TCM diagnosis Based on Syndrome Differentiation:
Qi and Blood stagnation
This is a pattern of post-herpetic neuralgia, when the Qi and Blood are weakened by illness or old age and so cannot move easily. Lesions will be partially erupted and pain will be severe pin-point pricks. Movement will make the pain worse. Other symptoms may include loss of appetite, disturbed sleep, and restlessness. 

Blazing Fire in the Liver Channel
This pattern presents with bright red, tight-skinned vesicles. The pain has a burning quality that feels like pin prickles. Other symptoms include bitter taste in the mouth, dry mouth/throat, thirst for cold drinks, restlessness, irritability/anger, and constipation/dry stool. 

Damp-Heat in the Spleen Channel
In this pattern, vesicles will be large and filled with a clear yellow-ish fluid. Vesicles are thin-walled and are easy to break open. There may be pus formation. Other symptoms include poor appetite, loose stools, and bloating. 

Diagnosis in Western Medicine:
Your doctor will ask about your symptoms and medical history. A physical exam will be done. It is important for you to be open and honest with your doctor about your symptoms and your sexual history. Your doctor needs this information so that he can properly diagnose you and provide you with the proper treatment. Your doctor will not judge you or your behavior. Sometimes genital herpes is easy to diagnose because the blisters or open sores are easily visible. However, just examining the sores or the rash is not enough. Also, you can have genital herpes even if the sores are not visible. There are a number of lab tests available to diagnose genital herpes.

Blood Tests
Your doctor may choose to do a blood test. These blood tests are also called antibody tests because they measure herpes simplex virus (HSV) antibodies-the disease-fighting substances in the blood. If the blood tests show HSV antibodies, you are most likely infected with the virus. Tests can distinguish between herpes simplex type 1 virus (HSV-1) and herpes simplex type 2 virus (HSV-2). This is done by assessing glycoproteins (a type of protein) that are specific to the two kinds of viruses. It is important that your doctor finds out if you have HSV-1 or HSV-2 because your treatment and counseling may be different depending on which virus you have.

Polymerase Chain Reaction (PCR)
PCR is a molecular diagnostic test. It can identify the virus if it has been damaged by the body’s immune system and may not grow in a standard culture. Like the viral culture, you could get a false-negative with this test, as well. But, the PCR test is much more accurate.

Viral Culture
If your infection is visible, your doctor will rub a swab over an open sore or blister to collect some cells. The cells are then tested to see if the virus is present in those cells. It is recommended that this culture test be taken soon after symptoms appear. This type of test is not always reliable, though. If the sore is healing or if you have recurrent outbreaks, the test may give a "false-negative." This means that the test reports that you do not have herpes, when you really do have the virus.