[Question #3850] Problem

32 months ago
A year ago I experienced a blister on the glans of my penis. As background i had been with the same girl for four months to that point, and we are faithful. I experience this bump which then scabbed over. I went to get a full std test including both IGG and IGM herpes tests. Everything came back negative. The blister never hurt, itched, or anything. Then  year later, i experienced bumps again, this time multiple. Went and got another test, which came back negative again for everything, so I am a bit at a loss for what it could be, and going in to see a doctor is going to be hard for the next week. Again they are completely painless, no itching, no other symptoms, just these blisters. After a day they scabbed over, and now about a week after first presentation they are healing rather slowly. My question is pretty much, what could present a painless blisters on the glans of the penis that wouldnt come up in std panels or herpes tests? They literally do not bother me at all, no stinging no pain. Just looking for some guidance. Is it common for the skin to heal slower on the glans than other parts of skin on the body? any and all help is super appreciated.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Welcome back to the forum, but sorry you found it necessary.

As you know, Terri Warren normally answers the herpes related questions, and this one seems to repeat your previous discussions with her. But I'll go ahead and reply this time.

I agree with everything Terri said. And in any case, this doesn't sound like HSV, in part because herpes lesions never appear and resolve as quickly as you describe. The lack of any pain or discomfort is also against herpes; all HSV lesions would be at least red and irritated looking part of the time. My guess is that this is some sort of allergic reaction or other mild dermatitis. Of if the episodes have occurred during hot or humid weather, perhaps it is a condition called miliaria -- i.e. blocked sweat glands, a harmless condition. (Google it for photos.)

So adding up all the evidence, partly gleaned from quick scan (but not detailed reading) of your other threads several months ago, plus your description of the lesions, obvious low risk for genital herpes, negative blood tests, plus atypical symptoms etc, I'm completely confident you don't have genital herpes.  

Having excluded herpes, if you feel you need a definite diagnosis, I would suggest you see a dermatologist, initially to just establish a relationship; after which you should be able to arrange to be seen very promptly (within 1-2 days) in the event a similar episode occurs again.

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

HHH, MD
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32 months ago
Thanks for the reaponse Dr. sorry for the redundancy. This has been really difficult. To just cover some things you said. The length of these bouts has varied, this last time it seems to be healing slowly. I’ve been using tea tree oil and neosporin, but if you have a better suggestion than those I’d love to hear them. The marks have been red, but usually after a shower if one of the scabs comes off.  If this is dermaritis or an allergic reaction, it wouldn’t be uncommon for it to occur in the same place? I will try to set up and appt with a dermatologist but  I think this will have healed up by then, and hopefully there is no next time. But for now speaking with you is better than whatever research I was doing online. Not having an answer to this is hard doc, I appreciate your words and whatever other advice or guidance you may have for me. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
I'm sorry this is difficult for you, but I'm afraid there isn't much more I can do. I will add that in most people with genital HSV1, recurrent outbreaks are infrequent, a lot less common than you seem to have had. Many people have no recurrences at all, and most with recurrent outbreaks experience them less than once every 1-3 years. Another approach is to have another HSV1 antibody test. Although it often remains negative, it's also possible for a previously negative result to eventually become positive.  In the event of another episode, I strongly advise against tea tree oil, neosporin, or any other treatment of any kind. These cannot have any effect on herpes, and the TTO could prolong inflammation and delay healing. Instead of treating, a quick visit to a dermatologist would be useful to test (again?) for HSV when the problem is most active.

In the meantime, I remain confident this isn't herpes. And even if it is, so what? Genital HSV1 is rarely transmitted sexually to partners:  in my 40+ years in the STD business, I have never see a new case of genital HSV1 acquired by intercourse; every case came from an oral sex exposure. I understand that's Terri's experience as well. So your wife is at low risk, especially if you avoid sex when having one of these episodes. And even if she catches it, what's the big deal? You'll have a low threshold for recognizing it and getting her promptly treated, so the initial infection won't be a big deal. And after that, you would never have to worry again:  people do not re-transfer HSV to partners more than once, i.e. after that she would be immune to catching HSV1 again. (Some couples even actively attempt to transmit it, for these reasons. I don't recommend that, but it illustrates why this shouldn't be so worrisome to you.)

Don't misunderstand: I still strongly doubt you have herpes, and so did Terri. But in the meantime, it really shouldn't be such a big deal!
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32 months ago
Thanks doc, I appreciate your thorough responses. Def difficult, but was looking to get filled in by experts as opposed to websites, so im very appreciative. I will contact a derm and make an appointment if this does happen again. What you said about dermatitis may make sense. I have generally not amazing skin, and its sensitive. I guess if i used certain soaps, or even this tea tree oil, it could be damaging to the skin on the glans? Would it traditionally be itchy? Obviously an uninformed decision to use tea tree oil but just wanted to expedite this healing process, for obvious reasons. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
FYI, if did have herpes, there is nothing except anti-HSV drugs (e.g. valcyclovir) that have any benefit in "expediting the healing process", or that reduces the period of infectiousness.  

That completes the two follow-up comments and replies included with each question, and so concludes this thread. I'm glad the discussion has been helpful. Thanks for the thanks!
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