What can be mistaken for Herpes?

Many common conditions can be mistaken for Herpes, including ingrown hairs, spots and boils, thrush, urinary tract infections, Syphilis, genital warts, Molluscum contagiosum, piles, insect bites, allergic reactions and Fordyce spots.

Herpes usually starts with tingling, burning or itching, followed by small blisters that burst to leave red, open sores that can be painful. Other conditions can cause similar bumps, spots or soreness, so it is not always possible to tell them apart by looking. Here is how the most common lookalikes usually differ from Herpes.

1. Ingrown hairs

Ingrown hairs cause raised, itchy bumps in areas you shave, wax or pluck, including the pubic area. The bumps may look red, especially on lighter skin, you may see pus in them, and sometimes you can see a hair trapped under the skin. Most do not need medical treatment.

2. Spots and boils

Spots can appear on the genitals, bottom and thighs, just like anywhere else on the body. A boil starts as an itchy or tender spot and becomes a hard, painful lump that fills with pus. Herpes blisters are usually smaller and burst to leave open sores.

3. Thrush

Thrush is a common yeast infection. It causes itching, soreness and irritation, and in women it can cause a white discharge that looks like cottage cheese. In men, it can cause redness and irritation under the foreskin. Read more in “Is it Herpes or thrush?”

4. Urinary tract infection (UTI)

Herpes can make it painful to pee, which is why it is sometimes confused with a UTI. A UTI causes pain or burning when you pee, needing to pee more often, and cloudy or bloody pee, but it does not cause sores or blisters on the skin. Read more in “Is it Herpes or a UTI?”

5. Syphilis

Syphilis is an STI that can cause a sore on the genitals, anus or mouth. Unlike Herpes sores, a Syphilis sore is usually painless, and there may be only one. Because it does not hurt, it is easy to miss. Syphilis needs treatment with antibiotics, so it is important to get any new sore checked, even if it goes away.

6. Genital warts

Genital warts are caused by HPV. They are small, rough lumps on or around the genitals or anus, and groups of warts can look like a cauliflower. Unlike Herpes, they are usually painless and do not blister or burst.

7. Molluscum contagiosum

Molluscum contagiosum is a common skin infection caused by a virus. It causes small, raised spots about 2 to 5mm wide, often with a dimple in the middle. In adults it can be passed on through sexual contact, and the spots may then appear around the genitals, lower tummy and thighs. The spots usually clear up on their own within 18 months.

8. Piles (haemorrhoids)

Piles are lumps inside and around your bottom. They can cause itching and bright red blood after you poo. Herpes can also cause sores around the anus, so it is worth getting any new lump or sore checked.

9. Insect bites

Insect bites usually cause small, red, itchy lumps that get better within a few days. Some bites, such as mite bites, can blister, which can make them look like Herpes.

10. Allergic reactions and contact dermatitis

Contact dermatitis is a skin reaction to something that irritates the skin or that you are allergic to, such as soaps, detergents, cosmetics or some metals, including nickel. It can make the skin itchy, blistered, dry and cracked, and it may look red on lighter skin or dark brown, purple or grey on darker skin.

11. Fordyce spots

Fordyce spots are tiny white or yellow spots, about 1 to 3mm wide, that can appear on the lips, inside the cheeks, and on the penis or vulva. They are harmless and very common, found in an estimated 80 to 90% of people, and they need no treatment, but they are often mistaken for Herpes.

Herpes is caused by the Herpes simplex virus (HSV). There are two types:

• HSV-1 is the usual cause of cold sores around the mouth and lips. It can also cause genital Herpes, often after oral sex, and it is now the most common cause of genital Herpes in the UK.
• HSV-2 mainly causes genital Herpes, with sores on or around the genitals or anus. It is more likely than HSV-1 to cause repeat outbreaks.

Symptoms

When Herpes causes symptoms, they can include:

• tingling, burning or itching around the genitals
• small blisters that burst to leave red, open sores around the genitals, anus, thighs or bottom
• pain when peeing
• discharge that is not usual for you

Many people with Herpes have no symptoms at all, or symptoms so mild that they do not notice them. Symptoms might not appear for weeks or even years after infection. After the first outbreak, the virus stays in the body and can cause repeat outbreaks, which are usually milder and tend to happen less often over time.

How Herpes spreads

Herpes spreads through skin-to-skin contact with an infected area, including during vaginal, anal and oral sex, when a cold sore touches the genitals, and by sharing sex toys. It is not spread through towels, swimming pools or toilet seats.

Herpes is most contagious from the first tingle or itch until the sores have fully healed, so avoid sex, including oral sex, during an outbreak. It can also be passed on when there are no symptoms, especially in the first 6 months after infection. Condoms lower the risk, but they do not cover all the skin around the genitals, so they cannot fully protect you.

You can’t always tell Herpes apart from other conditions by looking, so testing is the only way to be sure.

If you have a sore, blister or bump

The best time to test is while you have symptoms, because a swab taken from a sore or blister can find the virus and show which type you have. The Better2Know Blemish Screen tests a swab from the blemish for Herpes 1, Herpes 2, HPV and Syphilis, so you can find out which, if any, is causing your symptoms. Results are ready in 5 days. You can book it at one of our clinics or order a Blemish Screen home test kit. If you only want to test for Herpes, the Herpes Simplex Type 1 and 2 (Swab) test is also available.

If you do not have symptoms

If you have no symptoms but want to know whether you have Herpes, the Herpes Simplex Type 1 and 2 (IgG) blood test looks for antibodies to the virus. You can take it from 28 days after possible exposure, with results in 2 days, at a clinic or with a home test kit.

Blood tests have limits. They cannot show whether HSV-1 is in the mouth or the genitals, a test taken soon after infection can miss it, and a positive result at a low level can be a false positive. You can discuss your result with a Better2Know doctor, who can explain what it means for you.

Not sure which test to choose? Our Patient Care Team is available 24/7 on 020 7099 0955.

Can an ingrown hair look like Herpes?

Yes. Ingrown hairs cause raised, itchy bumps in areas you shave, wax or pluck, which can look like early Herpes. Sometimes you can see a hair trapped under the skin. If you are not sure, a swab test can tell you whether it is Herpes.

Can you have Herpes without knowing?

Yes. Most people with Herpes have no symptoms or do not recognise them, and symptoms might not appear for weeks or even years after infection. This is why Herpes is so often passed on without either partner knowing.

What if my sore doesn’t hurt?

Herpes sores are often painful, but a sore that does not hurt still needs checking. Syphilis sores are usually painless and easy to miss, and Syphilis needs antibiotic treatment. The Blemish Screen tests for both.

Can I test for Herpes at home?

Yes. The Blemish Screen home test kit uses a swab taken from outside the body, and the Herpes Simplex Type 1 and 2 (IgG) blood test is also available as a home test kit for people without symptoms.

Plenty of harmless conditions, from ingrown hairs to Fordyce spots, can be mistaken for Herpes. But some lookalikes, such as Syphilis and genital warts, are STIs that need attention, and Herpes itself can be managed well once you know you have it.

If you have a new sore, blister or bump, the only way to know what it is is to get tested. Book a Blemish Screen at a clinic near you or order a home test kit.

Not in the UK? Choose your country from the selector at the top of the page for local tests and prices.

This article originally appeared on 9 October 2020 and was last updated on 29 September 2026.

Medical review. This article was medically reviewed by Dr Steve Chapman, Doctor with a wealth of clinical experience in the field of STIs, on 2 October 2024. It is general information and not a substitute for personal medical advice.

Sources

1. NHS, Genital herpes, reviewed 27 June 2023. https://www.nhs.uk/conditions/genital-herpes/
2. World Health Organization, Herpes simplex virus, fact sheet, 30 May 2025. https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus
3. British Association for Sexual Health and HIV, UK national guideline for the management of anogenital herpes, 2024. https://bashh.org/_userfiles/pages/files/pateletal2024britishassociationofsexualhealthandhivuknationalguidelineforthemanagementofanogenital.pdf
4. Centers for Disease Control and Prevention, Herpes, Sexually Transmitted Infections Treatment Guidelines, 2021. https://www.cdc.gov/std/treatment-guidelines/herpes.htm
5. NHS, Ingrown hairs, reviewed 1 September 2026. https://www.nhs.uk/conditions/ingrown-hairs/
6. NHS, Boils, reviewed 20 June 2023. https://www.nhs.uk/conditions/boils/
7. NHS, Thrush in men and women, reviewed 28 July 2023. https://www.nhs.uk/conditions/thrush-in-men-and-women/
8. NHS, Urinary tract infections (UTIs), reviewed 11 July 2025. https://www.nhs.uk/conditions/urinary-tract-infections-utis/
9. NHS, Syphilis, reviewed 17 March 2026. https://www.nhs.uk/conditions/syphilis/
10. NHS, Genital warts, reviewed 10 July 2023. https://www.nhs.uk/conditions/genital-warts/
11. NHS, Molluscum contagiosum, reviewed 14 May 2026. https://www.nhs.uk/conditions/molluscum-contagiosum/
12. NHS, Piles (haemorrhoids), reviewed 1 April 2026. https://www.nhs.uk/conditions/piles-haemorrhoids/
13. NHS, Insect bites and stings, reviewed 1 June 2023. https://www.nhs.uk/conditions/insect-bites-and-stings/
14. NHS, Contact dermatitis, reviewed 3 May 2023. https://www.nhs.uk/conditions/contact-dermatitis/
15. Pietkiewicz P, Navarrete-Dechent C, Goldust M, et al. Differentiating Fordyce spots from their common simulators using ultraviolet-induced fluorescence dermatoscopy: retrospective study. Diagnostics, 2023;13(5):985. https://www.mdpi.com/2075-4418/13/5/985