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Dermatology  (Expert Forum)
 | 
Folliculitis or Genital Herpes
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.

Folliculitis or Genital Herpes

by CharleysGirl, Nov 26, 2006 12:00AM
I need some reassurance. Earlier in the week I noticed a slight itching sensation just inside the tip of my labia major. On Thursday I noticed there was a bump there w/what looked like a white film over it. (the white film was bigger than just a whitehead, but didn't look water filled like a blister). The bump had a red ring around it and didn't sit up past the surface of the skin. (like most "bumps")  By Friday I noticed 4 more (none of them were together). All of them had this white covering on it.  They were all just inside my labia major. Right at the top where my pubic hair basically ends.  On Saturday I go to a walk-in clinic because they are starting to burn really bad and I am unsure of what's going on.  Please note: I do shave my pubic area 4-6x a week, so my initial thought was that it was an ingrown hair gone bad.  The doctor took one look at me and said it is folliculitis.  But then, when he came back into the examining room he said he thought it also looked like Herpes and he wanted to do a culture.  I have no burning when I urinate, no vaginal discharge, nothing else I would consider would constitue an STD.  So he took a culture and let me leave w/medication prescribed for folliculitis.  Today is Sunday and I have a few more "bumps".  I guess my question is:  1) if this were a primary Herpes outbreak, does the outbreak happen over a couple of days..(like a bump this day, 2 bumps, this day, etc.) 2) does folliculitis spread? Could it be possible that the folliculitis is spreading? I do notice what looks like a pinhole through each bump which I am assuming is a hair follicle.  
From what I have read, most health care providers can determine folliculitis over herpes by looking at the bumps. But in this case, the doctor could not.  Are they that similar?  I have to wait 3 days for the test results and am going crazy.  I keep looking at pictures over the internet trying to see the differences and cannot really tell.  Oh yeah one other thing, I found 2 more bumps earlier today in the area outside the labia major where my pubic hair would be.... Can you tell me any surefire way for me to determine the difference?

Thank you!

by Alan Rockoff, MD, Nov 28, 2006 12:00AM
No, not really.  It does sound like folliculitis, not herpes though.  If the culture is negative--which I predict it will be--you might ask the doctor to order a herpes 2 blood test, just to reassure you more completely.  You'll need to wait a bit longer for reassurance, but that's the nature of medical diagnosis.  But if it turns out to be folliculitis, which I predict it will, than I suggest you not examine yourself quite so closely in the future if you get similar bumps.

Take care.

Dr. Rockoff
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