Herpes or Ingrown Hair? How to Tell the Difference

Finding a sore bump near the bikini line, groin or inner thigh can make anyone worried. Ingrown hairs are common wherever hair is shaved, waxed or plucked. But the CDC notes that mild herpes can be mistaken for an ingrown hair, so the worry is understandable. This guide shows the differences and what to do while you wait.

How do I tell if it’s herpes or an ingrown hair?

Look at three things: what led up to it, what the bump looks like, and how it changes.

• What led up to it. The NHS says you are more likely to get ingrown hairs in areas you shave, including the pubic area, and that waxing, plucking and threading can also cause them. Herpes often begins with tingling, itching or burning in the spot before anything shows.
• What it looks like. An ingrown hair looks like a raised, itchy bump, and sometimes you can see a hair trapped under the skin. If it gets infected, the bump can be painful and may contain pus. Herpes typically forms small, painful blisters filled with clear or straw-coloured fluid, which burst to leave open sores.
• How it changes. The burst blisters of herpes crust over and heal, which can take a week or more. Herpes can also recur over time, and later outbreaks are usually shorter and less severe than the first.

These are patterns, not rules. Herpes symptoms can be mild, and a single bump can be hard to tell apart from an ingrown hair. A clinician’s examination and a test give the most reliable answer.

What does an ingrown hair look like?

The NHS describes ingrown hairs as raised, itchy bumps. On white skin the bumps may look red. On black or brown skin the redness may be harder to see, and the bumps may look a different colour from the skin around them.

You may be more likely to get ingrown hairs if you have coarse or curly hair. Most ingrown hairs don’t need medical help, but see a clinician if the area is very painful, hot or swollen.

What about razor bumps and folliculitis?

These are close relatives of the ingrown hair, and they are also common lookalikes for herpes.

• Razor bumps. The AAD describes razor bumps as painful or itchy bumps caused when shaving irritates the skin. MedlinePlus explains that curly hairs cut too short may curve back into the skin and cause inflammation.
• Folliculitis. This is inflammation of one or more hair follicles, which can start when follicles are damaged or blocked, for example by shaving or friction from clothing. MedlinePlus lists a rash, itching, and pimples or pustules near a hair follicle in the groin or genital area, and says the pimples may crust over.

Because folliculitis pimples can crust over too, crusting alone doesn’t point to herpes. Our separate razor bumps guide goes further into shaving-related bumps.

How does herpes differ from an ingrown hair?

• Herpes often starts with tingling, itching or burning before a bump or blister appears.
• Herpes causes small blisters that burst into red, open sores, which can be painful. On brown or black skin the sores may look less red.
• Herpes can recur. The NHS says outbreaks are usually milder than the first, and tend to happen less often over time.
• A first outbreak can come with flu-like symptoms such as fever, body aches or swollen glands, according to the CDC.

Symptoms can overlap, so treat these as clues rather than answers.

What should I do while I wait?

• Don’t scratch, pick or squeeze it, and wash your hands after touching it.
• If it might be an ingrown hair, the NHS says the best way to prevent them is not to shave. If you do shave, wet the skin with warm water, use shaving gel, shave in the direction the hair grows, and don’t use a blunt razor.
• If it could be herpes, avoid sexual contact with the area. People with symptoms of genital herpes should abstain from sexual activity while the symptoms are present.
• Take a photo each day. It can help a clinician if the spot changes before you are seen.

When should I have a bump looked at?

See a clinician if the bump isn’t improving, keeps coming back, or is getting more painful. MedlinePlus advises contacting a provider about folliculitis if it comes back often, gets worse, or lasts longer than 2 or 3 days. Get checked soon if you have several blisters or open sores rather than one bump, or if you have a fever along with new genital sores.

A clinician who examines the area, with a swab if needed, gives the most reliable answer. There is no need to feel embarrassed about asking.

Which test tells me for sure?

If there is any chance it is herpes, the most sensitive test is a swab of an active sore (PCR). A clinician can take it. Once the spot has healed, a swab may not detect the virus, and that doesn’t rule herpes out.

A blood test for herpes antibodies shows whether you have been infected at some point, not whether this particular bump is herpes. It can miss a recent infection, so repeat testing about 12 weeks after a possible exposure may be needed. The CDC does not recommend routine HSV-2 blood screening for the general population.

If a clinician finds herpes, antiviral medicine prescribed by a clinician can shorten outbreaks and make them less frequent.