Herpes Photos in Different Stages
This page shows close-up medical photos of genital skin.
Herpes photos in different stages show the same pattern: a red, tingling patch, then small blisters, then open sores, then scabs that heal. A first outbreak usually takes 2 to 3 weeks to heal. Later outbreaks are milder and often heal in 7 to 10 days. Below: real herpes pictures of each stage, how herpes looks on women and men, and which stage is best for a test.
Herpes Photos in Different Stages: The 4 Stages
What does herpes look like? It depends on the stage. The stages of a herpes outbreak always run in the same order: it starts with tingling and a red patch, small blisters then form, break open into sores, and finally crust over and heal. Not everyone sees every stage — many people have outbreaks so mild they never notice them.
| Stage | What you see and feel |
|---|---|
| 1. Warning signs | Tingling, itching, burning or pain, then a red, swollen patch |
| 2. Blisters | Small blisters filled with fluid, often in a cluster on the red patch |
| 3. Open sores | The blisters break and leave red, open sores that hurt and may ooze or bleed |
| 4. Scabs and healing | The sores dry, scab over and heal |
These genital herpes stages are the same for HSV-1 and HSV-2, the two types of herpes simplex virus. Most people get only a few sores, but some get blisters and sores over a wide area, says the American Academy of Dermatology (AAD).
Stage 1: What Does the Start of Herpes Look Like?
Often, like nothing at all. Many people first feel tingling, itching, burning or pain in the skin, up to 24 hours before anything shows, according to the AAD. Then a red, swollen patch appears where the blisters will form. Some people also feel shooting pain in the legs, hips or buttocks (Mayo Clinic).
A mild first sign is easy to miss. The AAD says a few herpes sores are often mistaken for pimples or ingrown hairs. To see how one bump compares, read herpes vs. a pimple.
Stage 2: Herpes Blisters
Small blisters form on the red patch, usually in a tight group. They are filled with fluid. Herpes outbreak pictures at this stage show the classic look most people search for: a cluster of small, round blisters on red skin.
Don't pop the blisters. Touching a sore and then touching another part of your body, such as your eyes or fingers, can spread the infection there (Mayo Clinic).
Stage 3: Open Herpes Sores
The blisters break and leave red, open sores (NHS). The sores can ooze or bleed (Mayo Clinic), and the AAD describes them as painful. Some people have pain when they pee (AAD).
A popped herpes blister looks like a red, open sore, like the one in the photo above.
Stage 4: Scabs and Healing
The sores dry out, scab over, and then the skin heals (AAD). This is the last stage of an outbreak. The photos below show these genital herpes healing stages, from a fresh scab to skin that has almost healed.
Does herpes leave scars?
Usually not. DermNet NZ (a skin information site run by dermatologists) says repeat herpes sores normally heal in 7 to 10 days without scarring, and the AAD says the sores heal completely. If a sore lasts much longer than expected, or leaves a mark, have a doctor look at it.
How Long Does a Herpes Outbreak Last?
Here is the herpes outbreak timeline. A first herpes outbreak lasts about 2 to 3 weeks without treatment, says DermNet NZ. The AAD says the sores usually heal within 2 to 6 weeks. Later outbreaks are shorter, usually 5 to 10 days, and the sores heal in about 7 to 10 days. Treatment can shorten both.
First herpes outbreak vs. later outbreaks
| First outbreak | Later outbreaks | |
|---|---|---|
| When it starts | Usually 2 to 12 days after contact with the virus (Mayo Clinic); the AAD says up to 3 weeks | Often in the same area as before, though not always the exact spot |
| Warning signs | Tingling, itching or pain may come first | Tingling, itching, burning or pain, up to 24 hours before sores |
| Whole-body symptoms | Can include fever, headache, body aches, tiredness and swollen glands in the groin | Usually none — most people feel well |
| Sores | A few sores, or many over a wider area | Usually smaller blisters, closer together |
| How long it lasts | About 2 to 3 weeks untreated; healing can take up to 6 weeks | Usually 5 to 10 days |
Sources: Mayo Clinic, AAD, DermNet NZ. DermNet NZ also says first outbreaks tend to be more severe in women than in men.
Will it keep coming back?
Possibly, but usually less often over time. The AAD says repeat outbreaks are most likely in the first year. As the body builds immunity, they become less frequent and may stop. The CDC says genital herpes caused by HSV-2 comes back much more often than genital herpes caused by HSV-1. Learn more about HSV-1 vs. HSV-2.
Does treatment make it heal faster?
A little. Antiviral pills don't cure herpes, and they don't stop it from coming back once you stop taking them (CDC). But they ease symptoms.
The CDC says treatment works best when started within 1 day of the sores appearing, or during the warning tingle. The NHS says it may shorten an outbreak by 1 or 2 days. At STD Center NY, the doctor can prescribe antiviral pills, such as valacyclovir or acyclovir, at the same visit.
Herpes Pictures: Female
What does herpes look like on a female? In women, herpes sores show up on the vulva (the outer genitals), inside the vagina and on the cervix (DermNet NZ), and around the anus, buttocks and thighs (AAD).
A doctor needs an exam to see sores inside the vagina or on the cervix. Peeing may burn, and some women notice discharge that is unusual for them (NHS). The genital herpes pictures below show sores on the vulva at different stages.
Not every sore on the vulva is herpes. See other causes of sores on the vulva.
What Does Herpes Look Like on a Man?
On men, herpes most often shows on the head of the penis (the glans), the foreskin and the shaft (DermNet NZ). It can also appear on the scrotum, around the anus, and on the buttocks and thighs (AAD). These genital herpes men pictures show blisters, open sores and scabs in these areas. The AAD says men are more likely than women to have repeat outbreaks.
For the signs that point to herpes rather than something else, see signs a bump on the penis is herpes.
Herpes on the Mouth (Cold Sores)
Oral herpes, usually caused by HSV-1, shows up as cold sores in or around the mouth and lips (WHO). Cold sores go through the same stages: tingling, blisters, open sores, then crusting.
For how mouth herpes spreads, see can you get herpes from kissing.
Is Herpes Contagious at Every Stage?
Yes. Herpes can spread from the first tingle until the sores have fully healed, says the NHS — scabs included. It can also spread when no sores show at all, because the virus can come out on skin that looks normal (CDC). DermNet NZ says this happens most often in the week before or after an outbreak.
The NHS advises no vaginal, anal or oral sex until the sores have gone away. The CDC says most herpes is passed on by people who don't know they have it or have no symptoms at the time. Read more about asymptomatic herpes shedding.
Which Stage Is Best for a Herpes Test?
The blister or fresh open-sore stage. A doctor swabs the sore, and a lab checks the sample for the virus. The CDC says PCR (a lab test that finds the virus's genetic material) is the most sensitive test for a sore. An older method, a viral culture, becomes less accurate quickly once a sore starts to heal.
So if you have a sore now, have it swabbed before it scabs over. Swabbing skin without a sore is not reliable, and a negative swab doesn't fully rule herpes out, because the virus isn't always present (CDC).
At STD Center NY, I examine every patient myself and swab genital and mouth sores, and the lab runs PCR or a culture. A standard STD panel doesn't include herpes, so ask for it. To compare the swab with the blood test, see how to test for herpes.
What Can Be Mistaken for Herpes?
Besides pimples and ingrown hairs (see Stage 1), several common problems can look like herpes, especially in the early stages: friction burns, folliculitis (infected hair follicles), yeast infections and syphilis sores. Photos help, but only a test can confirm herpes. Compare them side by side in our herpes comparison guides.
