[Question #3231] Continued Axiety

38 months ago
Hello,

I am here again and this time it is not related to warts. 

Recently I have been getting pimples along my thong line of my underwear. On both sides of my inner butt cheek.  Last Thursday I found a red bump on the inside of my butt cheek and I went to the clinic doctor and he univocally said it did not look like herpes. Was not blistered or oozing or tingling: I picked it and it bleed and is now practically healed. I went back to the same doctor on Monday and he said even by the healing it was defiantly not herpes and for me to stop worrying.

I am sure you will tell me my anxiety is getting the best of me and I am looking for something that is not there, I am just looking for that reassurance. 

So my question is :

I did see the results of the person i was with 3.5 years ago (person outside of my marriage), he was negative for HSV2 and I do remember him being positive for HSV1 but in the range.  I did get cold sores when I was a kid so I am likely HSV1 positive as well. 

However, How likely is it that it would show up as an outbreak after all this time?  The other person, his wife and my husband have never showed any symptoms. 

After this question, I will make a sincere effort to let this situation go and move on. 

Thank you.

Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Welcome back to the Forum.  While I will do my best to help I really think that you need to see a trained counselor who will help you to work through your feelings of anxiety and guilt over your past exposures.  I can provide the fact and data regarding microbiology and the likelihood that what you are observing is close to zero but that really does not address what I perceive to be the problem which is anxiety and guilt over your exposure.  Please seek help from a qualified, trained counselor (who will keep your concerns confidentially, as is a professional ethical imperative).  With all due respect, you have pledged to move on before and yet you are back. 

The lesions that you describe have been examined by a trained professional whose assessment is that this is not an STI.  While the appearance, of STIs can be quiet variable, based on your past history and descriptions, I agree with this assessment.  It is far, far more likely that this is a folliculitis or other benign skin condition and most unlikely, particularly given the duration since your exposure, that this is HSV or any other STI.  Testing at this time would really be a waste of time.

I hope these comments are helpful  If anything is unclear, please feel free to seek clarification,  EWH


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Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
Since you are asking about herpes here,  I would like to chime in with Dr. Hook and say that the fact that you've had cold sores and that he is HSV 1 positive makes you both the same - neither of you should worry about infecting the other in a new location.  In 33 years of specializing in herpes, I have seen a person with a sound history of cold sores get genital HSV 1 infection one time - and I have read about it happening one other time.  So honestly, the odds of this happening are so incredibly low that you can take it off your worry list.  It is also great that you had someone look at the spot that concerned you and they also believe it is not herpes.

I agree with Dr. Hook that speaking with a professional to try to get past this event could be so helpful.  I would strongly suggest someone who specializes in cognitive behavioral therapy - it is the best approach to dealing with this type of worry.  With all due respect, you don't need to spend hours talking about your childhood - you need practical ways to get past this specific situation.  I so hope you will find the help that you need.

Terri
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38 months ago
Thank you both for you reassurance and assistance. I have taken your advice and have an appointment on Tuesday. 

I am an educated person with a very full life and unfortunately have not seemed to get past this on my own so I agree it is time to seek help. 

Thank you again. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
Good for you!  Very pleased that you took our advice on this.  Sometimes, we just get stuck and need someone else to help us get unstuck

Terri
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38 months ago
Hi Terri,

So I got a few more small bumps that i went to the doctor about and she told me she thinks they are follculites. I trap moisture in my buttcheeks and wear a lot of leggings. She did offer me the blood test though. Should I do it to ease my anxiety or not? 

I have my appointment tomorrow morning with the councillor so hopefully I will find some peace. 

Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Your "bumps" entirely consistent with folliculitis.  My personal advice is to not get a blood test.  The test has frequent    not false positive results and you already know that you have HSV-1'---
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Sorry , the auto text inserted a word in the second sentence.  It should say "the test has frequent false positive results and you already know that you have HSV1". EWH---
38 months ago
Last couple of questions:

These bumps that I had were complete on the inside of my butt cheeks. The doctors that I saw all said that it would normally be closer to the anus or genitals for it to be herpes. Is that true or is that just a generalization? 

I did remember having some itching in the two days leading up to the bumps showing up. Do you still not recommend blood test? Or if it comes again should I get them swabbed? 

Thank you for your patience with me. I am working with my counsellor however, she believes that unless I have confirmed test results I likely won't put it behind me. 

Thank you.  
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Final answers.  HSV lesions can occur at any site of diret contact but most ypically, your doctor is right and out onto the buttock is not a particualrly common site for HSV. 

I continue to believe that a blood test for HSV would be a bad idea for you.  If you choose to test them if and when they appear again, that is up to you.  If your doctor feels this is folliculitis however, this is most probably what it is.  If you test, the test should be a PCR test.

This is my third and therefore, as per Forum guidelines, final response.  I hope that our comments have been helpful to you.  This thread will be closed in a few hours.  EWH
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