Genital Pimples Vs. Herpes: How to Identify and Treat Your Symptoms

Tips for identification

Both pimples and genital herpes appear as clusters of red bumps. They may both feel itchy or irritated, and they can both show up on your butt, too. Pimples and herpes each have distinct symptoms, though.

Pimples

Pimples can appear one at a time or in small clusters. They’re usually perfectly round and appear in recognizable patterns.

If you wear a jockstrap or tight underwear, pimples may break out where the strap or underwear clogged your pores.

Pimples feel firm if you poke or squeeze them. They may fill with white pus that turns dark when it’s exposed to the air. They may also bleed or leak thick white fluid if they get scratched or irritated.

Because they develop in your pores, they’ll also seem deeper in the skin. They only jut out if they become filled with pus.

Pimples can get itchy or irritated but aren’t painful unless you put pressure on them. You may notice pimple outbreaks if you don’t bathe regularly or if you sweat a lot, so they can appear suddenly during hot weather or after working out for a while.

Pimples tend to disappear quickly and leave only minor scars behind, if any.

Herpes

You can live with HSV for years without experiencing any symptoms.

During a herpes outbreak, you’ll notice tiny, painful blisters filled with clear fluid. The blisters may appear in clusters and can also appear on your rectum and mouth. The blisters tend to feel squishy.

Other outbreak symptoms can include:

  • headaches
  • achiness
  • swollen lymph nodes
  • high fever of 101°F (about 38°C) or higher
  • pain or tingling in your legs

When herpes blisters break, fluid will spill out and may cause more pain. The blisters may not heal for 4 weeks.

You can have an outbreak at any time after contracting the virus. After the first outbreak, symptoms are usually less severe but can still be painful.

What causes each condition?

Pimples are a result of pore blockage, not sexual contact. HSV is spread primarily through genital sex but can be spread through oral or anal sex, too.

Pimples

Pimples, or acne, develop when oil and dead skin builds up in a skin pore or hair follicle.

Other causes of pimple-like bumps include:

  • Contact dermatitis. This irritation results from exposure to an allergen or irritant, such as perfume, a plant, or materials in jewelry.
  • Ingrown hairs. This irritation results from a cut hair that grows backward into the skin. Ingrown hairs are more common if you have thick, curly hair and shave, pluck, tweeze, or wax your hair often.
  • Folliculitis. This is a bacterial or fungal infection in a hair follicle. It can cause the follicle to fill with pus and crust. It may also swell or itch.
Herpes

Herpes is spread by sexual contact with someone who has the HSV virus.

There are two types of herpes virus:

  • HSV-1. This virus is spread through contact with saliva containing the virus and cold sores. HSV-1 can cause genital herpes.
  • HSV-2. This virus is spread through sexual contact. HSV-2 is the main cause of genital herpes.

Genital, oral, or anal sex can all spread the virus, even if there are no outbreak symptoms.

Although you’re less likely to develop the virus if you or your partner wears a condom or other barrier method during sexual contact, there’s still a chance of transmission.

How are these conditions diagnosed?

Pimples are easily managed with changes in your personal hygiene or by using over-the-counter (OTC) treatments.

If the bumps don’t respond to treatment — or if you notice painful, fluid-filled blisters after having sex — see your doctor right away. Your doctor may be able to make a diagnosis just by looking at the bumps.

Your doctor can confirm a diagnosis with one of several tests.

HSV culture

Your doctor will swab a lesion or blister and send the sample to a laboratory for testing. The sample can indicate whether the herpes virus is causing the outbreak. Results are ready after about a week.

HSV DNA tests

Known as nucleic amplification tests, these are often done using polymerase chain reaction (PCR) to get the virus to quickly multiply itself. It’s a quick and accurate way to get an HSV diagnosis. Results are available in about 2 hours.

Herpes serologic test

Your doctor will take a blood sample and send it to a lab for analysis of certain HSV antibodies. This test also takes about a week.

If your doctor diagnoses herpes, talk to them getting a full STI panel. You may be at risk for other STIs if you’ve had sexual contact without a condom or other barrier method.

However, general screening for HSV in people with no symptoms or potential exposure isn’t recommended because tests are most reliable when the infection is active.

How are these conditions treated?

You can treat symptoms of both pimples and genital herpes at home. Pimples usually go away after a week or so. HSV isn’t curable, but you can manage your outbreaks with home treatment and medication.

Pimples

Don’t pop genital pimples. This can make outbreaks worse and leave scars.

You can treat genital pimples at home in a number of ways:

  • Apply a warm, wet cloth to the pimples for 20 minutes four times daily.
  • Apply two drops of tea tree oil diluted in a carrier oil to soothe inflammation.
  • Use gentle antibacterial soap to clean the affected area.
  • Use a gentle anti-acne product with benzoyl peroxide or salicylic acid.
  • Use topical antibacterial cream for any outbreaks that may occur. Neosporin, Bacitracin, or creams with benzoyl peroxide and clindamycin work well. Triple antibiotic ointments with polymyxin B sulfate, bacitracin zinc, and neomycin also work.
Herpes

Oral and topical antiviral medications can treat HSV-2. Treatment makes the virus harder to transmit to others. Medications include:

  • valacyclovir (Valtrex)
  • famciclovir
  • acyclovir (Zovirax)

Don’t have sex until you’ve finished the full course of treatment. If you do, you may transmit HSV-2 to your sexual partner.

Don’t pop genital herpes blisters. This can make the virus easier to spread and make pain worse.

Pain medications, such as ibuprofen (Advil), can also relieve HSV-2 symptoms.

Can either of these conditions lead to complications?

Pimple complications are generally mild. Herpes complications are usually more severe.

Pimples

Complications from pimples aren’t common. When they do occur, they may include:

  • infection
  • permanent scarring
  • darkened or discolored skin
  • depression or anxiety as a result of the skin’s appearance
Herpes

The first HSV outbreak is usually the worst, but outbreaks can remain painful and easier to spread without treatment.

If left untreated, HSV may lead to:

  • permanent scarring
  • darkened or discolored skin
  • pneumonia
  • throat inflammation
  • brain inflammation (encephalitis)
  • brain or spine membrane inflammation (meningitis)
  • eye infection (keratitis)
  • loss of vision from herpes in the eye
  • damage to the liver (hepatitis)
  • infertility

What’s the outlook for someone with either condition?

You can easily treat genital pimples at home. But if they don’t go away in a week or more, see your doctor in case another condition is causing your pimples to appear.

Herpes can’t be cured, but it can be successfully managed with prescription antibiotics and OTC pain relievers. Researchers are working to find a cure or vaccine.

How do I prevent these conditions?

Pimples can appear suddenly for a number of reasons, so it’s hard to fully prevent them. Keeping the area clean with a gentle cleanser is usually sufficient.

You can take quick, easy action each time you have sex to prevent yourself from getting herpes.

Pimples

To help prevent pimples:

  • Take showers or baths regularly, especially after heavy sweating.
  • Wear loose, cotton underwear to ventilate your genital area.
  • Wash your genital area at least once or twice a day to remove dead skin and excess oil.
Herpes

Herpes transmission can only be fully avoided if you abstain from sex.

To prevent contracting or spreading HSV when you do have sex:

  • Wear a condom or other barrier method every time you have penetrative sex.
  • Use a dental dam, condom, or other barrier method every time you engage in oral sex.
  • Don’t have sex if you or your partner are experiencing an outbreak.
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