Herpes is common and it’s an incurable sexually transmitted disease. It’s very common in the United States that more than 1 out of every 6 people ages 14 to 49 has genital herpes, according to the Centers for Disease Control and Prevention (CDC). Because herpes is somewhat easier to pass from men to women than from women to men, more American women than men have it, the CDC notes.
Herpes is caused by the herpes simplex virus (HSV). There are two types of this virus: herpes simplex 1 (HSV-1) and herpes simplex 2 (HSV-2). Both viruses are transmitted by close contact with a person who has the virus. HSV-1 is usually associated with cold sores around the mouth, while HSV-2 most often affects the genital area.
However, research has shown about one-half of all new cases of genital herpes in developed countries are caused by HSV-1, not HSV-2. This is 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.
A first genital herpes outbreak may cause multiple blisters that break and leave painful sores that take a week or more to heal. After your first outbreak, you may have more outbreaks, especially if you are infected with HSV-2. But the repeated outbreaks tend to be shorter and less severe each time you have one.
That being said, Planned Parenthood notes that many people who are infected with HSV have no symptoms, or their symptoms are very mild, so they often don’t know they have the virus. They may also mistake their symptoms for those of another STD or skin condition, such as a pimple or ingrown hair in their genital region.
On the positive 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. Also, having herpes raises the risk of getting HIV.
Once you have herpes, you’ll always have it. There’s no cure for herpes. But there are medicines that can prevent or shorten outbreaks, as well as make it less likely you will pass it on to intimate partners. Still, if you have herpes, whether or not you take medication, you should tell anyone you have sex with so they know the risks. Your risk of spreading the virus is higher when sores or other symptoms are present, but it can be spread at any time. Also, while using condoms may help lower the risk of spreading herpes, it will not guarantee your partner will not get it.
That said, do you know how to recognize herpes or tell it apart from other conditions?
What Does Genital Herpes Look Like?
While you may not experience any symptoms of genital herpes, if you do, they can be mild or severe. Symptoms might include blisters or painful sores in your genital area or on your buttocks, a skin rash, or a burning sensation when urinating. However, these symptoms can also occur with other sexually transmitted diseases. While your doctor can often make a diagnosis on the basis of your symptoms, in some cases you will need to be tested, either from a swab of a sore or a blood sample, to figure out what is causing your symptoms.
An outbreak of genital herpes will heal on its own — but once you’re infected, particularly if you have HSV-2, you’ll likely have occasional outbreaks for the rest of your life. Taking antiviral medication can help speed up the healing of genital herpes lesions, reduce the number of outbreaks you have, and lower the risk of spreading the virus to sexual partners. But even with medication, you can still pass on genital herpes to another person during sexual activity, so it’s important to tell anyone you plan to have sex with that you have herpes. Using condoms also lowers — but does not eliminate — the risk of herpes transmission.
If you are pregnant, you can pass on herpes to your infant during pregnancy or childbirth or just after birth. Herpes in a newborn is a serious, sometimes fatal, condition. Be sure to tell your doctor that you have herpes so your baby can be treated quickly at any signs or symptoms of neonatal herpes, notes Boston Children’s Hospital.
Fever Blisters and Cold Sores Are Oral Herpes, Too
Fever blisters and cold sores are just different names for oral herpes, and they’ve been around for a very long time. Legend has it that in ancient Rome, the emperor Tiberius banned kissing at public events because of an outbreak of fever blisters. In other words, they even knew back then how contagious fever blisters are.
The best way to protect yourself is to avoid contact with a person who has a cold sore and refrain from sharing eating utensils, lip balm, and the like. Note that someone with oral herpes can give you genital herpes if they perform oral sex on you. Avoid kissing and oral sex when outbreaks are present.
There is no cure for fever blisters and no vaccine to prevent them, although research into preventing and treating them is ongoing. If you do get oral herpes, your doctor may recommend over-the-counter pain medication and topical anesthetics to relieve symptoms. Some people also choose to take antiviral medication to make cold sores go away faster.
Contact Dermatitis Can Be Mistaken for Herpes
Contact dermatitis is a skin condition that can cause red, itchy, cracked, dry, or scaly skin, blisters, or a rash. Like herpes, it recurs, and while it’s not an STD, 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 something you’re allergic to, per the Mayo Clinic. It’s not caused by a virus.
Contact dermatitis usually occurs within minutes to hours after touching an irritant. Common causes include poison ivy and reactions to medication, cosmetics, detergents, and jewelry. The skin rash from contact dermatitis usually clears up in a few 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 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.
Are Canker Sores Caused by the Herpes Virus?
Canker sores are not caused by the herpes virus or by any other virus. In fact, the cause of canker sores is unknown, although they may be triggered by a minor injury in your mouth from dental work or brushing too hard, an allergy, a vitamin B deficiency, stress, or a food intolerance. Some medical conditions, such as celiac disease and inflammatory bowel disease, may also cause canker sores, and they often occur in families, so it’s possible genetics or environment play a part, too.
Canker sores typically appear as small, round, or oval whitish sores with a red border, according to the Mayo Clinic. They typically occur on the tongue, inside the cheeks, inside the lips, or on the gums. The medical term for a canker sore is aphthous ulcer. Canker sores can be quite painful, but they usually heal within about two weeks without leaving any scarring.
Unlike cold sores, which usually occur outside the mouth, canker sores occur only inside the mouth. Like cold sores, canker sores are recurrent, but they are not contagious: You can’t give a canker sore to another person. Canker sores occur more often in teenagers and young adults, and they are more common in women than men.
A canker sore that is large or particularly painful can make it hard to eat and talk. In some cases, your doctor may suggest you use an alcohol-free mouth rinse or topical treatment to ease the pain of a canker sore. Gargling salt water may also help. If the sore lasts longer than 10 to 14 days, you should see a doctor or dentist.
Oral Herpes: Blisters Around the Mouth and Nose
Oral herpes (also called cold sores or fever blisters) is usually caused by HSV-1, but it can also be caused by HSV-2, which is typically associated with genital herpes. Not everyone infected with HSV-1 or HSV-2 will have symptoms of oral herpes, but many people do. Between 2 and 20 days after contact with a person infected with the herpes virus, you may feel a burning or stinging sensation around your mouth. Then blisters and sores may break out around the mouth or in the nose area. Occasionally, cold sores form inside the mouth, on the gums or roof of the mouth.
Cold sore blisters can appear in a range in sizes. Some are more painful than others, and they can last for 7 to 10 days. As they heal, they usually break, crust over, and eventually leave behind an area of red skin.
Although the skin lesions that occur with oral herpes usually heal completely — as with genital herpes — the virus can stay in your body and reappear in the same area again and again or in a new area around the mouth or nose. Exactly why outbreaks occur isn’t known, but some common triggers include stress, lack of sleep, too much exposure to sunlight, cold weather, and, for women, hormonal changes.
Cold sores can be spread through kissing and through sharing eating utensils, cups and glasses, straws, lip balm, or anything else that has come into contact with a sore.
When you have cold sores or fever blisters on your mouth, you should refrain from giving oral sex because you can pass on the herpes virus to your partner’s genitals.
A cold sore outbreak can be shortened with antiviral medication.
What About Chlamydia, the Most Common STD?
Chlamydia is caused by bacteria, whereas herpes is caused by a virus. This is why chlamydia is easily treated and cured with antibiotics. However, many people have chlamydia and don’t know it because they don’t have any symptoms. That’s why people who are at higher risk of chlamydia, including sexually active young women and men who have sex with other men, are advised to get a test for chlamydia every year.
If you don’t treat chlamydia, it can increase the chances of both men and women getting or giving HIV and AIDS, according to Medline Plus. Untreated chlamydia can also cause serious pelvic inflammatory disease in women, which can lead to infertility, and in men it can spread to the testicles and the tube that carries sperm, causing inflammation.
Screening for chlamydia is usually done by taking a urine sample or a swab from your genitals. Results of these tests are usually found quickly. Different testing methods are used for infections of the rectum and throat, and these take more time.
While the only way to completely avoid getting chlamydia or herpes is to not have sex, you can reduce your chances of getting both by being in a long-term, mutually monogamous relationship with a partner who is not infected with an STD and by using latex condoms every time you have sex.
How to Tell a Yeast Infection From an STD
Vaginal yeast infections are very common — 75 percent of women will have one in their lifetime, and nearly 50 percent will have more than one. Some of the symptoms of a yeast infection — including vaginal itching, rash, soreness, and pain when urinating — are similar to those of herpes, as well as of other STDs, like chlamydia and gonorrhea. Other symptoms of a yeast infection include a white discharge without a foul odor, swelling of the vagina and vulva, and pain during sex.
Most vaginas have healthy yeast in them. A yeast infection occurs when the acidity level in the vagina drops and too much of that yeast grows, notes Planned Parenthood. This can be caused by hormones, drugs, diabetes, weak immune systems, and more. While very rare, men can also get yeast infections on their penis and scrotum that cause redness and irritation.
Yeast infections are not STDs and generally aren’t contagious, but they can be passed from one partner to another during sex. Having sex can also lead to yeast infections if your body has a bad reaction to a lubricant or contraceptive product, according to Berkeley Wellness. Receiving oral sex is known to cause yeast infections in some women. And for some, vaginal sex, particularly with a new partner, triggers a yeast infection.
If you have a yeast infection, your doctor may suggest you take an over-the-counter or prescription antifungal medication. The infection will usually clear up in a few days.
How Can I Tell if It’s Scabies or Herpes?
Scabies is caused by tiny eight-legged mites (called human itch mites) that burrow into the skin to live, feed, and lay their eggs. There are millions of cases of scabies worldwide each year.
Herpes may be confused with scabies because both conditions can cause a skin rash of small, itchy bumps and blisters that spread through person-to-person contact. As with herpes, the scabies skin rash is sometimes seen in the genital area. It can be transmitted through close physical or sexual contact because the mites can move from one body to another. If you’ve never had scabies before, it can take two to six weeks to develop symptoms after the mites move in.
Unlike herpes, you can also get scabies from bedding, clothes, or furniture that’s infested with mites, since the mites can live for about three to four days without being on a human.
Also unlike herpes, scabies is most commonly found on the hands, arms, and legs, and the most common symptom is severe itching that occurs mainly at night.
Your dermatologist can tell if you have scabies by examining your skin or looking at a small piece of skin under a microscope, notes the American Academy of Dermatology.
Scabies is easily treated with a medicated cream or lotion that kills the mites.
Is That Spot a Pimple or a Cold Sore?
Acne is the most common skin condition in teens and young adults in the United States, and it’s increasingly common among women in their thirties, forties, and fifties. It can cause a range of blemishes variously known as blackheads, whiteheads, papules, pustules (pimples), cysts, and nodules, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Acne is sometimes confused with oral herpes because of the way a breakout looks. Although oral herpes sores usually appear as small, clear blisters filled with fluid, in some instances they can look more like the reddened skin and pimples associated with acne. However, herpes is typically associated with more itchiness and pain than acne.
And whereas oral herpes sores are usually found on the mouth, lips, chin, cheeks, or nose, acne can break out on any area of the face as well as on the neck, chest, back, and shoulders.
Acne is caused by excess skin oil, clogged pores, and bacteria — not the herpes virus. Hormones, stress, certain medicines, and sometimes diet can trigger or worsen acne outbreaks. While a single pimple may clear up in a few days, a larger acne outbreak may last for weeks to months.
Acne is not contagious, and topical and oral medication can help heal pimples, stop new pimples from forming, and prevent scars. To avoid scarring, don’t squeeze or pop pimples.
How to Know if It’s Gonorrhea or Genital Herpes
Gonorrhea is another common STD that has some symptoms similar to genital herpes. Herpes and gonorrhea can both cause sores in the genital area, skin rash, and burning pain when urinating. One symptom that distinguishes gonorrhea from genital herpes is discharge from the vagina or penis.
Like syphilis and chlamydia, gonorrhea can be serious if not treated, but it usually responds to antibiotics since it’s caused by a bacteria. Your doctor may give you a one-time pill or a seven-day dose to treat gonorrhea.
If women don’t get treated for gonorrhea, they are at risk for serious complications, such as pelvic inflammatory disease, which can cause infertility. In men, complications of gonorrhea may include epididymitis, an inflammation of a coiled tube at the back of the testicles. This condition can cause testicular or scrotal pain and, in rare cases, infertility.
If you have any symptoms of an STD, see your doctor or go to a sexual health clinic. Your doctor will know what test to give you to detect which STD you have. And if you’re sexually active, get screened regularly and always practice safe sex. Like all STDs, herpes and gonorrhea are only completely avoidable if you don’t have sex. All sexually active people are at risk.
Syphilis: A Greater Health Threat Than Herpes
Syphilis and genital herpes are both STDs that can cause sores in the genital area. Like oral herpes, syphilis can also cause mouth sores, which often clear without treatment. But despite these similarities in symptoms, the two diseases differ in their causes — syphilis is caused by a bacteria and herpes by a virus — and the health risks they pose.
For most people — the exceptions being infants and people who have weakened immune systems or who are chronically ill — herpes is more of an annoyance than a dangerous disease. But untreated syphilis can lead to severe complications, including bone, joint, liver, heart, and brain damage.
There are four stages of syphilis, according to the CDC, each with different signs and symptoms. In the primary stage, a painless sore or sores develop where the bacteria first entered the skin or mucous membrane. In the secondary stage, you may develop a skin rash, swollen lymph nodes, fever, and other flu-like symptoms. In the latent stage of syphilis, there are no signs or symptoms, and in the tertiary stage, the bacterial infection can damage the heart, brain, and other organs of the body.
Unlike herpes, syphilis is easily cured if antibiotics — usually Bicillin L-A (penicillin G benzathine) — are given in the early stages of the disease. However, antibiotic treatment can’t reverse any organ damage that has already occurred as a result of the disease, and you can get syphilis again after treatment if you engage in sexual activities with someone who is infected. While not having sex is the only way to completely guard yourself from syphilis, if you are sexually active, using condoms can help reduce your risk.