How Do I Know if I Have Herpes or Another Condition?

Genital herpes is a sexually transmitted infection (STI). At first glance, signs of genital herpes signs are not unique. This makes it difficult to tell the difference between herpes and other sores.

For instance, you may get similar-looking bumps from other STIs, such as syphilis and genital warts, or skin diseases like eczema and folliculitis. Learn more about what herpes looks like and how it differs from other conditions.

What Does Herpes Look Like?

The development of a typical genital herpes lesion begins with redness, swelling, and the formation of a papule, a small, solid bump with easily visible edges. Then, a blister develops.

Blisters often cluster and may break open and leak fluid, resulting in ulcers (open sores). Eventually, they crust over and heal on their own without leaving scars.

Only about 10-25% of people with genital herpes develop typical blisters, sometimes years after infection. The rest may develop lesions that are unusual or go away fast; they may also develop no lesions at all.

Differences Between Herpes and Other Conditions

One difference between herpes and other conditions is that you may experience flu-like symptoms before a herpes outbreak, such as:

• Fatigue
• Fever and chills
• Muscle aches
• Nausea
• Tingling or pricking in the area of future lesions

Other differences can be due to the absence or appearance of the skin. The conditions may also differ based on skin characteristics. For example:

• Bacterial vaginosis (BV): Bumps aren't a symptom of BV.
• Contact dermatitis: Genital contact dermatitis can appear as swelling without distinct boundaries—unlike the pustules in genital herpes—with a loss of skin texture.
  
• Jock itch: This condition doesn't spread to the scrotum or penis.
• Yeast infections: Herpes-like vulvar rashes are not a symptom of yeast infections.

Read on to learn more about 13 conditions that may look like herpes.

1. Contact Dermatitis

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Contact dermatitis causes skin inflammation and soreness after direct exposure to an irritant or allergen. While herpes lesions can happen anywhere around the genitals, a dermatitis rash develops where the triggering substance touches your skin.

Other symptoms of contact dermatitis include burning, itching, soreness, and pain. Also, you may get contact dermatitis from products like toilet paper, menstrual products, or condoms.

The first step to resolving and preventing contact dermatitis is avoiding the irritant or allergen. A healthcare provider may prescribe a topical corticosteroid cream to reduce inflammation or an antihistamine medication to reduce itching.

2. Syphilis

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Syphilis is an STI where you may feel swollen lymph nodes about three weeks after infection. You may also notice one or more ulcers on the genitals or other body parts exposed to the virus.

Six to eight weeks later, you may experience fever, headache, and a rash on the shoulders, arm, chest, or back, and often on your palms and soles. Syphilis is easily diagnosed and curable when caught early and treated with antibiotics.

3. Yeast Infection

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A yeast infection, known as candidiasis, happens when Candida—a fungus that usually exists in the body—grows too much. It can affect the vagina, the penis, and the throat. Symptoms may include:

• Vaginal: genital itching, burning, and white and clumpy discharge
• Penile: burning, itchiness, and redness on the head of the penis

People with a vagina can get a yeast infection as a complication of genital herpes, especially during their first outbreak. Yeast infections can be treated with prescription or over-the-counter antifungal medications. However, if you have herpes-related sores, medication for a yeast infection won’t clear them up.

4. Molluscum Contagiosum

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Molluscum contagiosum is a viral infection that presents as lesions that can appear anywhere on the body. Many adult molluscum contagiosum cases are transmitted sexually, but any physical contact with the lesions can pass on the virus. As long as you have bumps, you are infectious. Molluscum contagiosum lesions have the following features:

• Small raised bumps 
• Usually white, pink, or skin-toned
• Often appear pearly
• Have a dimple or pit in the center
• Occur anywhere on the body, including the genitals

Bumps can resolve on their own. Still, if you want to speed up the healing process, talk to a healthcare provider about creams, medications, or physical removal.

5. Genital Warts

Genital warts are among the most common STIs in the U.S., caused by the human papillomavirus (HPV). Warts appear between three weeks and eight months after infection. The warts are generally not uncomfortable or painful but can be itchy. They rarely ooze and typically appear as:

• Clustered in a few small bumps, possibly shaped like a cauliflower, or only appearing as one bump
• Light and pearly, dark purple, gray, brown, or skin-colored
• Bumpy or flat
• Smooth or rough
  

Without treatment, the warts can go away, stay the same, grow, or multiply. You can talk to a healthcare provider about getting prescription medication or physical treatment for the bumps. However, the warts may return since HPV is not curable.

6. Jock Itch

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Jock itch is a fungal infection that mostly affects the penis. It can happen because of friction or prolonged wetness in the groin area. Jock itch involves a rash, typically appearing in the upper thigh's creases—possibly spreading to the anus.

The rash is red, raised, scaly patches that may blister and ooze, often with visible edges. Jock itch can also cause abnormally light or dark skin. In most cases, jock itch can be cured with antifungal medications.

7. Bacterial Vaginosis

BV happens because of changes in the amounts of certain bacteria in your vagina. About 29% of women in the U.S. may get BV, though only about half experience any symptoms. Symptoms of BV include:

• Unusual vaginal discharge
• Burning while urinating
• Itching around the outside of the vagina
• Vaginal irritation

The exact causes of BV are unknown, but having sex without condoms or douching can raise your risk of getting the condition. It's generally treatable with antibiotics like metronidazole and clindamycin, but in most cases comes back after treatment.

8. Skin Irritation

The following causes of skin irritation can mimic genital herpes:

• Shaving or razor burn
• Hair removal products
• Bicycle seat friction
• Wearing thongs or tight jeans
• Friction from frequent sexual intercourse
• Not enough lubrication during sexual intercourse

If you experience irritation around your genitals, pay attention to your daily activities and clothing. Avoid tight or wet clothing and use lube during sex.

Also, note if the irritation doesn't go away on its own or comes back regularly without a known trigger. You'll want to talk to a healthcare provider about your symptoms and recommended STI testing.

9. Folliculitis

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Folliculitis happens when a hair follicle—the tissue around the hair root—becomes inflamed. This inflammation can be caused by friction or shaving and a staphylococci (staph) bacterial infection. Symptoms of folliculitis include rash, itching, and pustules or pimples near a hair follicle that can crust over.

You can take care of folliculitis at home by applying a hot, moist compress to the affected area and maintaining good genital hygiene. Talk to a healthcare provider if you experience the condition often or if it worsens or lasts longer than three days. They may prescribe antibiotics or antifungal medicine.

10. Genital Eczema

Eczema (atopic dermatitis) is a common skin condition that presents as an itchy rash. It may come and go throughout your life, but in many cases gets better over time, especially in children. Besides severe itchiness, symptoms of eczema include skin redness and, occasionally, blisters that easily break and leak liquid.

There's not much research on how frequently eczema spreads to the genitals. However, one study of more than 200 participants with eczema found that 45% had experienced genital symptoms.

Eczema doesn't have a cure, but over-the-counter and prescription treatments topical corticosteroids, alitretinoin, and immunosuppressant tablets can help reduce symptoms.

11. Psoriasis

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Psoriasis is another chronic skin condition that can affect the genitals and is often confused with eczema. About 63% of people with psoriasis develop genital lesions at least once in their lifetime, making the disease one of the most common genital skin conditions.

Psoriasis typically causes itchy, raised, and scaly patches known as plaques, but genital psoriasis may appear smooth. There is no cure for psoriasis, but some prescription medications and creams can help reduce and treat flares.

12. Behcet's Disease

Behcet's disease, or Behcet's syndrome, is a rare condition in the U.S. that may look similar to herpes. It is a condition of inflamed blood vessels that can affect several body parts. Behcet's disease can result in sores on the genitals and within the mouth. However, it comes with other symptoms, such as:

• Eye area swelling
• Joint pain, stiffness, and swelling
• Other skin lesions

This condition doesn't have a cure, but options are available for treating symptoms. Topical and oral medications may be prescribed.

13. Crohn's Disease

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Crohn's disease is a type of inflammatory bowel disease (IBD). However, the disease can affect the vulva, which consists of the outer parts of the vagina, in rare cases. Called vulvar Crohn's disease, it can sometimes occur without the form of Crohn's disease that causes gastrointestinal symptoms.

Some signs of vulvar Crohn's disease may include redness, swelling, ulcers, and tissue tears—known as fissures. Though treatment varies individually, steroid treatments can be helpful for short periods. If left untreated, the ulcers can worsen, and the skin may continue to break down. Untreated vulvar Crohn's disease can also result in other conditions like cellulitis, a skin infection, and abscesses, which are pus pockets.

A Quick Review 

Several conditions can present with symptoms similar to those of genital herpes. These may include BV, folliculitis, genital eczema, and skin irritation. If you're worried or your symptoms bother you, there's no need to self-diagnose and wait it out. Talk to a healthcare provider right away, as they can recommend the proper testing and treatment options for the causes of bumps in the genital area.