herpes, eczema, or what?

hi i'm a 23 year old heterosexual male I have a rash on the head of my penis that gets worse after friction for the past 3 months I have been going to the std clinic periodically and their last suggestion was to get a circumsition. I've been to a general Dr. also and he prescribe elocon which does not seems to work since the redness deminishes but has not gone away. I went then to a dermatologist who gave me some Locoid Lipocream which i applied to no avail. Ok this is the worst part in my paranoia i took a blood test for herpes and it came back testing positive for
HSV-1 my other tests came back negative for aids etc... my dermatologist received the tests and still says that what i have on my penis is not herpes so does the 3 nurses that have seen me in the STD clinic and his advice was to give me that Locoid Cream and to wait and see if I get blisters or something like that so he could tell is genital herpes!! he told me to wait around 6 months to see if i have an outbreak and that the HSV-1 i have could be oral and could have been acquired as a kid but i have no recall of oral herpes breakouts in my 23yrs. what do you think? nothing takes the rash at the head of my penis away sometimes it looks dry and sheds skin a little i heard that eczema does similar stuff but I would think elocon or locoid would take it away if it was eczema?! it get worst if i masturbate or have sex which ofcourse i stopped doing! do you think is herpes? my dermatologist would not prescribe herpes medication because he says is not herpes but it's driving me crazy!! could it be the fact that i am not circumsized? please tell me your opinion of the case i've been so many times to the std cllinic they are tired of seeing me but no cream helps and honestly i'm tired of looking for an answer. should I just wait and see for six months? i'm seeing a counselor as a result of my anxiety... well i guess thats all.

[Alan Rockoff, MD]

This isn't herpes.  It's redness.  Even after you clear up eczema, the skin looks red.  Friction and sex make it redder.  This means nothing.

Cortisone creams, even weak ones like Elocon and Locoid, perpetuate redness.  I advise you to stop using them.  Get your skin doctor to consider giving you Protopic or Elidel, two nonsteroid eczema creams, in case you get itching or scaling.  If you only have redness, I would do nothing.  It means nothing and will go away in time.

The blood test for HSV-1 means nothing.  It just means you were exposed to the oral herpes virus some time in your life, even if you never had a visible cold sore.

If you get a cluster of blisters on your penis, show a doctor.  Otherwise, work with a counselor to help use your positive news to get on with your life.

Best.

Dr. Rockoff

[Glans Troubled]

Six months ago I was diagnosed as having "non-specific balanitis."

I have had this condition for almost seven years; and I am 34 years old. (I saw a dermatologist regularly over this period, (every few months), but it was not until I sought a second opinion, that I got this aforementioned diagnosis).

The aetiology of this condition was a trauma from the application of a cortico-steroid that was prescribed for atopic dermatitis on my arms and neck; that cleared from my arms and neck almost immediately after application.

The structural damage to the glans (glands) penis is that the spongy tissue is no longer smooth, as it used to be, but is now cracked: including linear parallel ridges over a triangular region on top of the glans (glands), (from my perspective, looking down), including a circular region around the urethra. As well, the glans (glands) is red and inflamed over the region where the linear parallel ridges are and around the urethra, (identically where I applied the aforementioned corto-steriod: Can this be a coincidence?).

I have not engaged in any form of sexual relations since this condition manifested itself. Needless to say, this is a source of considerable grief.

I have been using Protopic 0.03% (8 weeks), Protopic 0.1% (2 weeks), and 1% hydrocortisone mixed with aquaphor, glycerin, and water (6 months); and have seen little improvement.

QUESTION:

Is there reason to be optimistic about recovery? What is the best that can be expected? And, any suggestions for additional, or other, treatment?

[G215]

A related discussion, female adult does not have hepes but has constant itchy red tight and hard skin in genital area not a yeast infection either probably eczema was started.