Monkeypox Pictures: What Do the Virus Lesions Look Like?

As Monkeypox continues to spread—with 12 countries now officially reporting cases—most people are still unfamiliar with what the rash associated with the virus looks like. How do you know if a suspicious rash is monkeypox?

While photos of viral monkeypox rash in humans often look alarming, it remains a rare illness and differs from other rashes caused by infectious disease.

Two clear stages of illness

The World Health Organization (WHO) describes two distinct stages of infection with the virus. In the first stage, which can last up to five days, patients experience fever, intense headaches, swelling of lymph nodes, muscle aches and fatigue. WHO defines swollen lymph nodes as a symptom that distinguishes monkeypox from other illnesses that might appear similar, such as chicken pox, measles and smallpox.

Patient's hands with monkeypox
A close-up of a patient in the Democratic Republic of Congo, with hands showing lesions from the monkeypox virus Getty

In the second stage, which usually starts one to three days after the appearance of fever, the infected person develops a rash, which is concentrated on the face and extremities.

In the majority of cases, the virus affects the face, palms of the hands and soles of the feet. In most cases, the rash also affects the skin inside the mouth, including cheeks and lips.

While the initial rash involves lesions with a flat base, these eventually develop into slightly raised firm lesions, before filling with clear fluid and ultimately turning into pustules, filled with yellowish fluid.

Monkeypox lesions
Skin of a patient showing lesions from monkeypox infection in Liberia, 1971. Getty

Infected people can have anywhere from a few lesions to several thousand, according to WHO. The lesions eventually evolve into crusts, which dry up and fall off. Monkeypox symptoms last between two and four weeks in most people.

Close up showing monkeypox sores on a person's hands. Getty Images

Transmission source of outbreak unclear

The current outbreak has been centered in North America, Europe and Australia, with 92 cases confirmed as of May 21. Although a number of recently reported cases have occurred in homosexual men, WHO and other agencies have emphasized that the illness is not sexually transmitted and is spread from person to person via close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.

Centers for Disease Control and Prevention handout graphic showing monkeypox lesions. Getty Images

Children, young adults and those who are immunocompromised are most at risk of developing severe cases, according to the European Centre for Disease Control (ECDC).

First documented in humans in the Democratic Republic of Congo (DRC) in 1970, monkeypox is believed to be harbored in African rodents and primates. The virus has been rarely seen outside central and western Africa, and cases outside those regions have been connected to travelers or imported animals, according to the U.S. Centres for Disease Control and Prevention (CDC); an outbreak in the U.S. in 2003 was linked to imported rodents from Ghana, which reportedly spread the virus to pet prairie dogs.