Do I have Herpes? Please help.

Hello.  I am a thirty year old male.  Sixteen days ago, I had two sexual encounters on consecutive nights (6/3 and 6/4) with a young woman known to me to be promiscuous, but claims to  practice only safe sex and gets "checked up" regularly.  On both nights, I performed oral sex on her with a saran wrap dental-dam (not sure if it was microwave safe, which I hear is less porous) large enough to cover her entire pubic area and including her anal area.  She performed oral sex on me once each night with a latex condom.  The first night, she had a few seconds of trouble with the condom wrapper and joked that she was "tearing everything but the wrapper itself."  In the heat of the moment, we failed to check the "integrity" of the condom, but it seemed okay (it seemed to hold the ejaculate okay).

Afterward, and surprisingly, she even had alcohol wipes for local cleansing immediately after.  This I did not do thoroughly, as I was afraid to apply alcohol to me penis/scrotum.  I was both relieved and worried at the time that she was so prepared - on the one hand, she seemed to take safe sex seriously - on the other, she must have had many partners, perhaps far more than I.  We did not have intercourse.

The first night, I did not get to shower for at least eight hours following our encounter.  The second night, I showered half an hour following.  About a day or two later, I began to have some minor itching on my scrotum and specifically the corona sulcus of my penis.  There was also a "red band" that ran from the opening of my urethra to the "v" of my penis head (circumsized).  I applied Neosporin liberally to both my penis and scrotum for almost two days.  This actually caused everything to swell up slightly and made my scrotum itch very badly.  At this time, my penis also stung very badly in the shower - especially my corona sulcus area.  It was made worse with soap.

I went to see my urologist on the 10th day.  He did a visual exam and noted the redness and slight "puckering" of the opening to my urethra.  He asked me to keep an eye on things, but did not feel it was Herpes.  There was also a small pin point sized red dot near the redness.  By now, the itching had gone away.  We did HIV and RPR tests and I got the results today that they came back clear.

For six days now, I have been washing at least twice a day with Dial soap (white, bar).  The stinging I experienced before went away and came back mildly a couple of times.  In the last six days, I have masterbated maybe five times - each time in the shower with the Dial soap.  Today, the stinging came back full force and following the shower (and masterbation (masturbation)), I noticed at least two "cuts" or openings on the lower portion of the corona sulcus.  No blood, but red.  Very painful.  Not really raised.  Skin is shiny in that area.  Also, this evening, I noticed a few other red bumps nearby and at least two under the rim of the head.  A total of maybe eight small (1-3mm) bumps.  PLEASE HELP!

[Alan Rockoff, MD]

All these symptoms sound like irritation, not like herpes.  Please use vaseline only and get yourself checked and perhaps tested with a herpes 2 blood test, so the likely negative result will let you forget about these encounters and move on.

Best.

Dr. Rockoff

[anxiouslyhopeful]

Lastly, I have not felt any distinct pain or soreness in my lower lumbar area, nor have I had any fever or overall sense of illness.    

This morning, the red bumps have subsided very slightly (it could also look that way because I examined my penis as it was starting to decrease in size from a "morning erection" and therefore the overall condition of the penile skin is in a more stretched out state).  

The rud bumps are still present (with one very small, pin-head sized bump having developed what appears to be a white top) but do not seem larger or more inflamed.  Basically, the bumps have not inflamed dramatically since their development last night (16 hours since first discovering the red bumps).

The two or three larger "cracks" or fissures or tears seem to be drying up.  There has been no pus that I could see. My corona sulcus is slightly swollen and puffy.  The tears are on and just below the corona sulcus.  

The opening of my urethra is still discolored (red) and slightly puffy, but the condition has not worsened in the last couple of days.

Any advice would be greatly appreciated.  Thank you in advance.

[Alan Rockoff, MD]

Nothing to add.

Dr. Rockoff

[anxiouslyhopeful]

Thank you for your imput thus far.  I have spent all of today dealing with this.  These are the developments:

I went back to my urologist and he took a quick look at the open/cut areas.  He said they look like they could be from herpes.  The areas in question are mostly dried over now.  There never seemed to be any pus.  The other red bumps have mostly subsided, but they are still slightly visible and red.  He ordered blood tests for both simplex 1 and 2.  I left with him telling me a definite "maybe."  

When I got to the lab for my bloodwork, it was already closed.  I was then sent to a "walk-in" clinic nearby.  The clinic informed me that in order for them to administer the tests, I would have to consult with their doctor as well.  So I saw their general/family practitioner.  He listened to me explain my history and these specfic events.  Then he did a physical exam of the area.  His opinion is that it is "99.9%" not herpes.  He suggest waiting for the blood tests, but feels confident it is not herpes.  

So, I have my urologist, whom I trust and have known for ten years, telling me that the open areas look like herpes and that I may have herpes.  I also now have a seemingly competent and very patient doctor from the walk-in clinic telling me he really doubts that it is herpes.  He did say that the redness around the opening of the urethra seems odd and that there is starting to be a bit of scarring there.  He suggested maybe ecszema?  Lichen?  Not really resolved regarding that.

The condition is basically unchanged for today.  Some localized itching and minor pain.  No pain from the open areas.

Who would have more experience dealing with initial cases of herpes?  I really hope the test results come back negative, as you seemingly believe they will...  Thank you again.  Any input would be greatly appreciated.

[Alan Rockoff, MD]

Your urologist didn't say you have herpes--he said it "could be" herpes.  That is correct--it could be.  Let the tests tell you.

Dr. Rockoff

[anxiouslyhopeful]

Test results are back.  HSV-1 = 6.63 (was told this is really high) with no oral sores (I don't think I've ever had a cold sore).  So it looks like the genital symptoms may be from HSV-1?

HSV-2 = 1.0

Was told this is unequivocable.  The general practitioner said the HSV-1 antibodies seem really old and that I am IMMUNE?  What does this mean?  GP (clinic doctor) said the HSV-2 results are too close to call.  Wants me to re-check in four weeks.

HOWEVER,

My urologist (with the same test results) said that the HSV-1 results were so high that they interfered with the HSV-2 results.

He is telling me I have HSV-1 for sure and that it occurred on the genitals.  The outbreak (my first) is not very severe - in fact, the GP didn't think it could be herpes at all.  My urologist is also saying that I am NEGATIVE for HSV-2.  He believes this entirely.  

SO,  did I get HSV-1 from the aforementioned oral sexual encounters?  Again, we did use protection throughout both exchanges.  

Can I transmit anything from my mouth (through kissing, oral sex on a woman, etc.?)  Once the HSV-1 heals from my genitals, am I as likely to transmit herpes genitally?

ABOVE ALL, is my urologist's diagnosis/opinion correct?  Even the GP said that an urologist may have more experience overall than a GP might.  My urologist said I don't need to re-test for HSV-2 for a while (maybe six months?).  

What should I do from here on out?  Thank you.  My world feels turned up-side down.  Any advice would be very greatly appreciated.

[anxiouslyhopeful]

PS  My urologist feels the HSV-1 infection occurred recently b/c the 6.63 is so high.  Thanks again.

[Alan Rockoff, MD]

I can't make any sense of your synopsis.  You need to check with the lab to get a proper interpretation (such as whether the HSV-1 can "interfere" with HSV-2, or whether a "high" titer of HSV-1 means recent infection, or anything at all.)

If the urologist indeed said, "He is telling me I have HSV-1 for sure and that it occurred on the genitals," then I would seriously question that opinion.  You need another, from a specialist in infectious disease or herpes.  Dr. Handsfield, who runs the sexually-transmitted disease (STD) forum on this site, is such an expert, so I suggest you ask him.

Dr. Rockoff

[anonomus12312]

i dont know if i have hepes i had spots in my genetle area but thought nuthing of it beacause i had it be for i had had sexual intercours and ive had cold sours eversence i was a little kid. i have spots that are under the forskin of my penis it will tingle sometimes and it sometimes hurt when i pee and i sometimes will get a pimple like bump that i can pop and it goes away but thats once in a great while. i havent said anything about it to my parents or my doctor. i dont know if i should think anything of it and is it possible to have herpes when ur born

[anonomus12312]

i dont know if i have hepes i had spots in my genetle area but thought nuthing of it beacause i had it be for i had had sexual intercours and ive had cold sours eversence i was a little kid. i have spots that are under the forskin of my penis it will tingle sometimes and it sometimes hurt when i pee and i sometimes will get a pimple like bump that i can pop and it goes away but thats once in a great while. i havent said anything about it to my parents or my doctor. i dont know if i should think anything of it and is it possible to have herpes when ur born