Genital Pimples vs. Herpes: Symptoms, Causes, Treatment - Verywell Health
Pimples occur when oil and bacteria become trapped in hair follicles under the skin. They can appear anywhere, including in the genital area. Herpes is a sexually transmitted infection (STI) (also called a sexually transmitted disease, or STD) caused by the herpes simplex virus. Herpes causes outbreaks of genital sores that disappear in days or weeks. At times, these genital sores can be mistaken for pimples.
Both pimples and herpes sores can be red, have a discharge, and disappear on their own in a few days. Herpes sores, however, tend to be larger and redder, and they can turn into painful blisters that can break open and take a few weeks to heal. Herpes outbreaks can also include flu-like symptoms.4
This article covers the differences between genital pimples and genital herpes.
Symptoms
Genital pimples and herpes can have similar symptoms, but there are also key differences between the two conditions.
Genital Pimples
Symptoms of genital pimples include:
- Redness
- Swelling
- Discharge of pus when broken
- Painful sensation (in some cases)
Herpes
Symptoms of herpes include:
- Sores around the genitals, anus, or surrounding areas
- Redness
- Swelling
- Tingling or pain around the genitals, anus, hips, buttocks, or legs
- Itching around the genitals or anus
- Patches of blisters
- Blisters that break and then scab over
- Flu-like symptoms like headaches, fatigue, fever, or swollen lymph nodes
In some extreme cases, herpes can lead to severe outbreaks or neurological (brain-related) inflammation. This risk can be minimized by getting treatment during the very first outbreak.
Genital Pimples vs. HPV Warts
Human papillomavirus (HPV) is an STI that can cause warts that, much like herpes sores, disappear over time. HPV warts can take weeks to months to disappear.
Syphilis is an STI caused by bacteria. One of the symptoms of syphilis is at least one sore around the genitals, anus, or mouth that lasts for about three to six weeks. Syphilis is treated with antibiotics.
Causes
Genital pimples and herpes sores have different causes, though herpes can look like pimples. The following are the different causes of genital pimples and herpes.
Genital Pimples
Pimples happen when skin cells and sebum, an oil that is released by our pores to maintain moisture in skin, are trapped in a hair follicle. As skin cells stop shedding and oil is trapped, bacteria can grow and cause inflammation, which may result in redness and swelling.
Pimples can be caused by:
- Ingrown hair from shaving
- Pressure, such as from tight clothes
- Humidity
- Pollutants
- Scrubbing skin
- Picking at skin
- Stress
- Hormonal changes
- Medications (especially those containing hormones, including lithium and corticosteroids)
Herpes
Herpes is caused by one of two types of herpes simplex viruses: type 1 (HSV-1) or type 2 (HSV-2).
Herpes is classified as an STI. While HSV-2 is usually passed through sex with a person with HSV-2, HSV-1 can be transmitted orally but show up in the genitals.
Herpes can be spread through:
- Contact with skin that appears normal or with a person who has no visible symptoms and isn't aware of their diagnosis
- Contact with herpes sores
- Contact with genital or oral discharge from a herpes-positive person
Diagnosis
Genital pimples and herpes can both be diagnosed by appearance, however, there are some differences in their diagnoses as well.
Genital Pimples
To diagnose a pimple, a healthcare provider will likely:
- Examine the skin lesion to determine if it is a pimple.
- Order lab testing to rule out other causes, if necessary, or if the pimple looks severe.
- Ask about any other symptoms you are having.
- Discuss any recent medication changes.
- Note changes in menstrual cycles.
When Could Genital Pimples Be Something Else?
If you have genital pimples that are getting larger, softer, or redder or that last longer than a week, it might be time to get tested for an STI. Inflamed pimples that do not go away in a few days could be a sign of an STI like herpes or syphilis. Early treatment of STIs is key to preventing future outbreaks or adverse health effects.
Herpes
Herpes can go undetected in most people since symptoms are often mild. In mild cases, herpes sores can be confused with pimples. Getting tested for herpes may be necessary for all parties who've had sexual contact with a person who could be infected, whether or not sores exist on the skin.
A herpes diagnosis could include:
- An examination of herpes sores by a healthcare provider
- Lab testing of skin samples from herpes sores
- A blood test that detects HSV antibodies, which are disease-fighting blood proteins
Treatment
While both genital pimples and herpes sores disappear on their own, there are treatments available that can shorten their duration.
Genital Pimples
If genital pimples are painful, occur frequently, or are large and red, seek medical attention or get an STI test. Treating genital pimples might include:
- Keeping the surface clean with mild, fragrance-free soap
- Avoiding picking at or "popping" the pimple
- Applying a warm compress several times daily until it opens up and heals
- Keeping the pimple dry
- Wearing loose-fitting clothing
- Applying anti-pimple or anti-inflammatory creams (it's best to check if they are safe for the genitals or to see a healthcare provider beforehand)
Herpes
The most important time to get antiviral treatment for herpes is during the first outbreak, which can be the longest or most severe outbreak (and often the only outbreak someone experiences). The risk of regular future outbreaks is higher with a more prolonged first outbreak, and untreated herpes can cause brain disorders in rare cases.
Three commonly prescribed antiviral medications for herpes are:
- Zorivax (ayclovir)
- Famvir (famciclovir)
- Valtrex (valacyclovir)
There are three kinds of regimens (courses of treatment) for antiviral medications for herpes:
- First-episode regimen: This is when an antiviral is used at the onset of an outbreak to shorten its duration. Specialists advise that it's important to take antiviral drugs during the first outbreak, even if the outbreak is mild. Antiviral drugs are taken three times a day for a week to 10 days for an antiviral regimen.
- Suppressive regimen: Some people take antivirals regularly to suppress the virus and prevent it from spreading to others. For suppressive purposes—meaning a 70% to 80% reduction of the likelihood of spreading the disease with sexual contact—these same medications are taken once or twice a day. People with frequent herpes outbreaks are more likely to need suppressive medications.
- Episodic regimen: Episodic treatment of herpes is when antiviral medications are taken whenever an outbreak occurs. This requires one or two daily pills for one to five days, depending on the medication and dose amount.
To manage outbreaks, it can also help to:
- Keep sores clean with plain or salt water.
- Apply ice wrapped in a cloth to sores.
- Apply petroleum jelly (Vaseline) or a pain-relieving cream on sores.
- Pour water over the genitals while urinating.
- Wash hands before and after handling sores.
Prevention
Both genital pimples and herpes can be prevented.
Genital Pimples
To prevent genital pimples, it is recommended:
- If shaving the genital area, use shaving cream and shave in the direction of the hair with a sharp, not dull, razor
- Keep genitals dry
- Avoid pressure from tight clothing on the genitals
- Talk to a specialist about any possible hormonal changes, such as from menstrual cycles
- Avoid scrubbing roughly or picking at genital areas
Herpes
Avoiding sexual contact is the best way to prevent spreading or getting herpes. Other methods that decrease risk include:
- Correctly use condoms, including covering the entire infected area
- Avoiding sex during an outbreak or if one seems to be arriving (Itching or a sore can be signs of an outbreak.)
- Taking antiviral medications to suppress the virus if you do have herpes, which can decrease the chance of spread by 70% to 80%
- Not sharing sex toys
Summary
Genital pimples happen when hair follicles on the genitals are blocked by sebum, an oil released by the skin to keep it soft. Sometimes, genital pimples and herpes sores can be mistaken for one another. Herpes sores tend to appear with tingling, itching, blisters, and flu-like symptoms.
Both genital pimples and herpes sores can appear for a few days and disappear, however, if a genital pimple gets larger and redder, it is advised to get tested for STIs to rule out herpes.
A Word From Verywell
Having herpes might seem embarrassing, but the infection is treatable and can be mild. The key is getting treatment as soon as possible to prevent future outbreaks. While herpes might come with a stigma, staying informed can help keep it from negatively affecting your personal life.
Genital pimples can be distressing, but they are largely harmless and can disappear on their own. However, if you're concerned or your pimples are getting worse, it never hurts to get an STD test for peace of mind and to keep yourself and your partners safe.
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