Balanitis vs. Herpes: How to Tell the Difference

A closeup of a man from the waist down. He is wearing a dark shirt and khaki pants and has his hands place over his genital area.
Summary
  • Herpes is caused by a simplex virus that triggers the formation of blister-like sores on the genitals, mouth, or face. It’s usually transmitted by direct skin-on-skin contact.
  • Balanitis — also known as a side-effect or symptom of herpes — is a condition that causes a rash to develop on the genital area. It results from a bacterial or yeast infection, typically affecting the head of the penis and the foreskin.
  • Although these two conditions may be caused by similar factors, they are not the same. Knowing how to tell the difference is essential to getting the right treatment to ensure that your sexually transmitted infection (STI) doesn’t become serious.
  • Treatment options will depend on the type and severity of your STI diagnosis but typically includes prescription medication, topical products, and lifestyle changes.

Sexually transmitted diseases (STDs) affect millions of Americans during their lifetime, with herpes and balanitis being some of the most common infections.

It’s essential to identify which STD you’ve been exposed to in order to seek the correct treatment.

Both balanitis and herpes can cause similar symptoms, making it difficult to tell them apart.

In this article, we’ll take a closer look at both of these conditions and their key differences.

We’ve also included a list of treatment options and best practices to help manage your symptoms.

What is Herpes?

Herpes is a common STI that is caused by the herpes simplex virus (HSV). Infection can cause sores to develop on the genitals or mouth.

Although it’s an uncomfortable condition to deal with, herpes is rarely serious and can be easily treated with the right medical attention.

There are also two types of herpes caused by variations of the same virus. Let’s take a look at what they are.

Genital herpes

This form of the herpes virus is usually caused by the HSV-2 variation. It causes sores to appear on the genitals, inner thighs, and even the anus.

Genital herpes symptoms might be preceded by bouts of shooting pain and other systemic manifestations.

HSV-2 herpes infections are usually transmitted through sexual intercourse but can also spread through other forms of skin-on-skin contact.

Oral herpes

This type of herpes is caused by the HSV-1 virus and causes cold sores or fever blisters to appear around the mouth. The blisters can also spread to other parts of the face.

An HSV-1 infection is the most common herpes infection and can also occur on the genitals. It’s also spread through contact with the affected area, similar to HSV-2.

A young man with a herpes sore on his upper lip checks it out in the mirror.

How do you get herpes?

Herpes can be contracted in a number of ways, usually involving direct skin-on-skin contact with the infected area. These usually include:

  • Kissing
  • Oral sex
  • Sexual intercourse
  • Sharing sex toys
  • Touching a person’s cold sore and then touching your own face before washing your hands

The virus can also be ‘shed’ — a process that occurs when your body rids itself of particles of HSV in developed sores — and infect others.

What are the signs of a herpes infection?

A herpes infection doesn’t always cause visible symptoms. It will usually depend on whether you are experiencing primary or recurrent outbreaks.

Primary infection

These symptoms can appear anywhere from a few days to a few weeks after being exposed to the virus. They typically include:

  • Swollen lymph nodes
  • Tingling, burning, or itching of the infected skin
  • Painful blisters
  • Fever
  • Body aches
  • Fatigue
  • Lack of appetite
  • Shooting pain where you’ve been infected
  • Pain during urination

Recurring infection

Some people who live with HSV outbreaks may have recurring infections every few months. As your body produces antibodies, these infections will become less frequent over time.

Common symptoms of a recurring infection may include:

  • Blisters
  • Pain
  • Itching
  • Burning or tingling sensation at the site of infection

How is herpes treated?

A herpes infection should be diagnosed by a medical professional or through a testing center.

These licensed individuals will be able to make treatment recommendations depending on the cause and severity of your infection. Common treatments may include:

  • Antiviral medication that can reduce the severity of the infection and help you manage symptoms, like pain. This medication can also decrease the risk of transmission before you show visible symptoms.
  • Home remedies like applying a warm or cold compress to the affected area or using aloe vera to soothe symptoms like inflammation and pain.

You and any sexual partners should also consider getting tested for various STDs.

It’s also always recommended to wear proper protection when engaging in any penetrative sexual activities.

Not only do these steps lower your risk of contracting infections like herpes, but it also helps to prevent you from spreading them to other people.

What is Balanitis?

Balanitis occurs when the head of the penis or foreskin becomes inflamed and infected, typically causing severe pain and discomfort.

This type of infection is a fairly common side-effect of other sexually transmitted diseases and is rarely serious.

There are three types of balanitis, namely:

  • Zoon’s balanitis: This is the most common type of balanitis that affects middle-aged people, usually occurring in individuals with uncircumcised penises.
  • Circinate balanitis: This type of balanitis is caused by reactive arthritis: a type of arthritis triggered by infection. It mainly causes tiny sores on the head of the penis, alongside other symptoms like pain or inflammation.
  • Pseudoepitheliomatous keratotic and micaceous balanitis: This is a very rare type of balanitis that mainly affects people over the age of 60. It causes scaly, wart-like bumps to develop on the foreskin.
Key Point: How is Balanitis Diagnosed?

Balanitis should ideally be diagnosed by a healthcare professional. They will usually be able to diagnose it during a physical examination because balanitis symptoms are visible.

You might need to have other tests done to determine the cause of your balanitis infection. These include:

  • Blood tests
  • Skin scraping samples
  • Urine tests
  • A swab of your urethral opening to check for other STDs

How do you get balanitis?

Balanitis can be caused by a number of lifestyle and medical factors, but is usually the result of a fungal, yeast, or bacterial infection.

It can also develop due to improper hygiene when impurities — like bacteria, dead skin cells, and oil — become trapped in the foreskin, creating an environment for bacteria to thrive in.

However, overwashing in an attempt to prevent balanitis can also be damaging and strip the skin of vital moisture. This can cause irritation and swelling.

Balanitis is also commonly caused by sexually transmitted infections like herpes-, gonorrhea-, and trichomoniasis-induced irritation.

Other common causes of balanitis are:

  • Allergic reaction to latex condoms
  • Allergic reaction to some medications like certain kinds of antibiotics and pain relievers
  • Scabies (also known as an infestation of tiny skin mites)
  • Injuries on the foreskin or genitals
  • Medical conditions like diabetes and reactive arthritis
A man in a striped shirt holds is hands toward the camera as he opens a condom package.

What are the symptoms of balanitis?

Two common symptoms of balanitis are redness and swelling in the genital area, often affecting the foreskin.

Depending on the exact cause of your balanitis infection, you may also experience the following symptoms:

  • Itchiness
  • Unusual discharge
  • Sores
  • Foul-smelling genitalia
  • Painful urination
  • Swollen lymph nodes in the groin

What are the treatment options for balanitis?

The initial course of action for treating balanitis is to improve your genital hygiene and avoid using products that are too harsh for sensitive areas.

Infection can also be prevented by ensuring that your sexual partner is clean — ask them to get tested if they’re unsure — and by using proper protection.

Your doctor will likely prescribe a combination of medication and topical treatments to help heal your infection. These may include:

  • Anti-fungal creams — like clotrimazole or miconazole — can help reduce inflammation caused by a yeast infection.
  • Steroid creams may help relieve inflammation and itching.
  • Antibiotics can help reduce the severity of the infection and help you manage symptoms.

Those with male genitalia may also want to consider circumcision to avoid a balanitis infection.

What Are the Differences Between Balanitis and Herpes?

Location
Herpes: May appear on the genitals or on the face, depending on the method of infection.
Balanitis: May appear on and around the genitals.

Pain and Other Symptoms
Herpes: Infection might be preceded by local shooting pain in the genitals or on the face. Fever, fatigue, and other flu-like systemic symptoms may develop. Balanitis: Shooting pain in the hips, thighs, and legs. No other systemic symptoms.

Incubation Period
Herpes: Two to three days after exposure.
Balanitis: Two to three days after sexual contact with an infected person.

Rash Appearance
Herpes: Flesh-colored bumps filled with fluid. Has a blister-like appearance. Can also look like crusted sores. 2-3mm in diameter.
Balanitis: Tiny, bright red bumps that aren’t filled with fluid. Skin irritation is common. Shallow ulcers may also appear.

Lesion Spread
Herpes: Herpes lesions are usually grouped together in one area.
Balanitis: Widely spread on and around the genital area.

Lymph Node Enlargement
Herpes: Local — groin or inguinal — enlargement of lymph nodes.
Balanitis: None

Discharge
Herpes: Insignificant discharge. Any detected fluid comes from the blisters. Balanitis: Significant (thick, white discharge from the genitals).

Is balanitis always caused by herpes?

Balanitis is a symptom or side-effect of a genital herpes infection.

This means that you will likely develop balanitis symptoms — like a rash, discharge, and ulcers — if you’ve contracted herpes.

Luckily, balanitis is rarely a serious or life-threatening condition and can be easily treated.

A man in a light blue button down shirt and brown hair smiles happily at the camera. He is outside and there are trees or bushes behind him.

When Should I See a Doctor About Balanitis or Herpes?

STDs can be dangerous if left untreated and some can even decrease a woman’s chances of getting pregnant and can increase a person’s chance of contracting HIV.

That’s why it’s important to see your doctor as soon as possible if you suspect that you may have an STD.

You can also get tested before making an appointment with your healthcare provider. A medical professional will be able to recommend the right treatment and prevention plan, based on the cause and severity of your condition.

Are You Worried About Your Balanitis or Herpes Symptoms?

Herpes and balanitis are two medical conditions that should be treated as soon as possible. Fortunately, with LifeMD, you can talk to a board-certified doctor or nurse practitioner right from home (or wherever you are). Head over to LifeMD to make a video appointment.

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective.
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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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