Hi there

Thanks for your services.

I have a few general questions about HSV-2 and balanitis. 

I contracted HSV-2 around 10 years ago. In the first year I had I think 3 noticeable breakouts and since then, I haven't noticed much. Once in a while I do have some small red splotches on the glans. I suffered from a little eczema on my penis before I ever got HSV-2, so I always chalked it up to mild irritation.  

Then I read about balanitis and it def seems like that. When it comes, it's usually a few red dots, or a few red dots and one or two red patches. No sores or vesicles or blisters.  Just redness, sometimes a little scaly and shiny, that goes away in a few days. I also tend to have a lot of after-drip after I pee, so I assumed that could be the irritant. It seems to show up more after I've sweat, or worked out, or masturbated, but I can't be certain.

BUT I've also read that HSV-2 can *trigger* balanitis. So here are my questions:

1. How can I tell the difference between balanitis and herpes?  Is it all about seeing little blisters or not?  Is is possible that after 10 years, a herpes outbreak would look more like a slight rash, or eczema, without any sores at?

2. If it is balanitis, and it's triggered by herpes, does that mean it IS a herpes outbreak? I'd wear condoms in any case, but would be nice to know how this all connects.

3. When I got outbreaks 10 years ago, they were all on the glans.  The balanitis/eczema/whatever is always on the glans.  So I always felt that as long as I used condoms, and they didn't break, my partner would be safe (because the head is always very covered).  And I’d avoid sexual contact during these intervals anyway.

But I've read that condoms only reduce transmission odds by 30%.  I'm wondering about the mechanics of that?  How much might someone shed the virus, without symptoms, from the very slight area at the base of the shaft that's not covered by the condom?  I'm assuming the virus cannot go through the latex, so I don't fully understand why condoms don't reduce transmission by even more??

Thanks!

1. How can I tell the difference between balanitis and herpes?  Is it all about seeing little blisters or not?  Is is possible that after 10 years, a herpes outbreak would look more like a slight rash, or eczema, without any sores at?

The lesions of balanitis and herpes look nothing alike. Generally, balanitis is caused by a fungus or yeast, the dots are small and scattered and red. Herpes lesions start out as water blisters and then ulcerate and scab.

2. If it is balanitis, and it's triggered by herpes, does that mean it IS a herpes outbreak? I'd wear condoms in any case, but would be nice to know how this all connects.

Herpes does NOT trigger balanitis. They are separate conditions. it is possible to acquire herpes and a fungal infection on the head of the penis at the same time but that's only because a sexual encounter yielded both, not because one triggers the other.

3. When I got outbreaks 10 years ago, they were all on the glans.  The balanitis/eczema/whatever is always on the glans.  So I always felt that as long as I used condoms, and they didn't break, my partner would be safe (because the head is always very covered).  And I’d avoid sexual contact during these intervals anyway.

I have rarely seen recurrent HSV only on the head of the penis, but I'm sure it happens. The balanitis by definition is on the head of the penis.

Condoms reduce transmission from males to females by 96% when used with every intercourse.

Terri