genital conditions that may cause itching and irritation.

Genital herpes is a sexually transmitted infection (STI) often mistaken for other conditions due to its non-unique symptoms. The signs of genital herpes can closely resemble those of other STIs, such as syphilis or genital warts, as well as various skin conditions like eczema and folliculitis.

This overlap makes it challenging to differentiate herpes from other causes of similar-looking bumps and sores. In this article, we’ll explore 13 conditions that are commonly mistaken for herpes, helping you understand the differences and when to seek professional medical advice.

What Does Genital Herpes Look Like?

HSV-1 generally causes oral herpes, leading to fever blisters or cold sores around the mouth, often contracted through infected saliva during oral sex. On the other hand, HSV-2 primarily affects the genital areas, resulting in painful genital lesions.

There is no significant difference in the early clinical manifestation of genital herpes between HSV-1 and HSV-2 infections. Multiple lesions, usually bilateral, develop on the genitals or nearby skin after an incubation period of 4 to 7 days.

These lesions typically progress through stages: starting with erythema (redness), then forming papules (small bumps), followed by short-lived vesicles (blisters), painful ulcers, and finally crusts. These crusts usually subside within 2-3 weeks.

The appearance of flu-like symptoms before the formation of lesions is a distinguishing factor between genital herpes and other conditions.

Conditions That Can Be Mistaken for Herpes

Contact Dermatitis Can Cause Itchy, Red Skin

Irritative eczema on the penis head can resemble herpes but typically lacks the blisters and sores that are characteristic of herpes outbreaks

Contact dermatitis causes skin inflammation characterized by burning, pain, itching, and soreness, but it occurs only at the site of skin contact with the allergen. In contrast, genital herpes lesions typically appear around the genitals.

Contact dermatitis can develop in the genital area due to allergens from sanitary napkins, condoms, or toilet paper. The inflammation from contact dermatitis can often be resolved by avoiding the allergen, using antihistamines, or applying a topical corticosteroid.

Read more: Contact Dermatitis vs Cold Sores: Identifying the Difference

Syphilis Can Also Cause Sores on the Genitals and Mouth

Penile ulcer shown here may be caused by infections like herpes or syphilis, both of which can produce similar sores on the genitals.

Syphilis is also a Sexually Transmitted Disease which begins with swollen lymph nodes 3 weeks after the incubation. Syphilis will also form few ulcers on the genital areas and mouth followed by fever, headaches and rashes on arm, chest, shoulders and neck areas after 6-8 weeks whereas genital herpes begins with fever, chills, swollen lymph nodes and then only form the genital lesions.

Read more: Syphilis vs. Herpes: How to Tell the Difference

Yeast Infection May Also Cause Genital Itching and Discomfort

Yeast infection is a fungal infection called candidiasis caused by the fungus Candida. It targets the areas penis, vagina and throat. Along with burning and itching sensation a white discharge may be visible from vagina and a redness could be observed on the head of penis.

So yeast infections in vagina could be mistaken as vaginal herpes conditions. Candidiasis may resolve by the intake of antifungal medications that won’t combat genital herpes.

Molluscum contagiosum Presents with Small, Pearly Bumps

Molluscum contagiosum lesions on the upper pubic region, often visually mistaken for herpes due to their similar appearance. Both conditions can present as small, raised bumps.

Molluscum contagiosum is also a viral infection that develops lesions anywhere on the body including genitals. Although this is a Sexually Transmitted Disease, physical contact with the lesions too can spread the viral infection. It may form small white or skin colored bumps with a dimple in the middle. They may disappear on their own. Infection stays in the body as long as the bumps stay on the body.

Read more:

• Molluscum Contagiosum vs. Genital Herpes: How to Tell the Difference

Genital Warts Often Appear as Painless Bumps

Genital warts under the scrotum may present with symptoms like small bumps and irritation, which can closely resemble those of herpes.

Genital warts are one of the most common sexually transmitted diseases in the U.S., caused by the Human Papillomavirus (HPV). These warts are typically painless but can be itchy, and they rarely ooze. They may develop anywhere from 3 weeks to 8 months after exposure to the virus.

Warts usually appear as clusters or single bumps that can be dark-purple, brown, or skin-colored. Even though the warts may disappear on their own or with treatment, the underlying HPV infection is not curable, and the warts can return in the future.

Read more: Genital Warts vs Genital Herpes: Spot the Differences

Jock Itch Can Cause Red, Scaly Rashes in the Groin Area

Jock itch can cause red, scaly rashes in the groin area, which may resemble the symptoms of herpes.

Jock itch also known as Tinea Cruris, primarily affects the groin area and is a fungal infection. Long-term moisture and friction in the groin create an environment conducive to the development of jock itch. It manifests as a red, scaly rash that may spread to the thighs and anus. The symptoms of jock itch can resemble those of genital herpes, making it difficult to distinguish between the two.

Bacterial Vaginosis May Lead to Vaginal Irritation and Discharge

While the exact cause of bacterial vaginosis (BV) remains unknown, it is often associated with an imbalance in the natural bacteria found in the vagina. BV can develop even without noticeable symptoms and is sometimes linked to sexual activity.

Common symptoms include vaginal irritation, unusual discharge, and a burning sensation during urination. Although antibiotics like Metronidazole and Clindamycin are effective in treating BV, the condition can recur.

Skin Irritation from Shaving or Clothing Can Mimic Herpes Outbreaks

Skin irritation in the genital area, caused by shaving products, razor cuts, tight clothing, frequent sexual intercourse without lubricants, or friction from a bicycle seat, can sometimes be mistaken for a herpes outbreak. It’s important to pay close attention if these irritations occur frequently and to seek medical advice if the irritation does not resolve on its own.

Folliculitis Can Cause Painful, Pustular Bumps

Folliculitis can cause red, itchy bumps around hair follicles, which may be mistaken for a herpes outbreak.

The root of the hair follicle may get inflamed and form folliculitis. This may be either due to friction in shaving or staphylococcus bacterial infection. Itchy rashes, pimples or pustules develop around the hair follicles in genital areas and they may go away on their own. Practicing genital hygiene, applying hot compresses and use of antibiotics or antifungal medications could reduce folliculitis that stays more than 3 days.

Genital Eczema Causes Itchy, Inflamed Skin

Eczema or atopic dermatitis is a skin condition that come and go throughout one’s lifetime. It is an itchy skin rash with fluid leakage occasionally. These kinds of eczema conditions may develop on genitals that might be mistaken as genital herpes. But an eczema may temporarily go away with topical corticosteroids and oral immunosuppressant tablets.

Psoriasis May Lead to Persistent, Scaly Patches

Psoriasis in the genital area can be mistaken for genital herpes, as both conditions can cause smooth, itchy, and raised patches of skin.

Psoriasis is also a chronic skin disease that may spread into genital areas too. Nearly 63% of the patients with psoriasis have genital lesions at least once in their life span. So this could be mistaken as an eczema as well as genital herpes. Genital psoriasis will develop as a smooth itchy skin condition with raised and scaly patches. It can be controlled by some prescription creams and medicines.

Behcet’s Disease Can Cause Painful Mouth and Genital Sores

This is a rare condition in US with sores in genitals and within mouth. It is caused by the inflamed blood vessels that can affect many areas of body. So Behcet’s disease is easily mistaken as genital herpes. But because of the other symptoms like swollen eyes, joint stiffness and swollen joints, this could be differentiated from genital herpes. Oral and topical medicines might be helpful in controlling this condition.

Crohn’s Disease Can Lead to Genital Ulcers

This is a rare condition in US with sores in genitals and within mouth. It is caused by the inflamed blood vessels that can affect many areas of body. So Behcet’s disease is easily mistaken as genital herpes. But because of the other symptoms like swollen eyes, joint stiffness and swollen joints, this could be differentiated from genital herpes. Oral and topical medicines might be helpful in controlling this condition.

When to See a Doctor

Identifying Symptoms That Require Medical Attention

If you notice any unusual appearance or sensation on your genital skin, it’s crucial to see a doctor and request a herpes screening. Seek immediate medical attention if blisters form in the genital area and do not heal within 3-5 weeks. Additionally, if you’ve been previously diagnosed with genital herpes and are experiencing new symptoms like difficulty urinating or defecating, prompt medical consultation is necessary. If you suspect you’ve been exposed to the Herpes Simplex Virus (HSV), it is also wise to consult a doctor for a diagnostic test.

Diagnostic Tests for Herpes and Other Conditions

For accurate diagnosis, a swab from a blister that is less than 4 days old can be sent to a laboratory to test for Herpes Simplex Virus (HSV). A blood test may also be performed to identify the specific type of herpes virus present, helping to determine the most effective treatment. Consulting a doctor as soon as blisters appear on the genital area or around the mouth is advisable for timely diagnosis and treatment.

Read more:

• How Long Does It Take for Herpes Symptoms to Show Up?
• How To Test For a STD?

Experiencing genital itching and irritation? Noticing redness or discomfort? These could be signs of an infection or another genital condition.

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