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Genital herpes in/on anus... but never anal intercourse
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Genital herpes in/on anus... but never anal intercourse

Hey all. I was just diagnose with genital herpes. I had an outbreak on my right buttocks, and I noticed some almost at the opening of my rectum.

My question is, I am sexually active and gay, but I have never had anal sex! Unprotected oral, yes. But no anal, as I am very cautious with HIV and scared of it.

I am so ashamed I have herpes. I don't know why I have this on my anus, if I have never had anal sex! Is this possible?

And the pain is AWFUL. I cannot even pass stools without cringing.

Also, is a swollen lymph node in my groin related to this?
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101028_tn?1348750963
you don't have to have anal sex to get lesions in the anal area. when you are infected, it infects the same nerve group that supplies the entire "boxer short" area and ob's can occur anywhere in that area.  

best thing to do is to be seen and get these anal symptoms checked out. did they give you medication for your newly diagnosed genital herpes? if so what, how much and for how many days?

try things like holding a tucks pads in between your butt cheeks for 10 minutes at a time as a compress. Also soaking your bum in epsom salts water is also helpful.  Take a stool softener/laxative like benefiber or mirlax or  colace.  keep your stool as soft as possible so it hurts less as it comes out.  

grace
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they gave me valtrex- 2 pills twice a day, 4 grams daily. and some cream also. I noticed the first blister five days ago- when can I expect this outbreak to end?
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101028_tn?1348750963
not sure which cream they gave you but if it's acyclovir/zovirax ointment, it's pretty much ineffective :(

they gave you the wrong dose of valtrex too. It should be 1gm 2x/day for 7-10 days since this is a newly acquired infection for you we assume.  Give them a call monday and tell them to check the PDR to see that they prescribed you the wrong medication and get them to correct their mistake and give you the proper prescription.

grace
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No my doctor told me to take it for 5 days, 2 pills twice a day- he said he wanted me to take a high dosage of it.

My main worry is, why on my anus? I haven't had anal sex! I have done rimming and fingering with men, but NO ANAL... I am so worried that someone did anal to me without knowing it but this is impossible.... so why are they at my anus?
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Grace replied to this question above:

"you don't have to have anal sex to get lesions in the anal area. when you are infected, it infects the same nerve group that supplies the entire "boxer short" area and ob's can occur anywhere in that area."

Best to get it checked out, as Grace stated.
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101028_tn?1348750963
the proper dose for valtrex is 1gm 2xday for 7-10 days. the dose your doctor gave you is the wrong dose. also once you've finished that first round of medication if you are still getting new symptoms, you need more medication.

what testing did you have done so far?
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Grace, my doctor is a very smart man and he knows what he is doing. And the pharmacy told me this is correct. So thus, I will follow him. Also, they did a blood test. It hasn't come back yet but I mean, let's be honest, what the hell else could these red bumps and painful blisters be? It's herpes and the sad thing is, I have never had anal or vaginal intercourse.

Is it normal to get herpes without ever having had intercourse (not oral) ?
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897535_tn?1295210035
Actually Grace is spot on about the dosing; even on the GlaxoSmithKline Website (manufacturer of Valtrex), the correct dosing for the initial episode of genital herpes is 1 gram twice daily for 10 days.

If your question is, can you get genital herpes via oral sex, the answer is very much yes.

How were you diagnosed as having herpes? You didn't mention it.
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i haven't officially been diagnosed- i am going to my dermatologist tom, but my doctor strongly sensed it was. they did bloodwork, test to come back tuesday. the valtrex is def helping, though. how long can the first outbreak last?
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897535_tn?1295210035
Your doctor should have taken a swab/culture of symptoms. If you still have lesions/blisters, this should be done. A blood test, if positive, will only tell you that you have herpes; it won't tell you that your symptoms in fact ARE herpes.
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Well they are MOST LIKELY HERPES... what else would cause a burning, painful, tingling sensation in my boxer short area? They are red bumps that now are forming like a white reddish crust and they hurt like hell.... cmon people! lol
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897535_tn?1295210035
Other things can mimic herpes. A good doctor or dermatologist won't make a solid visual diagnosis, as 1/3 of visual diagnoses of herpes are wrong  My gynecologist diagnosed me with folliculitus (folliculitis) when here it was my first herpes outbreak (fortunately she did do a swab/culture - again key when there are physical symptoms). I'd insist on a swab culture of these bumps, and/or consider a dermatologist.

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Seeing my dermatologist tomorrow! Also, I have a tingling sensation on the back of my upper right thigh when I rub it... is this related to herpes and normal? It occurs only on the right side, where the supposed outbreak occurred on my anus. It also hurts to fart and poop.
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101028_tn?1348750963
the only accurate way to diagnose hsv1 genitally which would be your highest risk is through a lesion culture of active symptoms. a blood test only tells you what you have and not where you have it. too late now for a lesion culture since it's been so long and you've also been on valtrex.  I can help you with  your blood test results when you get them.  If this is a newly acquired herpes infection though it's too early for it to be reflected in the blood tests though.  

you also can contract hsv2 from foreplay. have you had naked foreplay at all ?

also do you have a regular partner that can be tested to know their status?

grace

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yes I have only done naked foreplay! never anal sex. But you haven't answered my questions!

How long does an initial outbreak last? When I pass gas it hurts. Badly. And to poop. Also there is an odor in that area and it smells very bad when I pass gas.
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101028_tn?1348750963
the first ob takes 2-3 weeks on average to run its full course.

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The dermatologist thought it may be shingles, did a culture so awaiting results... the tingling and pain is driving me nuts!
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101028_tn?1348750963
you've already been on valtrex so odds are that the culture will come back negative regardless :(
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Also, there is a distinct smell in the area of the outbreak- it is a very foul odor, when I touch where the blisters are and smell it, it smells awful. What is this more indicative of- shingles or herpes?
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101028_tn?1348750963
neither. herpes lesions don't have an odor no matter if they are herpes simplex or herpes zoster.

grace
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so why the smell? there is white fluid/puss appearing over the red rash and they smell.... what is this from?
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101028_tn?1348750963
something non-herpes is evidently going on causing it.  follow up on it with your provider.
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Blood test for herpes- negative. Still waiting on culture...

What the heck was this?! No one knows yet and it is getting better but the redness and bumps are still there and though they have stopped hurting mostly and oozing puss, they are there. It's been 8 days.

My doctor thinks it was shingles. But I am 23! How could I have shingles? Can stress bring out shingles? My dad had a heart attack last week and I was so stressed, having major diarrhea for a week! Then this happened along with my strep throat. Is this related?
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Clearly you need to be seen again. Puss and a foul smell is completely indicative of a bacterial infection, which can be serious! Shingles or herpes will NOT smell or produce puss!
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I've been on penicillin for 8 days now for a strep throat infection diagnosed the same day this rash/bumps started... it's getting better. Will the penicillin help with the rectal infection? It seems to be going away slowly...
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It's best to discuss treatment as such with your doctor. Surely he was aware of the puss and foul smell??
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Yes, he said it was just some kind of bacterial infection. He said it is normal for the puss to smell. I just want to know what the heck it was! And what caused it!
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Sadly we can't help with that.  We can only tell you what we think and it doesn't sound like HSV.  You should continue to work with your doctor they can work with you on telling you what it is.  
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Thanks people. Well I guess I can be glad it isn't herpes and that it's going away, albeit Vvery slowly :)
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The culture came back positive for herpes 1,the cold sore kind. But the blood test said negative, Is this weird? My dermatologist said It's not genital herpes, it's cold sore herpes (not recurring). She gave me two valtrex a day. This sound right?
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897535_tn?1295210035
As grace replied above, in regards to genital herpes anywhere in the boxer short area:

"you don't have to have anal sex to get lesions in the anal area. when you are infected, it infects the same nerve group that supplies the entire "boxer short" area and ob's can occur anywhere in that area."

You have HSV1 genital herpes. There's no such thing as cold sore herpes in the genital area. Cold sores are strictly oral. Your doctor is confusing type with location, but if you have herpes in the genital/boxer short area, well then you have genital herpes, regardless if it's HSV1 or HSV2.  Genital HSV1 is almost always transmitted via oral sex - I in fact have genital HSV1, transmitted from my partners mouth (he's had oral herpes for years, but no outbreaks in the 5 years we dated)....

The good news is, HSV1 doesn't "like" the genital area, so you'll have very few outbreaks, typically, and the virus doesn't shed as much as HSV2.

You can read more about genital herpes in the herpes handbook, here:
http://www.westoverheights.com/genital_herpes/handbook/view_the_chapters.html
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thanks so much!
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A few questions:

On Valtrex- I have been noticing dizziness and AWFUL GAS! Like, all the time and it smells very bad. Normal?

General:

How long will this outbreak last? It's been about 10 days. Going away but still red on my buttocks, where it occured. And it still hurts a bit. Is this normal? How long will it last and when will the redness/pain go away?

Also... can I swim? I have to swim for work... day camp counselor. It's almost going away. Can I work out?

(I have been on Valtrex for a week now).
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Also, I have a prescription for Valtrex until Monday. That is when I finish it! THANKS!
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101028_tn?1348750963
the gas is not related to your herpes. You even said you had diarrhea last week so it's probably related to that plus you are on or were just recently on antibiotics which can also cause both.  

yes you can swim. it's not an issue.

if your provider thought you had a bacterial infection causing your odor, did they treat it with anything?   if you still have this odor, you need to follow up on it. it's not normal and not a part of herpes infections.  

I already said it takes 2-3 weeks on average for a newly acquired herpes infection to run its course. Also the herpes handbook has tons of info in it too.
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Can I work out? My dermatologist said it is the pus that smells....
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101028_tn?1348750963
herpes lesions don't have pus and they don't smell.

yes you can work out.
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