HSV-1 is the type most commonly associated with cold sores (oral herpes), while HSV-2 accounts for the majority of genital herpes infections. However, HSV-1 can also be spread to the genitals and HSV-2 can be spread to the mouth through oral sex.

This gallery of images describes the signs and symptoms of a herpes infection, including what a herpes sore looks like. It also differentiates herpes from similar conditions with similar features so that you can seek appropriate treatment.

Note: Some of the following images are of genital areas.

When herpes reactivates, the virus will travel up the string of nerves to the surface of the skin where it will cause an outbreak of tiny blisters called vesicles. The vesicles will then erupt, causing painful open ulcers commonly referred to as herpes sores.

This photo shows an example of the early stages of a herpes rash, the blisters of which are clustered in a red patch. In addition to pain, there may be itchiness or a pins-and-needles sensation.

The outbreak may also be preceded by flu-like symptoms like fever, fatigue, and swollen lymph nodes, particularly during the first outbreak.

Prodromal: This is when the virus reactivates and migrates to the surface of the skin, causing non-specific nerve pain or sensations. Vesicular: This is when blisters (vesicles) develop. Ulcerative: This is when the blisters break open to form skin ulcers.

This picture illustrates the formation of vesicles. 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.

Zovirax (acyclovir) Famvir (famciclovir) Valtrex (valacyclovir)

Severe cases like this tend to occur during a first outbreak (called primary herpes). Thereafter, the body will have produced immune proteins, called antibodies, that are not able to neutralize the virus but can help control the infection.

As a result, subsequent outbreaks tend to be far less severe.

In this picture, the lesions look more like erosions (where only part of the top layer of skin is damaged). If you look closely, however, you can see that each red area has a cluster of small sores.

Females are four times more likely to get an HSV-2 infection than males. In addition, females may have symptoms that are not readily recognized as herpes.

For instance, a female may feel pelvic pain if the rash is located inside the vagina or on the cervix. This could lead to a misdiagnosis of pelvic inflammatory disease (PID).

Also, many females experience burning with urination during a genital herpes outbreak. The burning may be misdiagnosed as a urinary tract infection (UTI). 

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 on skin.

The timeline of a genital herpes outbreak can vary. With primary herpes, the outbreak will usually occur within four days of exposure to the virus (although it can occur anywhere from two to 12 days after exposure).

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.

Cold sores progress in much the same way as genital herpes. HSV-1 can also affect the tongue, gums, or face.

This can occur between someone with herpes and someone without. You can even auto-inoculate by touching a sore on your body and then another part of your own body.

The finger is a common place to get a herpes infection to spread. In fact, it’s common enough to have its own name: herpetic whitlow.

This picture shows the early stage of a herpes whitlow infection. Since the skin on the fingers is thicker, the blisters aren’t as fragile and may not break open.

This picture shows herpetic keratitis, a herpes infection that involves the cornea (the outside covering of the eye). Note the blisters around the eyelid and crusting ulcers near the eyes.

Symptoms of herpetic keratitis may include:

Eye painSensitivity to lightWatery dischargeBlurry vision

With the chickenpox, note that each blister in this photo has its own red base and is not clustered in a group like HSV.

As opposed to a localized outbreak, chickenpox usually starts on the torso, scalp, and face before spreading to the arms and legs. The rash can also cause sores in the eyes, mouth, and vagina, although this is uncommon.

And, unlike HSV, a chickenpox rash can leave behind scars after it heals.

Aphthous ulcers (also known as canker sores) are painful, non-contagious ulcers limited to the inside of the mouth. As opposed to herpes blisters, aphthous ulcers start as painful sores that are yellowish or whitish in color with a red border.

Aphthous ulcers can be caused by the following.

Coxsackievirus Contact dermatitis Chemotherapy Autoimmune diseases (like Crohn’s disease and ulcerative colitis)

Herpes progresses in stages and causes the outbreak of blisters and painful ulcerative sores. This is followed by the crusting of the sores. Healing usually occurs within two to four weeks.

A Word From Verywell

Herpes infections are common. While they cannot be cured, they can be managed or prevented with antiviral drugs. If you have symptoms of herpes, see your healthcare provider as soon as possible. They can take a swab of the sore to confirm whether you have been infected.