The symptoms of herpes depends on the site of disease:

• Oral herpes (cold sores): Sores around the mouth and nostrils. They may itch or be painful. They might look like the sore in this picture:

• Genital herpes: Sores on the penis in males or near or in the vagina in women. Genital herpes can also cause sores near the anus, including the area between the anus and the genitals (the perianum). Sometimes, genital herpes can cause pain when urinating or defecation. They might look like the sores in this picture:

How is herpes diagnosed?

Oral and genital herpes are well-known diseases. Most doctors and other health-care providers know herpes when they see it. In turn, both types of herpes can often be diagnosed—and treatment recommended— simply by examining the sores. However, guidelines published by the Centers for Disease Control and Prevention (CDC) recommends that mouth sores in particular be confirmed by laboratory testing as oral herpes can sometimes be more difficult to diagnose in people with HIV.

When in doubt, a small sample of the sore is sent to a lab for testing. If the virus is found in the sample, a confirmed diagnosis can be made.

Because a large number of people are infected with HSV-1 and/or HSV-2, there is no value in having blood samples tested for the presence of antibodies to either virus. Being infected with the virus does not necessarily mean that herpes sores will occur.