Is it possible to have a herpes outbreak on shoulders and legs?

Dear Bubbie,

While herpes outbreaks commonly occur on the mouth or genitals from infection with the herpes simplex virus, it is possible for the virus to be transmitted to and appear on other parts of the body. Infection on non-mucosal skin, such as the lower legs or shoulders, is rare but possible, especially if the skin was broken and came into contact with the virus. Two additional types of herpes, herpes gladiatorum and herpes zoster, more commonly result in outbreaks on parts of the body other than the mouth and genitals.

Herpes gladiatorum is an infection that often occurs among high school and college wrestlers, thus earning it the nickname "Mat Herpes". Outbreaks usually appear on the face, neck, shoulders, and arms as a rash-like cluster of blisters that may or may not be painful. These blisters can appear on other parts of the body, including the lower legs. Wrestlers are at risk because of the close contact experienced during matches, but non-wrestlers are susceptible, as well, if they come into physical contact with a person who has the virus. Outbreaks of herpes gladiatorum usually last around 7 to 10 days, after which they are much less likely to be contagious. As with oral and genital herpes, outbreaks of herpes gladiatorum can be recurrent, or brought about through things such as stress or exposure to the sun.

Shingles is caused by herpes zoster, the same virus that causes chicken pox. After the initial outbreak of chicken pox, the zoster virus lies dormant in the body, but can reappear later in life as shingles. Symptoms of shingles include a painful rash of blisters on one side of the body or face. Though the rash may disappear after a couple of weeks, the pain can last for months or years.

If you think you might have herpes, don't let anything, including a seemingly "out-of-place" series of blisters, delay your trip to a health care provider. No matter the cause of the outbreak, they can provide the answers you need. You can fully discuss your situation and any other symptoms you may have noticed. It's good to visit your health care provider while the outbreak is still present so a visual examination may be conducted and a culture may be taken and analyzed. And finally, if it is the first episode of a type of herpes, the sooner it is treated, the less severe this and subsequent episodes will be. And, if you learn your symptoms are not due to herpes, your health care provider can diagnose and treat the symptoms of what you do have, as well.