Genital Herpes: What the Rash Looks Like in Women and Men

Genital herpes is an infection caused by the herpes simplex virus; it is transmitted through vaginal, anal, and oral sex and can cause rashes in the intimate area, on the buttocks, and on the thighs. A doctor's examination and a test help determine the cause — especially if blisters or sores are present.

What genital herpes is and how it is transmitted

The causative agent is the herpes simplex virus, including type 2 (HSV-2). Transmission occurs through skin contact with an infected area, including vaginal, anal, and oral sex; the virus can also be transmitted without visible rashes. Infection is possible if herpes on the lips touches the genitals, when the infection is transferred by fingers, or through shared sex toys. You cannot become infected through towels, swimming pools, saunas, or toilet seats: skin-to-skin contact is required. The virus remains in the body for life and can reactivate in the same area.

What herpes on the genitals looks like: stages of the rash

The typical picture: small blisters that burst and leave red open sores around the genitals, anus, on the thighs, or buttocks. On brown or black skin, the redness may be less noticeable. Before the rash, there may be tingling, burning, or itching; during it — pain when urinating and unusual discharge. The blisters may be grouped together. The rash resolves on its own, but the virus remains in the body and can cause recurrences. Repeat episodes are usually milder than the first, becoming less frequent and milder over time; some people never have recurrences.

Genital herpes in women: labia and other areas

In women, blisters and sores may occur on the labia, in the vaginal area, around the anus, on the buttocks, and thighs. Symptoms include itching, burning, pain when urinating, and unusual discharge. A doctor's examination and a test help determine the cause. During pregnancy, primary herpes or an outbreak before childbirth should be discussed with a doctor: there is a risk of neonatal herpes.

Genital herpes in men: the penis

In men, rashes appear on the penis, around the anus, on the buttocks, and thighs. The blisters may be grouped. The sensations are the same: tingling, burning, itching, pain when urinating, unusual discharge. The sores heal on their own, but the virus persists in the body.

Atypical forms and what can be mistaken for herpes

The infection often occurs without symptoms or very mildly. Only 10–20% of people with HSV-2 report previously diagnosed genital herpes. Before the sores, there may be tingling or shooting pain in the legs, thighs, and buttocks. On dark skin, the sores are less red.

• no rash, but the virus is shed and can be transmitted;
• symptoms are so mild that the person does not notice them;
• tingling or pain in the legs, thighs, and buttocks before sores appear;
• very mild symptoms that the person mistakes for something else.

The cause cannot be determined accurately by appearance alone: a doctor's examination and a test are needed.

How the diagnosis is confirmed and when to see a doctor

The diagnosis is confirmed by a doctor (dermatovenereologist, urologist, or gynecologist): they ask about symptoms and sexual partners and take a swab from a blister or sore. The test is not performed without visible lesions; it does not show how long ago you became infected or from whom. You should see a doctor (dermatovenereologist, urologist, or gynecologist) as soon as possible if you have symptoms, even if you have not had sexual contact for months or years: blisters can appear months or years after infection.

On its own, it is not a reason to call an ambulance. 103/112 — for life-threatening conditions, for example, a severe sudden deterioration in well-being.

This is reference text, not a diagnosis: the decision to undergo examination is made by a doctor.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer