Infection with the herpes simplex virus (HSV) can lead to a skin rash. Early signs include burning and tingling, after which sores appear that can turn into blisters or pustules. Treatment with antiviral drugs may shorten the healing time.

A herpes rash usually develops on the genitals or around the mouth, but it can occur nearly anywhere on the body.

There are two types of HSV that can cause a skin rash in different areas: HSV-1 and HSV-2.

HSV-1 typically causes orolabial herpes. It spreads in the saliva and tends to affect the area around the mouth and nose.

HSV-2 typically causes genital herpes and usually spreads through sexual contact. The rash appears around the genitals. Sometimes, it is also responsible for orolabial herpes.

This article explains the symptoms of a herpes skin rash and explores its causes and treatments. It also examines some other possible causes of skin complaints that may look similar to herpes.

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Herpes causes small sores to appear on the skin. These sores usually develop around the mouth and nose or genitals, but they can appear nearly anywhere on the body. Where the rash appears will depend on where and how the person contracted the infection.

The first symptom of a herpes outbreak tends to be a tingling, burning, or itching sensation in the affected area. This initial symptom might occur a day or so before the sores appear.

The sores can be tender and painful. They may look like clusters of small, fluid-filled blisters that become pustules. For a few days to a week, they may break open, ooze fluid, and form a crust before healing. The rash typically lasts for around 7–10 days.

The first time a rash appears, it may last for different lengths of time depending on the type of herpes. For example, oral herpes symptoms tend to clear up in 2–3 weeks, while genital herpes symptoms usually clear up in 2–6 weeks.

When someone experiences a herpes outbreak for the first time, they may also experience some or all of the following symptoms:

  • fever
  • muscle aches
  • swollen lymph nodes
  • difficulty urinating

Once the virus is inside the body, it invades the nerves that supply the area of the skin it affects and stays there for life. There is currently no cure for this virus, and it tends to reactivate and cause symptoms occasionally. The prevalence of outbreaks varies from person to person.

Herpes can cause a rash in various areas on the body, depending on the type of herpes virus causing the outbreak.

Mouth

Oral herpes, or cold sores, occur around and in the mouth. Most of the time the sores and blisters from oral herpes appear on the lips or around the mouth. They can also occur on the tongue or other areas of the face.

Eyes

Sometimes, the herpes virus can spread to one or both eyes. When this happens, it is known as herpes keratitis. This may cause various symptoms, including:

  • light sensitivity
  • pain
  • gritty feeling
  • discharge

Herpes keratitis requires prompt treatment. Without this, it can cause issues such as vision loss.

Genitals and anus

Genital herpes is a sexually transmitted infection (STI). It can be transmitted via vaginal, anal, and oral sex. It can appear on the genitals or rectum. It can also appear around the mouth if it is contracted via oral sex.

Genital herpes may cause only mild symptoms that can be mistaken for other skin conditions such as pimples or ingrown hairs.

Herpes rashes tend to look like clusters of small, fluid-filled blisters on a small area of the body.

Other skin conditions may cause symptoms similar to herpes. It is important for a person to speak with a healthcare professional if they experience a new and unexplained rash.

Contact dermatitis

Having a reaction to an irritant can cause contact dermatitis.

There are two types of contact dermatitis: irritant and allergic. Irritant contact dermatitis occurs when a person experiences a reaction that is not an allergic reaction due to the immune system. Allergic contact dermatitis is a delayed allergic reaction that can take 1-2 days to appear after exposure to an irritant.

Common irritants include:

  • detergents
  • soaps
  • solvents
  • poison ivy or oak
  • nail polish
  • hair dye
  • makeup

In infants, contact dermatitis may develop in the diaper area.

Contact dermatitis can cause flushing, swelling, and even blistering in the area it affects.

Shingles

Shingles causes a rash of blisters to occur on the skin. The same virus that causes chickenpox (the varicella-zoster virus) causes shingles.

The first symptom of shingles tends to be a severe burning or tingling pain on one side of the body. Other symptoms include:

  • fluid-filled blisters
  • tingling, numbness, or itching of the skin
  • burning, shooting pain
  • fever
  • chills
  • headache
  • upset stomach

These blisters tend to appear in one area of the body, most commonly one side of the trunk, near the waistline.

The condition usually clears up within 3–5 weeks. Treatment includes antiviral medications. However, shingles can also often be managed at home.

Scabies

An infestation of a microscopic parasite known as the human itch mite, or Sarcoptes scabiei, is what causes scabies.

The mite will burrow into the skin to lay its eggs and deposit its feces. Its presence causes an extremely itchy rash that resembles little pimples, creating flushed, scaly areas on the skin.

Doctors use a class of drugs called scabicides to treat these infestations. These drugs are only available with a prescription.

There are two types of HSV that cause herpes. Although these types are closely related and both spread through bodily fluids and human contact, they transmit in different ways.

The virus does not need to be causing any symptoms for it to spread to another person.

HSV-1, or oral herpes

Most carriers of HSV-1 contracted it when they were infants or children. It can spread through:

  • having skin-to-skin contact with someone who has the virus
  • kissing
  • sharing items such as lip balm, tableware, or toothbrushes

HSV-2, or genital herpes

Sexual contact tends to be how HSV-2 spreads. HSV-1 can also cause genital herpes, and it can spread in saliva during oral sex. HSV-2 can also pass to an infant during childbirth.

Both forms of the virus enter the nerve cells of the body, where they remain for life. The virus tends to lie dormant, or asleep, in the cells until something activates it and causes an outbreak of symptoms.

Factors that can lead to an outbreak include:

  • emotional stress
  • illness
  • fever
  • exposure to the sun
  • menstruation
  • surgery

There is currently no cure for herpes, but the sores usually clear up on their own.

Treatments that can shorten the duration of the outbreak and ease the symptoms are available.

If a person experiences frequent outbreaks, their healthcare professional may recommend taking medication every day as a means of prevention. This treatment is known as prophylaxis.

Antiviral creams or ointments can relieve the burning, itching, or tingling. Antiviral pills can help speed up the healing process. Both types of medication tend to contain the same active ingredients. They include:

People can get herpes medication from a doctor or pharmacist, or some are available over the counter.

For otherwise healthy people, a herpes skin rash is not usually anything to cause concern, other than spreading it to others. The sores can be painful and uncomfortable, but they typically go away by themselves. Medications to treat them are available from drugstores or through a healthcare professional.

The virus can cause complications in some people. Anyone with a long-term health condition or weakened immune system who thinks that they may have herpes should speak to their doctor.

People with cancer, HIV, or AIDS and anyone who has recently had an organ transplant should seek urgent medical attention if they think that they may have herpes.

Anyone who suspects that something other than herpes — such as dermatitis, shingles, or scabies — is causing their rash can talk with their healthcare professional about a diagnosis.

Herpes is a common virus that can cause a rash of blistering sores on the skin. These tend to develop around the mouth or genitals but can appear almost anywhere on the body.

There is currently no cure for the virus, and carriers tend to experience symptom outbreaks at various times throughout their life.

The clusters of fluid-filled blisters may be painful, but they are usually harmless. However, it is possible to spread herpes to others. A person experiencing a herpes outbreak should use caution when around other people.

Antiviral treatments that can help ease the symptoms and shorten the duration of an outbreak are available in many drugstores or through a healthcare professional.