How to tell if you have genital warts or herpes

Genital warts and herpes can be hard to tell apart since they both appear in the genital area. However, genital warts are small, flesh-colored bumps whereas herpes sores look like blisters or open wounds. 

Both genital warts and genital herpes can be sexually transmitted through skin-on-skin contact. If genital warts or herpes are inflamed or irritated, it can be especially challenging to tell the difference, says Brooke Grant Jeffy, MD, a dermatologist with Spectrum Dermatology in Phoenix. 

The main difference between genital warts and herpes are the underlying viruses. Genital warts is a common term for an infection of the human papillomavirus (HPV), and herpes is a common term for a herpes simplex virus (HSV) infection.

Here are more details on the difference between genital warts and herpes.

What are genital warts?

Genital warts are one of the most common sexually transmitted infections, says Michael Cackovic, MD, a maternal  fetal medicine physician at The Ohio State University Wexner Medical Center in Columbus. 

The warts are caused by an infection from the human papillomavirus (HPV). Many HPV strains can be spread through sexual contact. If you have HPV, it's possible to spread the infection even if you don't have active warts, Jeffy says.

Here are a few symptoms of genital warts:

• Flesh-colored bumps that may or may not be visible. Warts usually appear in the genital area but can also be in the mouth or throat from oral sex with an infected person, the American Academy of Dermatology reports.
• Mild pain or no pain at all
• Itchiness in the genital area
• Bleeding of warts during sex
• Warts may feel sore if they rub against skin or clothing.

Left untreated, an outbreak of genital warts can last months or even years. Sometimes they will go away on their own, but usually they require treatment, says Cackovic. Treatments for genital warts include prescription topical medications such as imiquimod, freezing them with liquid nitrogen, or excision, i.e. surgical removal. 

Although topical treatments may take a few weeks to work, they are the easiest to prescribe because you can use them at home every day, Cackovic says. The US National Library of Medicine advises avoiding sexual contact while using treatments such as imiquimod because it can weaken condoms and vaginal diaphragms.

Some strains of HPV can cause cervical cancer, vulvar cancer, anal cancer, or penile cancer, Cackovic says. If you have genital warts and were not previously aware that you had an HPV infection, ask your doctor what other routine cancer screenings you may require. For instance, women with HPV need more frequent pap smears to monitor for cervical cancer.

There also is now an HPV vaccine offered to teens and young adults to lower their chance of getting the strains of HPV that are linked to various cancers, Jeffy says. Condoms and dental dams also can help prevent the spread of genital warts, Planned Parenthood reports. Because HPV can be passed through skin to skin contact, internal condoms may provide a little extra protection than external condoms. 

What is herpes?

Herpes sores are caused by the herpes simplex virus (HSV). According to Jeffy, there are two strains of HSV:

• Herpes simplex virus-1 is often spread through oral-to-oral contact and causes sores in or near the mouth. HSV-1 is often located in the mouth area can also cause genital herpes if there is contact from the mouth to the genitals during oral sex.
• Herpes simplex virus-2 is what usually causes genital herpes, which is spread by oral, anal, or vaginal sexual contact.

Genital herpes is generally contagious until the sores heal. However, even if someone does not have an active sore, they can still pass the virus on to others, Jeffy says. 

Symptoms associated with genital herpes include:

• A blister-like appearance
• A burning sensation
• Pain at the site where the lesion is about to occur. During your first outbreak, the pain can be severe, Cackovic says.

Outbreaks usually occur for one to two weeks. Although herpes lesions can go away on their own, topical or oral antiviral medications such as acyclovir will speed up their elimination and help to prevent recurrences, Cackovic says. Sometimes, doctors will recommend the daily use of antiviral medication to help avoid recurring herpes flares and to prevent transmission of the virus to others. 

If you have active genital herpes sores, there's an increased chance of getting other sexually transmitted infections because you have open wounds, Jeffy says. This is why it's best to avoid sexual contact while experiencing herpes symptoms, according to the World Health Organization. 

Having herpes sores also can make you more prone to bacterial infections and urinary retention. It is possible to transmit HSV to a baby through vaginal delivery, Cackovic says.

Sexual contact is not the only way HSV is transmitted. For example, young children often get HSV-1 from kissing family members or putting play toys in their mouths that have also been in other children's mouths. 

Genital warts vs. herpes

Here's a quick guide that compares genital warts and herpes:

Although treatments can make genital warts and herpes go away temporarily, the person still carries the virus that caused them. There is no cure yet for HPV, HSV-1, or HSV-2. For some people, HPV goes away on its own; for others, it doesn't. It can stay dormant and then come back even years later. Stress is often an outbreak trigger for viral diseases. 

Herpes outbreaks may also go away but can come back in the future. There's a continued risk of passing the virus on to others through sexual contact even without active lesions.

The most important difference to understand between genital warts and herpes, says Jeffy, is that they are caused by different viruses.

Insider's takeaway

Both genital warts and herpes can be caused by sexual transmission. However, the sores have different causes and treatments. Herpes is typically associated with more pain, Jeffy says. 

"Once a person has become infected with one of these viruses, they are always infected and can spread the virus to others or, at times, have flares themselves," she explains.

Using condoms consistently can help to prevent genital warts and herpes, but it won't cut out your risk entirely.

Related articles from Health Reference:

• How to choose the right fitting condom and material to protect against STIs and pregnancy
• Sex in water: 5 safety tips for better water sex
• How to tell the difference between a yeast infection and UTI
• How to treat a UTI at home, and prevent one from occurring in the first place
• 3 ways to treat a yeast infection at home

Join the conversation about this story »