[Question #4686] HSV?

29 months ago
Hi there,

I've had four monogamous partners in my life, all used condoms every time, and I have been tested for herpes after each one of them. Three had been tested for herpes and were negative, one had not been tested, but had never experienced symptoms. I've always tested negative for both HSV1 and HSV2 (though I know these tests aren't 100%). I have not often been the recipient of oral sex, though it has certainly happened in the context of my relationships. Despite all this, I get this one area of redness in the same place on the outer labia every once in a while. It usually feels irritated for a few days and then goes away. I always look very closely with a magnifying mirror to see if there are any bumps and there never are. Sometimes it seems like there could be spots where the skin seems slightly discolored but I can never quite tell if that's shadows or my normal skin. I've had clinicians look at the area when it arises but they all say it doesn't look concerning and it has never been swabbed. Does this sound like herpes to you? I've heard herpes can look like paper cuts. Does that just mean a thin split in the skin? Could it ever look like a stretch-mark-like striation? When HSV1 appears on the lips/nose, does it always look like a sore or can it look like a cut as well?

Thanks for all your help!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
29 months ago
It doesn't really sound like herpes to me BUT I think you should have it swab tested anyway to get greater clarify.  If you get two negative PCR swab tests, I think you should believe the IgG tests and decide that this is truly not herpes.  Yes, herpes can present as a skin split though that is not the usual presentation.  It would not look like a stretch mark, no.  When it appears on the lips or nose, it almost always looks like a group of blisters, yes, not a cut.

Terri
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29 months ago
Hi Terri,
Thanks very much for your expertise and help. I'll work on getting it swabbed. Every time I go in to see someone about it, they say that the skin looks completely normal (and thus won't swab), so I'm not sure if I'm over-observing or not. I've never seen any bumps/skin splits otherwise and I pay pretty close attention to any hint of irritation/discomfort. Would yeast cause something like this?  Or dry skin? Thanks again!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
28 months ago
This could be normal skin changes or it could be fungal (yeast), yes.  If you go in to be swabbed and they can't see anything, this is extremely unlikely to be herpes

Terri
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28 months ago
Hi Terri,
The discomfort cropped up again and I want to a STD clinic and they swabbed and it came back negative. The clinician said he never says never but that he really didn't think it looked like herpes and seemed more like yeast was the cause. He seemed pretty unconcerned and expected the swab to come back negative, which it did. I'll work on getting it swabbed a second time as well. Does a negative swab suggest that it isn't herpes? 

Thanks again!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
28 months ago
This didn't sound like herpes to me either but if doing a second swab would help to reassure you, that's fine to do again.   I would encourage you to ask for PCR swabs rather than culture swabs as they are more sensitive. 

Terri
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