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Herpes and hidradenitis suppurativa (HS) may look and feel similar, but these two skin conditions have some key differences, including their causes and treatments.
Because herpes is caused by a virus (herpes simplex virus 1 or 2), it can be spread from one person to another. HS, on the other hand, can’t be caught or spread through sexual activity or any other form of physical contact.
Although it’s possible to have HS and herpes at the same time, they have several distinct differences. Here’s what you should know.
Herpes and hidradenitis suppurativa can have some similar symptoms, making it easy to confuse the two.
Type 1 herpes mainly occurs in and around the mouth, and type 2 typically affects the genitals. However, it’s also possible to develop herpes symptoms in other areas of the body.
A first outbreak of oral herpes can take between a week and 10 days to heal. A first outbreak of genital herpes can take two to four weeks to resolve. Outbreaks after that first outbreak are usually shorter and less severe.
Along with blisters that break open, ooze, and crust over, people with herpes may experience:
Sometimes people confuse boils with herpes. Boils are painful bumps that fill with pus and burst. Boils are generally caused by a bacterial infection, rather than a virus. Unlike herpes, boils caused by bacterial infections are not chronic, meaning they don’t recur over a long period.
Boils can develop anywhere on the body, including places affected by herpes or HS.
If you notice a boil on your genitals, such as one on the vulva (sometimes called a vaginal boil), you may wonder if it’s herpes, a boil, an ingrown hair, HS, or something else. The best way to get clarity is to schedule a visit with a healthcare professional.
HS symptoms develop in areas where skin rubs against skin, including the armpits, buttocks, breasts, and genitals. It’s not typical for someone to have herpes in the armpits or breasts.
Lesions (areas of damaged or inflamed skin) can progress into more severe wounds and tunneling (connections under the skin, also called sinus tracts).
HS also can cause painful pea-sized lumps and pus-filled bumps that get larger and eventually break open. Complications from HS may include:
The herpes virus can affect people of all races and ages. Infection depends on exposure to the virus.
There are ways to help prevent transmission of herpes, such as practicing safe sex. Oral herpes can also be transmitted through kissing.
Although it’s less common, herpes can spread when symptoms aren’t visible. Many people have herpes with minimal or no signs of infection, so exposure can be difficult to avoid.
The cause of hidradenitis suppurativa is less clear, but certain groups are affected more than others.
According to Mayo Clinic, women are three times more likely to have the condition, and Black people have higher rates compared with other racial groups. Usually, people with HS begin showing signs between puberty and age 40.
Health experts believe that genetics probably play a role in who gets HS. But there’s still a lot to be discovered about the disease.
Along with having a family history of HS, people with a history of smoking and certain medical conditions are more likely to have HS. Those medical conditions include:
Herpes is a relatively common condition. Worldwide, type 1 (also called oral herpes) affects 64 percent of people under age 50.
Hidradenitis suppurativa isn’t nearly as prevalent. Researchers estimate that less than 1 percent of the world’s population has HS. That means some doctors aren’t very familiar with it.
Members of myHSteam have reported being misdiagnosed with herpes before learning about HS. “I was told I had herpes back in the ’80s, even though I was practicing safe sexual measures, then later found it was the symptoms of HS,” one member said.
Your healthcare provider can assess whether you have herpes by taking a swab of a sore and sending it to a lab. They can also do a blood test to see if you’ve been exposed to the virus in the past, even if you don’t have a current outbreak.
Unfortunately, diagnosing HS isn’t as straightforward. An experienced dermatologist can evaluate your symptoms and medical history, as well as do testing to rule out similar conditions.
If herpes treatment isn’t enough or your skin problems progress to more significant and painful lesions, another underlying issue — like HS — may need medical attention.
Another myHSteam member described their long path to diagnosis: “I had no clue that HS was a thing and that there was a community of people who suffer as well. I’ve been dealing with HS since I was 13 years old. I am now 25. I have lived in secret ALL OF THIS TIME,” they wrote.
The member continued, “I’ve spoken to care physicians in the past, and they all automatically question if it’s herpes. I’ve been tested numerous times for herpes, and it’ll come back negative. But they insist on continuously retesting as if nothing else could be the answer. This, of course, has made me very frustrated!”
Your dermatologist can offer a range of treatment options to help control the symptoms of herpes or hidradenitis suppurativa. Both herpes and HS can have periods of flare-ups and remission.
Maintaining a healthy lifestyle and seeking treatment as soon as flare-ups begin can help you avoid complications like infections and scarring.
Herpes symptoms range in severity. Some people show few signs of the disease and don’t require treatment.
Prescription ointments or antiviral creams such as acyclovir (Zovirax) can help kill the virus and speed healing when applied to the skin during outbreaks. Some people take daily oral antiviral medication to avoid flare-ups of genital herpes.
You can also use at-home remedies to address herpes outbreaks. Treatments include:
If you have HS, your doctor may suggest various treatment options. Examples include:
Both herpes and hidradenitis suppurativa can significantly affect your quality of life, intimate relationships, and self-esteem. Taking time to care for your overall health and well-being is important for lowering stress and preventing flare-ups.
You can get helpful ideas, insight, and support by connecting with others who can relate to your experience.
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Using herbal natural remedy was what got me tested negative to HSV 2 after being diagnosed for years. I have spent so much funds on medications like acyclovir (Zovirax), Famciclovir (Famvir), and… read more
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