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What Can Be Mistaken for Genital Herpes?

Genital herpes can cause genital sores (but not always) and can be confused with other conditions such as syphilis, genital warts (HPV), chancroid, Lymphogranuloma venereum, bacterial vaginosis, yeast infection, irritation from shaving, ingrown hairs, pimples, molluscum contagiosum, and others.
Genital herpes can cause genital sores (but not always) and can be confused with other conditions such as syphilis, genital warts (HPV), chancroid, Lymphogranuloma venereum, bacterial vaginosis, yeast infection, irritation from shaving, ingrown hairs, pimples, molluscum contagiosum, and others.

Genital herpes is a viral infection that may cause blisters and open sores on the genitals. It is a type of sexually transmitted infection (STI) caused by herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

A number of different conditions could be mistaken for genital herpes. Treatment for each condition may be different, which is why it is important to see a doctor for an accurate diagnosis. Conditions that may resemble genital herpes include: 

What Are Symptoms of Genital Herpes?

Many people who have herpes do not have any symptoms or have only mild symptoms. For others, symptoms may occur within a few weeks of being infected with the herpes virus and include:

  • Blisters in the genital area
    • In the penis, scrotum, vagina, anus, buttocks, or thighs
    • Sores may look like pimples or fluid-filled blisters that are red, white, or yellow
      • Sores inside the vagina may be difficult to see
    • Blisters may become painful open sores, which ooze and develop a yellow-colored crust as they heal
    • There may be a single sore or a cluster of sores
  • Difficulty or pain urinating 
  • Blisters on the mouth or lips
  • Fever
  • Headache
  • Pain in the joints
  • Swollen lymph nodes in the groin

How Is Genital Herpes Diagnosed?

Genital herpes is diagnosed with a physical exam and can often be diagnosed just by looking at the sores. 

If blisters or sores are present on the genitals, tests used to diagnose herpes or to rule out other conditions that can be mistaken for genital herpes include:

  • A sample of cells or fluid from a sore is sent to a lab
  • If no symptoms are present, a blood sample may be taken to check for herpes antibodies

What Is the Treatment for Genital Herpes?

There is no cure for genital herpes, most symptoms occur during the first few years. After that, the virus causes mild to no symptoms. 

Antiviral medicines may be used to help reduce and prevent symptoms of genital herpes and speed up the healing of an outbreak, such as:

To help reduce the pain of genital herpes during an outbreak, home remedies include:

  • Over-the-counter (OTC) pain medicines such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to help with pain
  • Keep the genital area clean and dry
  • Use a portable bath ("Sitz bath") or your bathtub and sit in warm water for about 20 minutes
  • Avoid tight clothing

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References
https://www.uptodate.com/contents/genital-herpes-the-basics?search=herpes&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.cdc.gov/std/herpes/default.htm

https://www.aad.org/public/diseases/a-z/genital-herpes-symptoms

https://stdcenterny.com/articles/herpes-and-other-genital-sores.html