Herpes vs. HPV (aka warts)

Written and reviewed by Slava Fuzayloff | Published on September 22, 2024

When we (doctors) try to differentiate between two medical conditions, we compare two parts of those diseases: the disease's history and the skin's visual exam. What does each part mean?

1. Disease History consists of:

✓ How transmission happens

✓ How soon did the rash appear after exposure (the rash incubation period)?

✓ How are the rash and other symptoms changing over time?

2. Skin Visual exam consists of:

✓ Rash appearance

✓ The area where the rash is located

In medical practice, 90% of diagnoses are based on a visual exam and 10% on the history of the rash. So, the history of the rash plays a confirmatory role.

This infographic provides a summary of the comparison between genital herpes and HPV.

How does the disease history for Herpes and HPV differ?

How transmission happens

Both herpes [1] Genital Herpes – CDC Detailed Fact Sheet https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm and HPV [4] Human Papillomavirus (HPV) https://www.cdc.gov/hpv/index.html are transmitted via direct skin-to-skin contact. and it is not considered a major differentiating factor.

How soon do symptoms appear?

Unlike the herpes [2] Genital Herpes Symptoms, Pictures, and Treatment https://www.webmd.com/genital-herpes/ss/slideshow-genital-herpes incubation period, which is short and takes 2-4 days on average, the HPV incubation period [5] About Genital HPV Infection https://www.cdc.gov/sti/about/about-genital-hpv-infection.html is much more extended and usually 2-3 months after exposure.

How do symptoms change over time?

This part of the history is the most significant differentiating factor between herpes and HPV.

✓ Unlike HPV, herpes symptoms are preceded by systemic symptoms of fatigue, flu-like symptoms, fever, and localized swollen lymph nodes, as well as the tingling of the area and shooting nerve pain.

✓ Herpes rash goes through multiple stages—skin redness, blister, and sore—unlike HPV, which starts as a bump and only enlarges and can spread to different areas.

✓ Herpes lesions, unlike HPV, are very painful during all stages (bumps, blisters, and sores). The HPV bumps are painless and, for that reason, are often missed.

✓ Unlike HPV, which takes a long time to heal (from a few months to 2 years), herpes lesions heal within a week or two.

This pictures provides a summary of the comparison between genital herpes and HPV.

Warning

Contains sensitive content

View Photos

Herpes

Warts

Visual exam

What do the lesions look like?

✓ Herpes lesions are clustered on the red (inflamed) skin, unlike HPV bumps, which are skin-colored, and the underlying skin is normal-colored.

✓ Unlike HPV bumps, herpes lesions appear and heal simultaneously. HPV bumps can spread and grow over time, so the bumps can be of different ages, sizes, and colors.

✓ Unlike HPV, herpes lesions are usually clustered on one side (either the left or right) of the body and rarely cross the midline. HPV bumps can affect more extensive areas on both sides.

✓ Only herpes can have minimal discharge when the blister turns into an open sore. HPV bumps are dry.

What is the location of the rash?

Herpes rash, unlike HPV [4] Human Papillomavirus (HPV) https://www.cdc.gov/hpv/index.html , prefer thinned skin areas of the vagina, shaft, and head of the penis. HPV can affect any skin, with the pubic area being the most common one.

Genital Herpes – CDC Detailed Fact Sheet
https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm
Genital Herpes Symptoms, Pictures, and Treatment
https://www.webmd.com/genital-herpes/ss/slideshow-genital-herpes
Genital herpes: Overview
https://www.ncbi.nlm.nih.gov/books/NBK525769/
Human Papillomavirus (HPV)
https://www.cdc.gov/hpv/index.html
About Genital HPV Infection
https://www.cdc.gov/sti/about/about-genital-hpv-infection.html