[Question #1574] Test Results Follow Up

44 months ago
Hello, I asked a question #2060 "Large Pimple On Penis" on December 10 perhaps you can look back on links to similar photos I provided for understanding of my next question. To summarize my initial situation: 4 days after my first ever sexual experience (kissing and extremely brief oral) I showed almost every symptom of an initial oral herpes outbreak. (Extremely sore throat, fever, cold sores parallel on each edge of my mouth.) 7 weeks after my exposure I started waking up with a sore throat that developed into a cold. I started to worry because I was paranoid I simultaneously caught genital hsv1 with my oral. I began constantly checking my genitals every few minutes (I pretty much did this ever since the oral outbreak). While at the time I thought I was being silly and paranoid, while using the bathroom I discovered a large pimple in the middle/upper part of my shaft. It behaved EXACTLY like a pimple on my face. I popped it, white puss came out, and it remained painless healing in a few days. I was unable to get swabbed because it had healed too much when I went to the clinic. (They didn't seem to take it very seriously) The nurses told me not to worry about it too much, but I have NEVER had a true pimple on my shaft. 3 months later I was blood tested and to no surprise was positive for hsv1. (I already had the oral outbreak and I'm aware that most people already have hsv1 so I could have had it since i was a kid, my mom+sister have it.) My question is, If you were in my shoes, do you go on pretending this never happened and was just a pimple or do I assume I now have genital herpes?? Like I said the nurse didn't think it was serious but it all just adds up so well. (Never had a pimple there until first sexual experience, cold symptoms while the pimple was present) It's eating away at me and I need to make a decision to move on or not.
44 months ago
Also, It's worth noting that the night I discovered the pimple I had what could have been a very mild "fever". It was enough to make me take some advil but It could have been the stress of my discovery I was feeling as I was experiencing a huge anxiety attack.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Welcome back, but sorry to see you remain so anxious about this despite the reasoned advice you had from Terri. As she told you, there is no realistic chance your penile pimple was herpes. As she also told you, we don't look at photos of genital lesions, rashes, etc. But based on the information you provided to Terri, you were also told by a number of health care providers that you had only had a pimple, nothing more. Let me go through the scientific reasons.

The average risk of catching genital herpes after receiving oral sex from a person with a history of oral herpes, but no active outbreak at the time, probably is no higher than one chance in several thousand. Second, initial herpes rarely presents with only a single lesion, usually multiple. Third, herpes lesions are superficial -- think of them as blisters or pimple-like bumps on the surface of the skin -- compared with pimples, which well up from deeper -- think of them as starting "in" the skin, not on it.  What looks like a pimple of the face was certainly the same thing on your penis. Fourth, contrary to what you think you learned (probably from online searching), your oral symptoms were not typical of herpes, which doesn't cause nasal congestion. Sore throat can be due to initial oral herpes, but not runny or stuffy nose, congestion, etc: and the sore throat of new herpes usually is accompanied by painful sores in and around the mouth. Fifth, you now know you have antibody to HSV1 which, as you say, probably dates back to childhood. Half of all adults have positive HSV1 tests and most of them have no recollection of oral herpes symptoms, so you are absolutely typical in that regard. And the fact that some household members at the time had oral herpes also suggests you shared their infections. Sixth (closely relating to the fifth), people with antibody are immune to new infections with the same HSV type they already have -- so you could not have acquired genital HSV1 from the exposure you are concerned about.

So you are wrong that "it all adds up so well" to genital herpes. Just the opposite:  it adds up to evidence against herpes. You had a zit on your dingdong, that's all. That this never happened before your first sex is irrelevant. Pimples occur on the genital area all the time; if you've not had one before, you were just lucky. Its occurrence had nothing to do with your sexual exposure, and the cold at the same time was also just a coincidence. So you don't have genital herpes; and you will never (again) catch HSV1.

Finally, one more fact that should put you at ease. If you had acquired genital HSV1, the odds are you would have no further outbreaks, or at most one or two; and would not be at significant risk for transmitting it to a future sex partner. That's a major difference between GH due to HSV1 vs HSV2. (Telling you this does NOT mean I think there is actually any chance you have genital HSV1. Just to let you know it wouldn't matter much if you did.)

So all is well. Time for you to put all this behind you and move on with your life. And don't let this have an adverse effect on your future sexuality. You did nothing that warrants all the guilt and perhaps shame that seem to be implied by the nature of your questions and concerns about herpes. Assuming you had a willing partner, you did nothing unusual or shameful. Sex is just part of life. Don't make a bigger deal out of this than it deserves.

I hope this has helped. Best wishes--  HHH, MD

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44 months ago
Hi Doctor Handsfield, first I just want to say for almost 3 months now I have extensively researching your material, and have developed great respect for you as "The Man" once it comes to STD expertise. Therefore, coming from Michael Jordan of STD research, I will take your very clear opinion/advice on my situation and drop it, a this is exactly what I needed. Although I forgot to mention I did have white spots on my tonsils (Which I have had before from strep), I will still take your advice and thank you for the elaborate response.(The psychological breakdown at the end was very impressive) Cheers, and thanks to you all for running this website.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Thanks for the kind words. I'm glad to have helped.

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44 months ago
Sorry to bother, but during my 3 month internet research I came across a claim a few times that says only 25% of people with genital hsv-1 viral shed at all. Just out of curiosity is this true or a myth? Thanks
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
I don't recall the exact results of research data, but that figure seems about right. However, it's irrelevant to your situation, right? The very fact that you ask it implies that you haven't fully accepted that you don't have genital herpes. Trust me on this:  you do not. I suggest to promise yourself to completely lay off any further internet research about this. Like most anxious persons, you are selectively seeing information that inflames your fears and missing the reassuring parts. It isn't worth it.

That compeltes the two follow-up comments and replies included with each new question, and so ends this thread. I hope you're able to move on without worry about any of this.

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