STI Pictures: Herpes, Genital Warts, Pubic Lice & More

Sexually transmitted infections (STIs) can often be recognized by characteristic signs and symptoms. With that being said, many STIs will have no symptoms at all.

The reality is that most people with an STI won't have sores, discharge, or any other symptoms worth noting. Because of this, the only way to know for sure if you have an STI is to get tested.

Still, it is natural for people to wonder whether a lump, bump, or sore could be an STI. The following photos are intended to provide you some idea of what to look for. They are not meant to diagnose your condition or serve as a substitute for proper medical care.

Only a doctor can diagnose an STI. This usually requires some form of testing. Although some STIs can be diagnosed by appearance alone, they are the exception, not the rule.

Oral Herpes (Cold Sores)

Cold sores around the mouth.
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Cold sores, also known as fever blisters or oral herpes, are mainly caused by the herpes simplex virus type 1 (HSV-1). Cold sores are small, painful blisters that most often appear around the lips. They usually break open, crust over, and heal within a period of seven to 10 days.

Oral herpes can be easily transmitted through kissing. They can also be passed to a partner's genitals during oral sex.

While most people think of HSV-1 as an oral infection, it can easily become a genital infection if condomless oral sex is performed.

Genital Herpes

An outbreak of genital herpes is characterized by a cluster of small blisters that break open and become painful sores. It is most commonly associated with the herpes simplex virus type 2 (HSV-2).

Not everyone who has HSV-2 will develop symptoms. Those who never develop symptoms or only have mild symptoms (such as tenderness and unbroken bumps) may unknowingly infect others.

Even though genital herpes is most contagious during an ulcerative outbreak, it can also be transmitted when there are no outward symptoms.

Suppressive therapy not only shortens outbreaks in people with recurrent outbreaks, but it also makes transmitting the virus to a partner far less likely.

In the end, there is no way to know whether a person has herpes unless they've been tested. In fact, a great many people infected with HSV-2 will only realize they have the virus when a partner is diagnosed.

Genital Warts

Human papillomavirus (HPV) is recognized as the virus responsible for genital warts and the development of many cervical and anal cancer cases.

The anal lesions pictured are extreme but provide you some sense of what genital warts look like. Generally speaking, the warts are whitish or skin-colored and have an irregular surface, much like cauliflower. They can be big or small and occur in clusters or as a single wart.

Genital warts can develop on the vulva, vagina, cervix, penis, scrotum, or anus. They are sometimes itchy, but most of the time they don't hurt.

Whatever the presentation, it is important to get any wart-like growth checked by a doctor. In this way, any cancerous or pre-cancer growths can be discovered before they become severe.

Sadly, there is no way to tell if someone has been infected with HPV by looking at them. Testing is invariably required. Moreover, there is no commercial test to diagnose HPV in men. For this reason, you should always practice safer sex to help reduce your chance of infection.

STI-Associated Urethritis

In men, chlamydia and gonorrhea often have no symptoms. If symptoms do appear, they will often manifest with a discharge from the penis and other signs of urethritis, including redness and swelling around the opening of the penis and burning or pain when urinating.

Men with gonorrhea are more likely to experience discharge than those with chlamydia. With gonorrhea, the discharge can often be profuse. In some cases, the discharge may only be noticed by yellow stains in your underwear or by a glazed, dry film around the opening of the penis.

Other symptoms may include pain and swelling around the testicles and a greater frequency and urgency of urination. If the infection occurs in the throat, a sore, scratchy throat may develop.

STI-Associated Cervicitis

Cervicitis viewed through a vaginal speculum.
CDC

Cervicitis is the term used to describe the inflammation of the cervix. It can be caused by many things but is characteristic of STIs like trichomoniasis, gonorrhea or chlamydia. Often, the only time cervicitis is detected is during a pelvic exam, although other symptoms may develop, including:

Vaginal itching or irritation
Bleeding between periods
Pain during sex and/or bleeding after sex
Painful urination
A foul-smelling gray or which discharge
A feeling of pressure in the pelvis

Because STIs are often internalized in women, they are frequently missed or misdiagnosed.

The U.S. Preventive Services Task Force (USPSTF) recommends chlamydia and gonorrhea testing in all sexually active women and girls.

Primary Syphilis

Primary syphilis is one of three stages of a syphilis infection. It is characterized by the appearance of an open, ulcerative sore known as a chancre. Chancres are normally round and painless, which can make them difficult to notice in the throat, vagina, or rectum.

Syphilis chancres are reasonably easy to spot on the external genitals and will usually heal on their own in three to six weeks. This does not mean the underlying infection has disappeared.

If left untreated, a syphilis infection can persist for years. After the secondary phase of infection (characterized by fatigue, flu-like symptoms, and, occasionally wart-like growths around the genitals), the disease will go into a period of latency, only to emerge years later as tertiary syphilis, the most severe form of the disease.

To reduce the risk of transmission and avoid complications, the USPSTF recommends syphilis screening for people at high risk of infection as well as pregnant women (to prevent congenital syphilis).

Pubic Lice

Pubic lice may seem more like an annoyance than a public health concern, but the sad truth is that "crabs" affects between six and 12 million Americans each year, according to a 2016 review in BioMed Research International.

Pubic lice are not the same thing as head lice. They are almost always spread through intimate contact and are far less likely to be transmitted through shared clothing or sheets.

Infestations are characterized by itching and the appearance of crab-like insects in pubic hair. You should also be able to see white oval eggs attached to hair shafts.

Pubic lice are usually found in the genital area but can be spread to other coarse body hair. They are not usually found on the head. Treatment includes a lice-killing lotion containing 1% permethrin or a mousse containing pyrethrins and piperonyl butoxide.

Pubic lice in children are of serious concern as it suggests sexual exposure or abuse.

Scabies

Scabies is a skin infestation caused by a mite known as the Sarcoptes scabiei. The microscopic insects live on the skin and can burrow into tissues to lay their eggs. This causes an itchy, red rash to develop. The itchiness tends to become worse at night.

Scabies symptoms commonly develop in areas such as between the fingers, on the wrists and ankles, and in the genital area.

Sexual contact is the most common mode of transmission of scabie in sexually active young adults, even though scabies is not classified as an STI per se.

Scabies can also be spread through casual contact with clothing, towels, and bedsheets.

Treatment typically involves topical medications such as Elimite (permethrin), Eurax (crotamiton), Lindane (gammaxene), or Stromectol (ivermectin).

Early Chancroid Symptoms

Chancroid is a bacterial STI rarely seen in the United States. Worldwide, chancroid infections are on the decline, although infections still occur in parts of Africa and the Caribbean. As such, infection is possible if you engage in sexual activity while in these regions or have sexual contact with someone from these regions.

Symptoms usually develop within four to 10 days of exposure. The rash will begin as a tender, elevated bump filled with pus. The bump can erupt into an ulcerative sore similar to a chancre, albeit with ragged rather than smooth edges. Unlike syphilis, the sores will be painful.

Chancroid can usually be cured with a single oral dose of azithromycin or a single intramuscular injection of ceftriaxone.

Genital ulcers, like those that occur with syphilis and chancroid infection, pose a bigger concern as they can increase your risk of acquiring HIV.

Late Chancroid Symptoms

In severe cases, chancroid can cause inguinal lymph nodes to literally burst. Inguinal lymph nodes are located near the hip crease and drain from the buttocks, legs, and groin.

Swelling of the inguinal nodes (known as inguinal lymphadenopathy) is a common symptom of chancroid and often the only sign of the infection. Although lymph node ruptures are rare, they may develop if symptoms are ignored and left untreated.

Because chancroid is often asymptomatic in women, the disease may go unnoticed until a more serious secondary infection (such as vulvar cellulitis or HIV) occurs.

Photo Gallery of Common STIs

Warning: Images are graphic and may be disturbing