Another herpes obsession

Dear Dr. Rockoff,

I recently posted a herpes question in the std forum. The answer was reassuring - until I read the good doctor's reply to the post above mine. He said that only 1 out of 10 people who have herpes actually know it, and that in these cases it's not a question of outbreaks, because these people don't have outbreaks. My dermatologist said that testing positive for type 1 (which I have tested positive for) or type 2 (which I haven't) doesn't in any case mean you "have it." I've never gotten a cold sore. I'm 37. Does this mean that I actually "have" HS1? Does it mean further that the vast majority of people who have herpes, 1 or 2, not only don't know they have it, but will never present? How, then, does one know exactly where on the body the virus is? What does it actually mean to "have" it?

My real fear now is that I got HS1 on my penis over 10 years ago - when a girl with a tiny, fading lip scab gave me brief oral - and have just never had an outbreak. There's never been lesion, vesicle, or blister. But ever since was stricken 4 years ago with a chronic condition called pelvic myoneuropathy (sending my hypochondria through the roof) I've developed a multitude of diverse symptoms, many of which are dermatologic: dry penile skin, red penile skin, red scrotal skin; most recent of all, a small spot of red skin on my circumcision scar that turned into dry skin and, perhaps (I'm not sure because it was so small) a very tiny scab. I had it checked out, twice. Both the dermatologist and the Urgent Care PA said it looked like nothing more than mild inflammation, or perhaps a hive. There was never a vesicle, never any pain at all, even when I tapped on it directly. It was all but gone in four days. My dermatologist said herpes of any kind, even the most mild, will always have some amount of "point-specific pain" when directly touched, and it will last more than four days. Is that a fact? Can one safely rule out herpes if there's no pain and no vesicle?

[Alan Rockoff, MD]

You can have herpes without point-specific pain.  But you can't diagnose it without symptoms, and you don't have herpes symptoms--the ones you list are those of eczema or irritation.  A positive herpes 2 test does imply that someone has genital herpes and can spread the virus through sex.  A positive herpes 1 test, as you have, means exactly nothing.  Please get help for your skin irritation and your obsessive worrying--neither is doing you any good.

Take care.

Dr. Rockoff

[dimhalo]

The other day I shaved my pubic area for the first time in a few weeks with a not so great razor. I had sex with my girlfriend of over a year and both been faithful.I have big blisters below my naval and the shaft of me penis and a few small ones.I've never had any symptoms of herpes in my life.my penis is swollen.curious if it sounds like herpes or a staph infection from shaving..my girlfriend has no symtoms (symptoms).