Chye ClinicGenital Herpes or Genital Warts? How to Tell
Genital herpes and genital warts are both common, both sexually transmitted and both caused by viruses, so they often get confused. They are not the same infection, and the treatment for one does nothing for the other. The differences are usually clear once you know what to look for.
The quick comparison
| Genital herpes | Genital warts | |
|---|---|---|
| Cause | Herpes simplex virus (HSV-1 or HSV-2) | Human papillomavirus, mostly types 6 and 11 |
| What you see | Small blisters that burst and leave shallow, raw sores | Flesh-coloured or grey bumps, flat or raised, sometimes with a cauliflower-like surface |
| How it feels | Painful or burning, often with tingling a day or two before | Usually painless, sometimes itchy |
| How it behaves | Comes in outbreaks that heal in one to three weeks, then can return in the same place | Stays and may slowly grow or spread over weeks to months |
| How it is diagnosed | A swab from an active sore | Usually by examination |
| Treatment | Antiviral tablets | Prescription creams, or removal at the clinic |
| Vaccine | None | Gardasil 9 protects against the main wart types |
Signs that point to herpes
Pain is the biggest clue. Herpes sores hurt, and they often announce themselves with tingling, itching or burning skin before anything is visible. The blisters break into sores that crust and heal. A first outbreak can come with fever, aches and swollen glands in the groin. Later outbreaks tend to be milder and shorter.
If a sore is there now, come in while it is. A swab from an active sore gives the clearest answer, and antivirals work best started in the first day or two.
Signs that point to warts
Warts are lumps, not sores. They do not blister or break open, and most people only notice them by touch or by sight. They can appear weeks or months after the contact that caused them, which makes it hard to know where they came from.
The wart types of HPV are not the types that cause cervical cancer. Women with warts still need regular cervical screening, because the two can be caught separately.
Lookalikes that are neither
- A syphilis sore. Usually a single, firm, painless ulcer that heals by itself. It needs a blood test, and it is the one to rule out with any genital sore.
- Molluscum contagiosum. Small, smooth, pearly bumps with a dimple in the centre.
- Pearly penile papules. Tiny, even bumps in rows around the head of the penis. They are normal skin, not an infection, and need no treatment.
- Fordyce spots. Small pale or yellow spots on the shaft or the lips of the vulva. Also normal.
- Ingrown hairs and folliculitis. Red bumps, often with a hair or a pus point, common after shaving.
Why not to guess and self-treat
Wart creams do nothing for herpes and can make the skin worse. Antivirals do nothing for warts. Several of the lookalikes need no treatment at all, and syphilis needs a completely different one. One visit, an examination and, where needed, a swab or a blood test settle it.
At Chye Clinic
Both are diagnosed and usually treated on the same visit. More detail is on the genital herpes and genital warts pages. For outbreaks or warts that keep coming back despite treatment, see herpes and wart immunotherapy.
Chye Clinic, Kepong Baru
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This article is general information and does not replace an assessment by a doctor who knows your history.
Genital warts and HPV at Chye Clinic
Genital warts are caused by HPV, usually types 6 and 11, which are not the types behind cervical cancer. They are treatable, they recur in a good share of people, and a vaccine covers what you have not already caught.