[Question #1640] Herpes or something else

54 months ago
Hi there

I am a male and I had a few casual sex encounters over the last year or so. All involved protected vaginal intercourse but some involved unprotected oral. My main concern is for the last encounter (19 Dec'16). I involved protected vaginal intercourse and unprotected oral.

Yesterday I started feeling an itch on my penis about 2/3's up my shaft on the right side. On inspection there was and still is a red mark that resembles a scab but it is not  raised above the skin. It is about 1mm by 2mm. 

About a week ago I also found what looks like an ingrown hair in my pubic hair region about 1cm from my penis shaft directly on the midline. I have hade these before, one on my right side and one on the left side of my pubic hair region but more towards the top. 

I also suffer from what I think is sebaceous cysts on my upper inner thigh close to my groin(left and right).

I currently also have what looks like two very small spots right next to the right side of my umbilicus which looks like ingrown hairs as there are hairs growing out of the spots. It is very ichy.

I have had oral herpes since childhood.

Does this sound like herpes? 
What was my risk for contracting herpes (1 and 2) from the mentioned encounters?
If not herpes, what else could it be?

Thanks so much.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
54 months ago
If you have had oral herpes since childhood, then the chances that you would acquire HSV 1 genitally (the same virus that causes cold sores) from receiving oral sex, is incredibly low.  The immune response that you built from the childhood infection would most likely protect you from getting it in a new place.  The other little dittzles that you describe in various places don't fit  the herpes picture either.  The fact that you've used condoms regularly for intercourse suggests that you would be unlikely to have acquired new genital herpes recently but condoms are not 100% protection against acquiring herpes.  You have a couple of options here - one would be to have a clinician look at the scab-like lesion and give you an opinion - that's my favorite option.  The next is to do an antibody to see if you are infected with HSV 2 from perhaps an earlier encounter.  It is too early to test with an accuracy from the december encounter though - for that, you should wait 12 weeks.  If you hadn't described a scab-liked situation, I don't think I would suggest testing in your situation but scabs on the shaft of the penis always worry me just a little bit. 

Terri
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54 months ago
Hi Terri

Thanks very much for the prompt reply. The area where the 'scab' is is in the area that would have been covered by a condom. It does not feel like a scab at all, it is smooth as the skin surrounding it. I can't feel a diiference at all between the 'scab' and surrounding skin. Is it possible to get HSV 2 from unprotected oral or from protected vagina sex if the area where the scab is is in region covered by the condom? I should add that I have masturbated recently and that the scab is exactly at the place where most friction would have occured. It is REALLY small and there are no ulcers or anything surrounding it. I am just a little confused as I have read that HSV 2 is rarely transmitted through oral and that transmission during vaginal intercourse normally occurs where there is most friction which would not be in the area covered by a condom... is my assumption correct? ALL my encounters were protected when it comes to vaginal intercourse. In maybe two encounters I had unprotected oral.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
54 months ago
It would be extremely unusual to get HSV 2 from unprotected oral sex as HSV 2 orally is uncommon and when it is there, it sheds very infrequently.  The thing is with men having sex with women who have herpes using a condon, and why it isn't 100% perfect, is that vaginal secretions and vaginal tissue can come into parts of the penis not covered by a condom.  But outbreaks of herpes acquired in that way can show up anywhere on the penis, with almost all first outbreaks showing up in the area not covered by a condom.  However, in your case, the "scab" doesn't sound like a scab to me - they are almost always raised above the surface of the skin.  So to me, this doesn't sound like herpes

Terri
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54 months ago
Hi Terri

Thank you again for the feedback. My last question... The itching started on the 12th of Jan and on the same day I noticed the 'scab' that we discussed before. The itching lasted for about a day. No other symptoms. Today, the 16th of Jan I noticed two very small white dots about 1 and a half cm's from the original 'scab'.

My questions:
1. Will multiple herpes blisters appear round about the same time or is there a chance that they can form days (4 to 5 days) apart?
2. If it is not herpes, what else could it be? Another STD or something else?
3. How long does blisters take to scab over?
4. How long does it take for Herpes scabs  to heal and go away completely?

If the new spots scab over I guess herpes is a real possibility.

Thanks for your time.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
54 months ago
White dots?  Are they ulcerations?  If they are ulcerations, you should be seen and have these swab tested today, if you can.

1.  They can form several days apart
2.  I don't know what it could be because I can't see it and "white dots" just doesn't help me - a clinician looking in person is the way to go.
3.  It varies - sometimes just a few days with established infection
4.  a few days, usually, sometimes longer.

I surely do hope you will consider being seen to sort this out.  Our comments here, probably hundreds of miles away from you, can only go so far. Surely do wish I could be of more help.

Terri
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