[Question #901] Follow up from question #177

86 months ago

1 year ago I had protected vaginal and oral sex with a sex worker in the Dominican Republic. I became extremely anxious afterwards and began having panic attacks and night sweats. I would also touch/rub my groin and genital area looking for herpes lesions. The sweating and rubbing of my genital region caused me to get a jock itch on both sides of groin about 5 days after the encounter. On The night of day 7 I masturbated for the first time since the encounter. The next morning I saw a white speck or pimple on my penis. I went to the Planned Parenthood and showed the nurse there the pimple and she said it was nothing and same for the jock itch. I had another pimple the next day on the lower part of my shaft. I had about 6-7 pimples in total over the course of about a month. All the pimples were superficial I think and had a white pus head that would keep growing outward until I rubbed off the white pus from the top or just touch it a bit and then a red base would remain which would disappear within hours. Found scabs for some of the pimples a couple days later. None of the pimples hurt, itched, or burned. They all happened one by one and would last 48-72 hours in total. They showed up usually hours after masturbation (Friction). All happened on my penis shaft.  Some had a hair sticking out of it but I think all were on hair glands which are visible all over my penis. I showed pictures of the pimples to doctors on the healthtap app and they all said it looked like folliculitis and not herpes. I haven’t had pimples like that since then. I have improved my hygiene of that area and use anti-bacterial soap.  I tested negative for stds/herpes IGG at 14 weeks after the exposure and also 11 months after the exposure. I really want to move on from this encounter but I am scared the pimples I had were herpes. I would really appreciate your input after seeing the description of the pimples and the blood test results. Thanks. 

Edward W. Hook M.D.
86 months ago
Welcome back to the Forum.  In preparing to respond to your questions I reviewed your earlier questions and Dr. Handsfield's responses.  I agree with all that he said.  Your repeat blood tests for herpes confirm the response that he provided nine months ago- the lesions that you noted were not due to herpes.  As to what they may have been, that is simply not possible to answer.  It is certainly now time for you to leave your concerns behind and not worry further than you might have acquired herpes or any other STI from the exposure you described.  Take care.  EWH
86 months ago
Hi Doctor Hook,

Thanks for your reply. I have a couple more questions for you. 

1. How reliable are the herpes IGG blood tests? Nurse Terri Warren just told me it's 95% accurate for HSV 2 and 70% for HSV 1. Would you agree with these numbers? 

2. Can something like folliculitis behave this way and can it be on the shaft of the penis? Can folliculitis disappear so quickly and be so painless and non-itchy? Can folliculitis show up as a single lesion and then go away and then affect another gland on your penis?

3. If somebody like me has some atypical symptoms and negative blood tests what should we believe? 

4. Can excessive sweating and some type of friction, possibly from masturbation, cause folliculitis on the penis? 

5. I received protected oral twice from 2 different massage workers. The contact was mostly limited to the condom. What are risks of herpes and other stds in this situation?

6. Should I test for herpes again in a couple more months? I have been tested 3 times in the past 11 months and it's always come back negative.

I look forward to your reply. I am trying to move on from this but there is so much conflicting data and it's all so confusing. I am getting overwhelmed with information and don't know what to believe anymore. Doctor Handsfield's reply to me 8 months earlier gave me a lot of relief because I felt I could trust his assessment of the situation. I really took the blood test again after 10-11 months to get finally get over this but instead it's made me more anxious. 
Edward W. Hook M.D.
86 months ago
1.  Yes, I agree with Ms. Warren
2.  Yes, all of this could be folliculitis.  There do not have to be visible hairs for folliculitis to occur.
3.  As we have told you, you need to understand that you did not get an STI, including herpes from the encounter that worries you.
4.  Yes, many factors may contribute to folliculitis.
5.  Repetitive question.  The answer does not change.  Virtually no risk.
6.  You don't seem to believe us.  Further testing would be a waste of time.

You need to control your guilt and anxiety.  Looking on the Internet will not help and is likely to worry and confuse you more.  This is not a medical problem.   I would suggest you see a counselor about your unwarranted anxiety and guilt.  EWH