What Does a Herpes Rash Look Like?

Herpes Pictures - Electron Micrograph of Herpes Virus

There are two types of herpes viruses:

  • Type 1 (HSV-1)
  • Type 2 (HSV-2).

You may be surprised to learn that herpes virus infections are common. In fact, 85 percent of the world has been infected with at least one type.

In the past HSV-1 infections occurred in the mouth and HSV-2 infections occurred in the genital area, but now either type of virus can infect either site. HSV infections can also occur throughout the body, often on the finger or even one or both of the eyes. This gallery shows pictures of various rashes caused by the herpes virus.

*Please note there are pictures of genital lesions in this gallery that have been cropped as best as possible.


Herpes Pictures - Close-up of Early Lesions

This photo shows an example of the early stages of the herpes rash. Notice the cluster of vesicles all appear to be on the same red base. This is different from the rash of chicken pox (see next picture) which has an individual vesicle on a red base.


Herpes Pictures - Chicken Pox Rash for Comparison

Compare this picture of a typical chicken pox rash to the previous picture of a herpes rash. Note that each vesicle has its own red base. The vesicles of chicken pox are rarely clustered together in a group like the herpes vesicles.


Herpes Pictures - Typical Lesions on Leg

This picture actually shows the three stages of the rash. The initial rash is a cluster of vesicles on a red base. These blisters are delicate and open easily, creating an ulcer. In areas of the skin that are not moist, the ulcer crusts over. There is usually no scarring when the crust falls off. This is also different from chicken pox, which may leave a scar after it heals.


Herpes Pictures - Typical Cold Sore

Cold sores and fever blisters are caused by the herpes simplex virus. Cold sores are caused by herpes simplex type 1 (HSV 1) more often than herpes simplex type 2 (HSV 2). Cold sores start like this one with vesicles and progress like genital herpes lesions to ulcers, crusting, then healing without a scar. Learn more about the course of cold sores and the treatment of cold sores.


Herpes Pictures - Early Cold Sore

This is another picture of an early cold sore on the lip. Note that there is not much redness yet. Recurrent oral herpes infections occur on the lip, not inside the mouth. However, the first oral herpes infection can involve ulcers throughout the mouth and can be painful. Also, some people develop flu-like symptoms with the first herpes outbreak like fever, fatigue, and/or swollen lymph nodes.


Herpes Pictures - Aphthous Ulcers for Comparison


This is a picture of aphthous ulcers, which are often confused with cold sores, but they are not caused by the herpes virus. Apthous ulcers can occur anywhere in the mouth but do not involve the outside of the lip. Someone who has herpetic stomatitis (herpes ulcers throughout the mouth caused by an initial oral herpes infection) may have ulcers in the mouth, but they will typically have cold sores on the lip also.

Aphthous ulcers can be caused by a number of factors:

  • Coxsackievirus - one of the viruses that causes ​colds and hand, foot, and mouth disease
  • Autoimmune diseases - Crohn's disease, ulcerative colitis, and Behcet's syndrome
  • Contact dermatitis - exposure to aspirin, strong mouthwashes, spicy foods, citrus
  • Chemotherapy medications


Herpes Pictures - Typical Lesion on Penis

This picture shows typical herpes lesions on the penis, including vesicles and ulcerations. Because the number of lesions is extensive, this may be a first outbreak of genital herpes for this particular person. Typically the first herpes outbreak (anywhere, not just in the genital area) is worse than recurrent outbreaks.


Herpes Pictures - Healing Lesions on Penis

This picture shows herpes lesions in the later stages of healing. The ulcerations are starting to fill in. Because the genital area is warm and moist, crusting may not develop as the lesions heal. 


Herpes Genital - Atypical Lesions on Penis

Because the genital area is warm and moist, sometimes herpes can have an atypical appearance. In this picture, the lesions look more like erosions, but if you look closely you can see that each red area has a cluster of small ulcerations. Due to the fact that herpes simplex infections can have an atypical appearance or mimic other skin conditions, it is best to confirm the diagnosis with a healthcare professional. 

Herpes Pictures - Crusting Lesions on Penis

This is another example of herpes lesions in the later stages of healing. In this case, there is crusting. A rash in this stage might be confused with scabies.


Herpes Pictures - Lesion on Vulva

This picture shows an ulcer on the vulva that is caused by herpes. Women are four times more likely to acquire a herpes simplex type 2 infection than men. In addition, women may have genital symptoms that are caused by a herpes infection, but not attributed to herpes. Learn more about the complicating factors involved for women with genital herpes.


Herpes Pictures - Lesion Around the Eye

Herpes Lesion Around the Eye.

The herpes virus can cause a rash anywhere on the skin—not just in the mouth or genital area. This picture shows a herpes infection around the eye. Note the vesicles around the eyelid and ulcerations on the eyelid.

Herpes Pictures - Early Infection on Finger

The finger is actually a common place to get a herpes infection, common enough to have its own name—herpetic whitlow. This picture shows the early vesicular stage of the infection. Because the skin on the fingers is thicker, the vesicles aren't as fragile and may not ulcerate quickly.

Herpes Pictures - Typical Lesion on Finger

This picture shows a herpetic whitlow (herpes infection of the finger) that has vesicles and ulcerations.


American Academy of Dermatology. Herpes Simplex: Signs and Symptoms.  

Bernstein DI et al. Epidemiology, Clinical Presentation, and Antibody Response to Primary Infection with Herpes Simplex Virus Type 1 and Type 2 in Young Women. Clin Infect Dis 2013; 56:344. 

Cernik C, Gallina K, Brodell RT. The Treatment of Herpes Simplex Infections: an Evidence-based Review. Arch Intern Med 2008; 168:1137.

Habif, Thomas. "Warts, Herpes Simplex, and Other Viral Infections" Clinical Dermatology, 4th Edition. Ed. Thomas Habif, MD. New York: Mosby, 2004. 381-388.

Horowitz R, Aierstuck S, Williams EA, Melby B. Herpes Simplex Virus Infection in a University Health Population: Clinical Manifestations, Epidemiology, and Implications. J Am Coll Health 2010; 59:69. 


Continue Reading