While pimples are the results of bacterial colonization of pores clogged with dirt, grime, oil, and dead skin cells, herpes, on the other hand, is a sexually transmitted viral infection. The latter is among the most common sexually transmitted infections across the world, with over 500 million people suffering from genital herpes. Pimples, though common, occur due to several factors impacted by hygiene, environment, and hormonal balance. So how does one tell the difference between genital pimples vs. herpes? 

While both genital pimples and herpes appear as red bumps or spots in clusters, several telltale characteristics help identify genital pimples vs. herpes infections. Though bumps on the vagina or around the penis might raise considerable alarm, it’s important to examine yourself patiently to identify the problem. We detail several distinguishing features that allow you to tell the difference between herpes vs. pimples, so you can take timely action and visit your doctor for further examination. 

Pimples & Acne

• Pimples are caused by bacteria from the species Cutibacterium acnes. This is a common bacterium found on human skin. The bacteria becomes a cause of infection when the skin’s pores become clogged with excessive grime, dust, oil, and dead skin cells. 
• The oil from the skin coupled with the dead skin cells becomes a perfect breeding ground for the bacteria that multiply in the pore. The expansion of the pore due to the increasing volume causes several white blood cells to rush to the area to check the infection. 
• Pimples often start as bumps under the skin that eventually become visibly red. When the pimple becomes visible, it often has a head that either contains a whitehead or pus. The pus in a pimple is a combination of sebum (oil), dead skin cells, dead bacteria, and white blood cells. 
• Pimples will often leak out either thick white or yellow pus when scratched or disturbed. The fluid darkens when exposed to air. You might also notice thick, yet clear or white fluid jutting out of the pimple head when disturbed in some cases.
• Draining the pimple by popping it is sometimes followed by blood oozing out. This is normal as blood collects in the inflamed area of the skin. However, popping pimples increases the risk of spreading the infection to other pores, and can lead to scarring of the skin. 
• Pimples are normally not painful unless they’re squeezed or put pressure upon. 
• What are genital pimples? They’re similar to the pimples that occur on the face. They can be caused by the clogging of the pores in the skin in and around the genital area. 
• Pimples can occur just about anywhere on the body due to the ubiquitous bacterial species present all over. 
• Genital pimples often occur in the areas with pubic hair, and in areas that have skin creases and moisture buildup. These areas are more prone to oil collection and provide a perfect space for bacterial growth. 
• Groups of pimples appear in a condition called acne, where regular pimple breakouts occur due to an increased occurrence of clogged pores. This is influenced by several factors such as hormonal activity, genetics, age (teenagers are more prone to acne), menstruation, pregnancies, and conditions such as PCOS. Acne is treated with several modalities that address both the causative bacteria and the underlying cause of excess sebum production. 
• How long do genital pimples last? Pimples often disappear soon, and they rarely leave behind scars and resolve rather uneventfully in most cases. 

Herpes

• Herpes is a viral disease mainly transmitted by sexual contact or through saliva. 
• While herpes has no permanent cure, it can be managed with several drugs that include antiviral therapy to reduce the spread of the infection and pain management. 
• Herpes is caused by two different strains of the Herpes simplex virus:
• Herpes simplex-1 (HSV1)
• This strain causes oral herpes, and the outbreaks of the condition are often restricted to the mouth and its surrounding areas. Blisters appear in the affected areas either in clusters or as solitary ulcers. 
• Also known as cold sores, the blisters often appear close to the mouth, on the face, or the nose. 
• HSV1 spreads through close personal contact and can spread via kissing or while indulging in oral sex. 
• Though commonly associated with oral herpes, HSV1 can also cause genital herpes through oral sex. 

• Herpes Simplex-2 (HSV2)
• This is the primary strain that results in genital herpes and is among the most common sexually transmissible infections. 
• HSV2 can spread via contact with an infected individual’s sexual fluids, or by coming in contact with an infected blister’s fluid. 
• Though common to affect the genital area, HSV2 can also affect the mouth if the individual indulges in oral sex with an infected person. 

• Both HSV1 and HSV2 can spread via oral, vaginal, and anal sex. Blisters appear in these areas and are often filled with clear fluid. 
• The blisters are often painful and ulcerate if they break open. Pain is intense when the blisters pop and ulcers take over 4 weeks to heal. 
• Transmission occurs even if the infected individual is not symptomatic.
• Symptomatic individuals tend to have multiple outbreaks, however, the 1st outbreak is the most painful one, with the subsequent outbreaks reducing in pain, intensity, and duration.  
• However, it is also possible for infected individuals to live with herpes for several years without ever experiencing a single symptom of the disease. 
• While practicing safe sex methods such as using dental dams and condoms can help, having sex with an infected partner still carries the risk of infection. 

Symptoms of Genital Pimples vs. Herpes

Genital Herpes and pimples have distinct symptoms that usually require a medical diagnosis for the condition to be accurately determined. However, below are the most common features of both conditions: 

• Genital Pimples
• Firm on touch and lie underneath the skin 
• Appear with a white peak or a whitehead at the center when filled with pus 
• Circular and reddish in appearance 
• Ooze pus when they break open, which is often a thick white liquid 
• Can either occur singly or in clusters 
• Are sometimes associated with pubic hair in the region, and arise due to folliculitis/hair follicle infections
• Not typically painful unless placed under pressure 
• Commonly found in regions with higher concentrations of sweat glands and high sebum production 

• Herpes
• Tender blisters that are painful to the touch 
• Appear like small, raised bumps that can occur either singly or in clusters 
• Often filled with a clear and transparent fluid 
• Ooze out a clear liquid when they break open 
• Broken blisters become painful ulcers 
• The appearance of blisters is associated with other symptoms such as:
• High fever
• Headaches 
• Malaise and exhaustion 
• Tingling pain in the legs 
• Body aches 
• Swollen lymph nodes 
• Tonsillitis 

Herpes vs. Pimples: Diagnosis

While the appearance of both genital pimples vs. herpes can be fairly distinct, in some cases it is easy to mistake one for the other - especially in the early stages of the development of herpes blisters. 

• This makes it important to check with your doctor when you’re in doubt about whether you have herpes or just a regular pimple. 
• Herpes is normally not included in the STD panel, so it’s important to specifically mention to your doctor the exact symptoms you’ve been facing before you can undergo an examination, followed by a diagnostic investigation. 
• Most often, your doctor will be able to tell the difference just by looking at the bump on the vagina or around the penis, however, when your doctor wants to be extra sure, they might send a sample to the laboratory to conduct genital herpes tests. 
• Tests commonly involve a blood test that looks for the antibodies created by the body against the herpes virus. 
• Other tests include the detection of the Herpes virus’ DNA in a patient’s sample to detect an infection. 
• Culture tests for herpes also exist, allowing doctors to detect the virus in a patient’s sample by analyzing the growth of the virus on a medium. 
• Alternatively, pimples are detected purely by visual confirmation. Doctors might suggest bacterial cultures in case they suspect rare forms of infections. 

Genital Pimples vs. Herpes: Duration of Illness

• If you’re concerned about how long genital pimples last, these skin bumps often disappear in about a week. 
• Whereas, the first outbreak of genital herpes might last between 2 to 4 weeks. Subsequent outbreaks last for shorter periods and do not cause as much trouble as the first outbreak. 
• The symptoms resolve by themselves for both conditions. 

Treatment & Management

• While pimples, in general, are managed by keeping the area clean and applying agents such as benzoyl peroxide or salicylic acid, implementing certain lifestyle changes can also help you avoid genital pimples. These include:
• Using a gentle antibacterial soap and cream
• Not wearing tight/constrictive underwear, and switching to looser options
• Keeping the area clean 
• Switching to trimming or laser removal of pubic hair instead of using a razor to shave the hair 
• Keeping the area dry 
• Avoiding irritants to the skin in the genital region 
• Most of the management of pimples is possible with over-the-counter medications. In cases where persistent and repetitive bouts of pimples break out, your doctor may suggest oral antibiotics. 
• On the other hand, herpes is treated using antiviral drugs such as acyclovir and valacyclovir that reduce the intensity of the infection and reduce the infectivity of the condition. Doctors may also prescribe fever and pain-relieving medications to ease the outbreak's symptoms. 

Other Conditions vs. Herpes

• While genital pimples can sometimes be confused with herpes, there are also other conditions such as folliculitis that can be mistaken for herpes. 
• Folliculitis is an infection of the hair follicle by a bacteria or fungus which causes the follicle to become inflamed. Their appearance is similar to pimples and they look like red bumps. Unlike herpes blisters that appear on several spots, folliculitis occurs only in association with a hair follicle - an important difference between folliculitis vs. herpes. 
• On the other hand, a natural anatomic variation called Fordyce’s spots is also confused with genital or oral herpes. Fordyce’s spots are sebaceous/sweat glands without hair follicles that appear around or inside the mouth, on the penis & scrotum, and on the vagina or labia. They appear as whitish-yellow bumps, as opposed to herpetic fluid-filled blisters - the main difference between Fordyce’s spots vs. herpes. 

If you’re still in doubt about whether it’s a genital pimple or herpes, it’s best to head to the doctor for a checkup!