[Question #927] Blisters after mutual masturbation

51 months ago
Hello,

I'm a 30 year-old male and my last intercourse was 10 years ago. I had a mutual jerk off with a guy I met online two weeks ago. Assumed it is considered a safe sex practice, we didn't use condoms.  I watched carefully for exchanges of body fluids, and use different hands for my penis and his (he did the same). I did ask him about his status and had a visual inspection (no signs of bumps or blister).

I had pain on my tip of my penis after the encounter, probably because we didn’t use lubrication (I spitted on my penis much later and that’s it) and he stimulated the opening of my urethra with some force twice. I applied some OTC ointment for my pain for about five days. The pain went away. Four days ago, I found some rashes on my glans and foreskin, and I didn't worry much back then because I had similar experience due to I'm uncircumcised and have sensitive skin. It usually recovers within 2-3 days without care.

However, I found 3 to 4 small clustered blisters on my glans 3 days ago, and they also happened to be at the location where I usually have inflammation. I went right away to a STIs clinic. Upon physical inspections, the doctor told me I have herpes.  But due to my history, HSV-2 blood test and type-specific viral culture were administered in addition to the regular testing. The doctor told me to go see a dermatologist if tests results came back negatives. The sizes of blisters shirked significantly yesterday before I started taking 1gm of Valtrex twice a day. 

Today, I found out my glans looks pretty normal other than few pimple-like bumps at the original occurrence. I don't have other herpes symptoms other than the muscle pain from my right chest (could be a sport injury, not sure). I tried to remain calm and educate myself with correct info, but this really upsets me since it happened right after I tried to become more sexually active. 

Despite being low chance, do I really get herpes from a mutual masturbation? Or, the virus remains dormant for this long and became active, but I am really doubtful due to timing. I don’t have core sores. Can HSV-1 pass from his hands to my genital? What do you suggest after I get my test results back?

51 months ago
I got my test results back.  

Type specific swap test: Negative 
HSV-1 IGG: >5
HSV-2 IGG: .09

I guess for now there is no way to tell HSV-1 was from my previous oral infection or a potential new infection? As far as I remember, I don't have symptoms for cold sore. I read somewhere oral herpes does not always show symptoms. Is that true? I recall we did kiss before I spitted on my penis. Although it sounds unlikely, could that be the source of transmission?

Besides second or third? IGG testing after the exposures, what else do you recommend. Will a PCR test help if I had outbreak again. Where can I find one? Other than the redness from the site, my blisters are healed and gone. I don't think seeing a dermatologist will help at this point? I look forward to hearing from any of you. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
I'm so sorry I missed this question earlier - not sure how, but I did. 
You did not acquire HSV 1 from the mutual masturbation encounter, period.  You did all the right things and were very careful.  Yes you have HSV 1, but it isn't possible to know for certain if you have it orally or genitally.  And yes, herpes doesn't always cause symptoms.  If you have another outbreak, if that was an outbreak, it should be PCR swabbed and typed.  I agree that it would not help to see a dermatologist at this point if you have no blisters.  When you did get the blisters, did they look like water blisters?  Did they break, make a scab?  Tell me more about them

Terri
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51 months ago
Thank you for your reply. From my observations,

Day 1: rash on several sites (glans and foreskin closer to the glans)
Day 2: three to four clustered water blisters on glans 
Day 3: (swap test) blisters broke and shrunk a little
Day 4: flattened out and became two tiny ulcers
Day 5: (started Valtrex) ulcers healed and became tiny pimples (no scarping)

I don't have any other herpes symptoms and it healed rather quickly like my previous reoccurrence of balanitis. My doctor shares the same view of the risk of mutual masturbation, and said I could pass the virus from my mouth to penis thru hands due to my skin condition (although I know from here is also highly unlikely). She thinks I don't need to be tested for either HSV 1 or HSV 2 in the future. What's your opinion on that? If recommended, when, what and how do I need to be tested?

I understand I have to make peace with it, but If had another outbreak, who can I most likely obtain a PCR swap test from? A dermatologist or an ID specialist.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
I don't agree that you went from mouth to genitals.  I do agree that you likely do not need to be tested again as the mutual masturbation experience was so incredibly careful - good job by the way!
Do you have a regular provider?  You don't need an ID specialist.  The issue is that it may be difficult to get in right away with the next outbreak, if you have one at all.  The best thing here would be to obtain a PCR swab to gather at home.  It is the same swab used for culture, if they are still doing that, only when it is sent to the lab, one can ask for PCR testing vs. culture.  Is there a clinician with whom you have a good relationship that would give you a swab to take home?  If not PCR in the office is best, but it should be done in the first couple of days, if at all possible.  If not, I would go to urgent care and be sure it is PCR vs. culture, if at all possible.

Terri
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