About 2-3 weeks ago, I starting experiencing discomfort around my rectum that I chalked up to wiping too much after bowel movements. But it never went away and has gotten worse and now is pretty itchy. Nothing too painful, but uncomfortable, which is probably being exacerbated by friction since my job requires being on my feet the whole time and walking a good amount. I decided to check it out today in the mirror. The area around my entire rectum is red and uncomfortable, but just below my rectum where it itches the most, I noticed a cluster of maybe 3 red pimple like bumps. I’m worried this could be herpes and plan to go back to the dermatologist. What is the likelihood of herpes? And if it is herpes, is it possible to transmit to a partner during vaginal intercourse or oral sex (mouth to penis) even if the rectum is never involved?

In terms of my sexual past, I am heterosexual, and have had unprotected sex with 5 female acquaintances over the last 6 months, and protected sex with another. All performed unprotected oral sex to my penis. One of them performed oral sex on my rectum numerous times, the last time being around 2 months ago. In the last 2-20 days, which I know is the normal herpes incubation period, I’ve had unprotected vaginal and unprotected oral sex (penis) with one woman and protected vaginal sex with another who also performed unprotected oral sex (penis).

I'm guessing there's a typo in the date of the sexual exposure. January 17 is only 3 days ago, but other info indicates is must be further back, right? Maybe December 17?

If you still have access to a dermatologist, that would be an ideal resource for this problem. If not, most family or internal medicine doctors would be able to accurately diagnose this sort of problem and recommend treatment. In the meantime, based on all you say, you needn't be concerned about herpes or any other STD.

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

HHH, MD

As for my symptoms in the anal area, there was some sexual exposure that I mentioned in my original post. Perhaps you don’t consider this sexual exposure but one of my partners performed oral sex to my anus numerous times over the span of 6 months, but that’s the only sexual exposure I’ve ever had in that area in my life and there was no penetration. Could this possibly cause herpes or other STDs? Never noticed cold sores or anything on her mouth.

I scheduled an appt with my dermatologist tomorrow because the cluster of red bumps around my anus freaked me out and look like some pictures of herpes I’ve found from online resources.

I will follow up and thank you very much for your help thus far.

I'll be interested to hear how things shake out after you've seen the dermatologist.

However, I don't agree entirely with the advice you had. I'm surprised to hear that the dermatologist feels biopsy is superior as a diagnostic method. There's never been a scientific study comparing PCR vs biopsy, but for a variety of reasons I'd be surprised if biopsy performed better. (However, if PCR is done on the biopsy specimen, it probably would be highly reliable.) In any case, when diagnosis is unclear, it never hurts to have more than one kind of test. But in addition, you should ask the dermatologist about an HSV blood test. If you have a negative blood test now and it becomes positive in a few weeks, it can confirm the  diagnosis if both PCR and biopsy are negative.

Normally threads are closed after two follow-up exchanges, but I'm going to leave this open. I'll be interested to hear your test results and how things go with treatment.