How to Identify a Herpes Rash

A herpes rash causes small bumps that turn into blisters or sores. Depending on the area infected with the herpes simplex virus (HSV), these may appear on the mouth, genitals, buttocks, and other areas. The rash can be painful. And while it can resolve, it can return over time because HSV never leaves the body.

There are two strains of the virus—HSV-1 and HSV-2. Either can cause this, though some herpes rashes are more likely to be due to one strain versus the other. There are also other rashes that can be easily mistaken for herpes.

This article describes the symptoms of herpes and how and where this common viral infection causes outbreaks. It also explains how a herpes rash is treated and lists the various conditions that resemble herpes.

What a Herpes Rash Looks and Feels Like

A classic herpes outbreak usually involves one or more blisters that start as small, red bumps. They rapidly develop into painful, fluid-filled blisters that sometimes merge into a larger blister.

The rash may be preceded by any of the following several days before there are any visible skin changes:

• Itching
• Numbness
• Tingling
• Burning

Herpes blisters commonly erupt, leaving a painful ulcer with raised edges. The sores can ooze and crust over. Severe outbreaks can cause scarring.

The location of the rash and its duration can vary depending on the infection:

When herpes infects the hand, it can cause herpetic whitlow on a finger, leading to symptoms such as finger swelling and pain, sores or blisters, and irritated skin that turns red and darker than your regular skin tone.

In addition to a rash, oral herpes may be accompanied by:

• Headache
• Fatigue
• Nausea
• Dizziness
• Swollen lymph nodes in the neck

In addition to a rash, genital herpes can cause:

• Fever
• Headache
• Muscle aches
• Fatigue
• Swollen lymph nodes in the groin
• Difficulty urinating
• Pain with urination

Herpes Rash Triggers

Once the herpes virus goes dormant in your body, it can reactivate again and again, causing more rashes.

Different things can trigger a herpes outbreak, including:

• Emotional stress
• Acute illness
• Fever
• Trauma (including surgery)
• Sun exposure
• Menstrual periods

Some outbreaks have no known cause.

Recognizing trigger/rash patterns may help you identify skin changes that are due to your infection.

What Could Be Mistaken for a Herpes Rash?

Not every rash that looks like herpes is herpes. There are other infections that cause painful blistering or blister-like rashes. These include:

• Aphthous stomatitis: Also known as canker sores 
• Dermatitis herpetiformis: An intensely itchy, blistering skin rash that affects people with celiac disease
• Herpangina: A viral illness caused by the Coxsackie virus that leads to mouth sores
• Herpes zoster: Also known as shingles
• Syphilis: A sexually transmitted infection that typically causes a single painless ulcer on the genitals or anus
  

How to Treat a Herpes Rash

A herpes rash will heal on its own, but there are prescription antiviral drugs that may lessen the duration or severity of an outbreak. Over-the-counter (OTC) medications and home remedies can easy discomfort.

Prescriptions

Antiviral drugs are those used to treat viral infections. As a rule, antiviral treatment is most effective when it is started at the first signs of an outbreak.

The treatment can vary by the location of the sores and other factors:

• Oral herpes and herpes gladiatorum can be treated with Zovirax (acyclovir), Famvir (famciclovir), or Valtrex (valacyclovir). The antiviral medications are taken by mouth. The course of treatment can range from one to seven days.
• Genital herpes can be also be treated with Zovirax, Famvir, or Valtrex. In addition to tablets, acyclovir can be delivered by injection or applied to the sore in ointment form. Famvir and Valtrex are taken by mouth. The course of treatment varies by whether it is a first or subsequent outbreak.

Over-the-Counter Medications and Home Remedies

OTC painkillers like Tylenol (acetaminophen) and Advil (ibuprofen) can help relieve the pain of herpes rashes.

You can also use over-the-counter topical anesthetics like lidocaine to numb sores; just be sure to wash your hands immediately after.

You can ease a herpes rash at home by:

• Applying a cold compress against a herpes rash for 10 to 15 minutes several times daily
• Sitting in a warm bath to soothe a genital herpes outbreak (if using soap, make sure it's fragrance-free)
• Avoid eating spicy or acidic foods when you have a cold sore
• Wearing breathable, loose-fitting clothing if you have a rash on your body, especially your genitals

Preventing the Spread of Herpes

Because herpes viruses are highly contagious, it is important to avoid skin-to-skin contact (sexual and otherwise) until the rash resolves. You can spread herpes to someone else, but also from one area of your body to another.

If you touch a herpes sore on your body, wash your hands right away.

Also, keep in mind that not every case of oral herpes involves HSV-1, and not every case of genital herpes involves HSV-2.

So, for example, if you touch a genital herpes sore and then your mouth, you can get oral herpes. If you have an oral herpes sore and perform oral sex on someone, that person can get genital herpes.

Summary

A herpes rash can be caused by HSV-1 or HSV-2, different strains of the herpes simplex virus.
Depending on the infection, a herpes rash can appear on the lips, around the mouth, on the genitals or buttocks, and elsewhere on the body.

A herpes rash starts as red bumps, progresses to blisters that may rupture and crust over, and can last a week or more. It is usually painful and itchy.

Herpes can be treated with antiviral drugs. They do not cure herpes but may lessen the severity or duration of an outbreak if started early. It's important to see a provider as soon as possible and avoid touching the rash or exposing others to your sores.