The Herpes Rash

Dr. Babak Ashrafi

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 26 Jul 2022

Herpes is an infection caused by the herpes simplex virus (HSV). Herpes can be found anywhere on the body but is most commonly found around the mouth or genitals. The main symptom is the herpes rash, which can cause blisters that burst, causing open sores that scab over. You can get treatment to get rid of the herpes rash and help your body to heal faster, such as antiviral medications.

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What is a herpes rash?

A herpes rash is a rash associated with HSV. You can get herpes anywhere, but you are most likely to get it on your genitals (genital herpes) or around your mouth (cold sores). It is contagious and can be passed on through contact with the infected area, such as through kissing or vaginal, anal, or oral sex. The herpes rash has different stages, starting with blisters that burst and eventually scab over.

What does a herpes rash look like?

A herpes rash starts as small, fluid filled blisters that appear on the skin. They can look yellow, white, or red, and are filled with a clear liquid. These can develop around your mouth and nose if you have oral herpes (cold sores). The rash can develop around your genitals and anus if you have genital herpes.

Men can get genital herpes on any part of their penis, but it most often appears on the penis head. Women can get a genital herpes rash on any part of their vagina, including inside the vagina. Both genders can get the rash around their anus, such as on the buttocks, and elsewhere around the genitals (for example, on the pubic area, inner thighs or perineum). Genital herpes can look a lot like a shaving rash when it first appears.

When a herpes rash first appears, you may also feel burning, itching, or tingling on the affected area of your skin. You may get these symptoms a few days before the blisters appear. The blisters can feel painful and tingly. You can have a lot of blisters or only some.

After a few days, the blisters will start to burst. This causes them to ooze fluid and turn into red, open sores. They will then begin to scab over before healing. The herpes rash usually lasts around 7 to 10 days but can take up to 3 weeks to heal. When you get your first outbreak, this can take longer to clear up and can be more severe. Further outbreaks do not usually last as long and tend to have milder symptoms.

What does a herpes rash look like on a baby?

Herpes can be passed onto a baby during pregnancy, labour, or after birth. This is called neonatal herpes and is a rare and serious condition. A herpes rash on a baby will look the same as on an adult, but the rash and sores can develop on the skin, eyes, and inside the mouth. A baby does not always develop a herpes rash.

What does a herpes rash look like on black skin?

A herpes rash looks very similar to what it does on white skin, although it may be more difficult to see any redness around the rash.

Is it a herpes rash or something else?

Many conditions can cause a rash on the body, so it is not always obvious whether the rash is caused by herpes or something else. If you have a rash for the first time, you should speak to a doctor and take a herpes test. This is the only way to know if you have a herpes rash or something else.

Other rashes that look similar to herpes

Contact dermatitis can sometimes cause blistering, redness, and swelling on the skin. This is usually caused by an allergic reaction. Babies often get this on their nappy area.

Shingles, which is an infection caused by the varicella zoster virus, can also cause fluid filled blisters. Unlike herpes, a shingles rash develops on one side of your face or body and most commonly affects the back and stomach.

Scabies is caused by a parasite which burrows into your skin and lays eggs. This can cause an extremely itchy rash that looks like pimples. This can cause scaly and flushed areas of the skin and is sometimes mistaken for a herpes rash. Scabies is more likely to appear on different parts of your body than your mouth or genitals.

How to treat a herpes rash

A herpes rash can be treated with the help of antiviral medications that work to stop the herpes virus from reproducing, giving your body time to fight the virus. ZAVA can prescribe a range of treatments for genital herpes and cold sores. The most common treatment for a herpes rash is aciclovir. You can get this in the form of a tablet that you swallow, or aciclovir cream.

To heal your herpes rash faster, you should speak to a doctor to get antiviral medication. This can reduce the length of an outbreak. The antiviral medication available for herpes includes:

  • aciclovir, such as the 400mg tablets that should be taken 3 times a day for 5 days
  • valaciclovir 500mg tablets (or Valtrex), a prodrug which turns into aciclovir inside your body and should be taken 2 times a day, for 5 to 10 days
  • famciclovir 500mg, an alternative antiviral medication that is also a prodrug, turning into penciclovir in your body and should be taken 3 times a day, for 5 days

There are other doses available depending on your symptoms and whether or not this is your first outbreak.

For oral herpes, you can also use antiviral creams and ointments, which can be applied directly to the affected area and work in the same way. Tablets are the most effective way to treat the herpes rash, especially if your infection is more severe.

Over the counter treatments can work for relieving the symptoms associated with the herpes rash. This includes painkillers such as ibuprofen and paracetamol. You can find numbing creams that help with the herpes rash, such as lidocaine 5% ointment. This is a local anaesthetic which works to numb the area. This can be helpful if you have genital herpes and have pain when peeing.

There are also other things you can do at home to help with the herpes rash, such as:

  • applying a wet, cold compress to the affected area
  • taking a cool bath to reduce inflammation and cool down the area
  • keeping the area clean with salty or plain water, to prevent open sores from becoming infected
  • using vaseline or petroleum jelly to soothe the area

There is currently no cure for herpes although there are clinical trials taking place to look for a cure, including a herpes vaccine.

Is the herpes rash contagious?

Yes, a herpes rash is contagious and you should avoid contact with the infected area. The herpes virus is categorised into 2 types, which are HSV-1 and HSV-2. Oral herpes or cold sores are usually caused by HSV-1 but can be spread to the genitals through oral sex. HSV-2 usually affects the genitals and is known as a sexually transmitted infection (STI). HSV-2 can be spread to the mouth from the genitals during oral sex.

Herpes gladiatorum is a skin rash caused by HSV-1 and is one of the most infectious herpes conditions. It is commonly found in athletes and those who play contact sports. The rash can appear anywhere on the body and is passed through skin to skin contact.

When is herpes most contagious?

Herpes is most contagious when there are visible sores and blisters. It can also be contagious a few days before any visible symptoms appear, such as when you first get a tingling sensation. Herpes is still contagious to a lesser extent for some weeks after your sores have healed. The risk of passing on herpes with no symptoms is low, but you can still be contagious without knowing you have herpes.

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Medically reviewed by:
Dr Babak Ashrafi Clinical Lead for Service Expansion

Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.

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Last reviewed: 26 Jul 2022





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