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Furthermore, these tender sores may come back periodically in the same sites.

Infections with the herpes simplex virus are very contagious and are spread by direct contact with the skin lesions. HSV Type 1 (HSV-1) infections usually occur around the mouth, lips, nose, or face, while HSV Type 2 (HSV-2) infections usually involve the genitals, lower back, or buttocks.

In fact, they may think that they have a recurrent skin condition such as shingles, a yeast infection, or an allergic reaction.

However, sacral herpes is considered to be a form of genital herpes.

These painful ulcers subsequently become scabbed over.

The scabs eventually fall off, leaving a red area that fades. In mild cases of primary herpes simplex virus infection, an individual may develop 1 or 2 lesions or may notice no symptoms at all.

HSV-2 infections are transmitted sexually or from a mother's genital tract to her newborn baby.

HSV-2 is often spread through direct skin-to-skin contact with active lesions on another person.

However, people who have herpes simplex virus infections may be contagious even when they do not have any skin lesions, which is called asymptomatic shedding.

Because sacral HSV is not located in the groin area, people may not realize that they have a form of genital herpes.

Repeat (recurrent) herpes simplex virus infections are often milder than the primary infection, though they look alike.

However, some people never develop the symptoms of a primary HSV infection and may mistake a recurrent infection for a primary infection. People who are prone to recurrent outbreaks tend to get them 3–4 times per year, though some may have 10 or more outbreaks per year.

Nevertheless, the virus remains in the body, hibernating in nerve cells.

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