[Question #10799] Looking for more info

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19 months ago
I had asked a question on my previous post at the end without really an opportunity to elaborate so I was just looking to update and maybe get some more information. I went to the strip clubs with friends almost 2 weeks ago and my exposure was just a lap dance where she jerked my bare penis off for no more than a minute I would say while I touched her but her underwear were on. I don’t recall masturbating that night after touching her. 6 days ago I had masturbated (which was the third night in a row) and when finished I noticed a cut on the bottom of my shaft close to where the shaft meets the sack. I only noticed it after masturbating otherwise I had not noticed anything in the days prior in terms of symptoms of an sti it could be.
I have read some things online which I know often times are misleading, but from my understanding this seems like a no risk event. My main concern of the cut was that it was herpes. So my questions are as follows
1. If this was herpes wouldn’t I have noticed some sort of blister or pain/itching in the spot before the cut appeared? 
2. Was there any risk with the exposure I described? I went to urgent care and the Dr said I couldn’t swab it because it can only be swabbed when it’s a blister. 
3. I put polysporin on the cut every day since I noticed it and within 2-3 days it definitely got better but there is still a mark there but the cut itself never scabbed. If this was herpes wouldn’t the lesion have scabbed over? Would the polysporin have caused me pain if it was herpes?
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H. Hunter Handsfield, MD
19 months ago
Welcome back, but I'm sorry you found it necessary. I reviewed your recent discussion with Dr. Hook and agree entirely with his evaluation and advice.

First, you are correct in your judgment that the events you describe were zero risk. Nobody ever gets any STD by being masturbated, i.e. by hand-genital contact. It doesn't matter if the "cut" was actually a herpes lesion:  still no risk. To your specific questions.

1. Atypical herpes oubreaks are not at all rare. In theory, most or all herpes lesions would start as a blister before becoming an open sore, but it certainly can be unnoticed. On the other hand, other aspects of your description also argue against herpes. Most herpes oubreaks have multiple, not single lesions; and herpes lesions more often are on the penile shaft. And if looks like an injury, most likely that's what it was.

2. As I said above, hand-genital contact is risk free -- even in the presence of skin lesions like cuts or herpes.

3. Once there is any open skin lesion, the appearance and time course of healing are more or less the same. The occurrence of a scab makes no difference either way. However, herpes lesions generally last a week or more. That your "cut" was healing within 2-3 days argues against herpes. And presence or absence of pain with antibiotic ointment also says nothing at all about herpes versus a skin injury.

In the event you have recurrences of similar "cuts" in the future, it might be reasonable to be evaluated for herpes. But at this point I really wouldn't worry about it.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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19 months ago
Thank you for the detailed response! So just to clarify. When I was at the strip club she placed her bare hand on my penis for no more than a minute I would say. At that time I had no cut or abrasion. I only noticed the cut or abrasion after I masturbated myself about 6 days later. I felt no symptoms of herpes in that 6 day span and only noticed that I felt a cut sensation directly after I masturbated myself. So I feel like it had to have been a cut as a result of masturbating myself if that makes sense. 

Being that the dr at urgent care said I was not able to swab and given the exposure details, Do you think it’s necessary to get tested? I just feel like given the circumstances it’s giving me a little bit of anxiety because I am trying to conceive a child with my wife. Should I get a baseline test ti see if the igg numbers jump up? I just feel like there was no way given that exposure that I could have acquired herpes from a handjob but I still have anxiety over it. Thank you again for your advice 
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19 months ago
Just to add the cut I experienced never really caused me any pain itching or burning or any discomfort really. I want to believe the cut was a result of masturbation or a friction burn because I had a silicon ring on a finger of the hand I had used. 
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H. Hunter Handsfield, MD
19 months ago
The circumstances certainly suggest the "cut" was the result of trauma during one or more of the masturbation or hand-genital contact episodes. Obviously only you can judge whether any of these episodes was sufficient to cause a minor injury:  you were there and I wasn't!

If it's herpes, it was almost certainly not acquired during those events; hand-genital contact has never been known to transmit HSV, even when genital fluids were used for lubrication. In other words, if you have genital herpes, most likely you experienced a recurrent outbreak of a previously asymptomatic infection.

You could consider having an HSV blood test, but if you do so, be prepared for uncertain results. The tests are good but not great. Be sure you ask for ONLY an IgG antibody test; avoid IgM testing even if offered by a lab. (The HSV IgM tests are notoriously unreliable and never done or advised by genuine STD/herpes experts.) But honestly I don't see the need.
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19 months ago
Thank you again for the response,

I have not had any exposures in the past other than intercourse with my wife that would put me at risk for herpes acquisition and I have never had any sore or lesion in the past so if this new “cut” that is essentially almost fully healed we’re to be herpes this would be the initial outbreak. I have had hsv1 almost my whole life not sure if that makes any difference. But your responses are giving me a bit of anxiety that this may be herpes. Again I just don’t understand how it could be given the circumstances of the exposure, the opinion of the Dr who saw the cut the day after it happened and said it couldn’t be swabbed, and the fact that the cut itself from the moment it happened was essentially painless. I know it’s hard to diagnose over the internet but I am definitely worried now. 

But like you said I am hoping that this cut was the result of some sort of trauma from when I had masturbated because that was the only time I had even noticed the cut was there. In terms of having sex with my wife and continuing to try to conceive a baby do you think I am safe to continue to do so or do you recommend to get a test before we continue. I worry about her safety and the safety of our future child more than my own to be honest. 

Thanks again for your help and information Dr H!
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H. Hunter Handsfield, MD
19 months ago
It's very possible to have genital HSV for years and have no outbreaks. Assuming you had other sex partners prior to your marriage, you still could have HSV. Or your wife might have it without symptoms.

I agree with your own analysis about the low chance of new herpes and do not believe you have herpes. But if you do, since there was no recent risk, it still would have to be from a distant past infection. It's just the way herpes is.

If I were in your situation I would continue unprotected sex with my wife without worry, independent of current attempts to conceive.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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