Is there topical treatment for lingering herpes lesions?

I'm 37 yr old male, very active and healthy, and was diagnosed with genital herpes 10 weeks ago when I started a primary outbreak of lesions in the pubic area.  I was on 1g/day Valtrex (for suppressive therapy because my girlfriend was diagnosed with hsv-2) prior to the primary outbreak and have been on 3g/day for 10 weeks since the outbreak began.  The lesions were classic herpes lesions with a second crop and they healed in 6 weeks, leaving a couple 1/4" scars.  The problem is that there is one lesion (or group of very small ones, not sure if it is a lesion at all because it never had a puss head but it must be herpes due to timing of occurence) about 1/4" diameter at the tip of my penis that has not healed in the 10 weeks.  The skin is very dry, a little flakey, harder than the surrounding skin.  It has been about 4 weeks since the other lesions have all healed and this one remains.  I have had eczema on my penis (mostly on the shaft not tip) for years (it seems caused from friction) and have used 1% or 1.5% hydrocortizone once or twice daily to control it.  I have read from a managing herpes book written by MDs that steroids in hydrocortizone can inhibit the immune system and healing herpes lesions so I have not tried hydrocortizone on the lingering lesion.  What over the counter and/or perscription topical ointments would you suggest trying in order of your preference?  I would like to research your recommendations and take that info. with me when I go see a dermatologist.  Or if topical therapy won't help, what other options are there, other oral drugs?  Can you recommend oral options as well for me to investigate further and discuss with my doctor that perscribed Valtrex?  Thanks

[Alan Rockoff, MD]

Although the books say that steroids weaken the immune system and trigger or spread herpes, that is more of a theoretical consideration than a real-life one.  You will most likely be able to use either a steroid or one of the new nonsteroid creams (Protopic, Elidel), if the dermatologist feels that's what's needed.  I do agree that what has persisted isn't herpes, though.  Meantime, just use a bland moisturizer and treat the area as gently as you can.

Best.

Dr. Rockoff