Herpes looks like a rash with blistering sores in its early stages.
The cluster of sores can quickly merge and break open, oozing fluid and crusting.
The rash can be different when found at the mouth, eyes, anus, or genitals.
Illustration by Tara Anand for Verywell Health
A herpes sore also can change with the stage of infection.
It’s essential to see a healthcare provider for a diagnosis and treatment.
Warning: Some of the following images are of genital areas.
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The inactive virus will embed itself in nerve cells near the spinal cord.
The vesicles will then erupt, causing painful open ulcers commonly referred to as herpes sores.
In addition to pain, there may be itchiness or a pins-and-needles sensation.
Getty Images / Amphawan Chanunpha
The prodromal symptoms may include:
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It’s then that blisters develop.
This picture illustrates the formation of vesicles.
CDC
Note the cluster of vesicles on a red base.
These fluid-filled blisters are delicate and break open easily, creating open, oozing sores.
Eventually, the sore will stop oozing and crust over.
CDC
The ulcerative stage begins when the blisters break open to form skin ulcers.
As a result, subsequent outbreaks tend to be far less severe.
Genital Herpes Outbreak in Females
This picture shows a herpes ulcer on the vulva.
CDC
The vulva is the external part of the female genitalia.
Females are four times more likely to get anHSV-2 infectionthan males.
In addition, females may have symptoms that are not readily recognized as herpes.
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This could lead to a misdiagnosis ofpelvic inflammatory disease (PID).
Also, many females experience burning with urination during a genital herpes outbreak.
The burning may be misdiagnosed as aurinary tract infection (UTI).
CDC
Healing of Genital Herpes Sores With Crusting
The timeline of a genital herpes outbreak can vary.
In addition to pain, the oozing sores will often have a fishy smell in both females and males.
The smell can increase after sex due to the abrasion of skin against skin.
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Note the crusting that has occurred near the head of the penis in this photo.
The crust forms as fluids from the blisters evaporate and leave behind whitish or yellowish crystals.
Typically, you will see a whitish or yellowish crust forming on the ulcers.
CDC
With that said, crusting may not be all that apparent.
Because the skin of the penis and vagina is moist, there may be minimal crusting.
Instead, there may be a whitish film covering or surrounding the open sores.
CDC
Symptoms of genital herpes do vary with the individual.
Cold sores progress in much the same way as genital herpes.
HSV-1 can also affect the tongue, gums, or face.
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The finger is a common place for a herpes infection to spread.
A herpes infection of the finger often is referred to asherpetic whitlow(a.k.a.
This picture shows the early stage of a herpes whitlow infection.
Reproduced with permission from © DermNet dermnetnz.org 2023
If left untreated, herpetic keratitis can cause corneal scarring and vision loss.
Because each is treated differently, a diagnosis may be needed by a healthcare provider.
The outbreak occurs on only one side of the body, most commonly the chest and back.
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The face, groin, and leg can also be affected.
Unlike HSV, a herpes rash can leave behind scars after it heals.
Both SJS and TEN are considered medical emergencies.
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Chemotherapy drugsandanticonvulsantsare among those that commonly cause drug eruptions.
However, there are times when a diagnosis by a healthcare provider may be needed to confirm the suspicion.
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Treatment
Both HSV-1 and HSV-2 are treated withantiviral drugs.
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They are most effective when started within 48 to 72 hours of the first signs of an outbreak.
They do not cure herpes but may reduce the severity and duration of an outbreak.
This is followed by oozing and the crusting of the sores.
Healing usually takes a week or more.
The appearance of a herpes sore can vary by the stage of infection and its location on the body.
This ensures that you are appropriately treated with antiviral drugs.
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