Burning skin on shaft penis - Herpes?

[Worriedchecker]

I performed M2M oral sex on a guy and he performed oral back on myself.  Each was for a few mins only.   Also we mutually touched each others penis and then immediately retouched our own penis during mutual masturbation and were using lube.   He also fingered my anus a little and I rubbed my penis around his anus area during this for a few mins.    The next day I found out he has genital herpes, however, he said he has had only one outbreak ever and it was over a year ago and he said he is on daily Valtrex so I shouldn't worry. (I have no proof of this but that's what he verbally told me).    However, on the 4th day after this meeting I experienced intense burning sensation on a spot of skin on my penis shaft approx the size of a quarter.  This one spot is at the top of the penis shaft right below the head.  No redness or sores visible on penis just this burning sensation.  This lasted for around 8hrs and subsided to a dull burning sensation in this same spot.   Then exactly 7 days after the first intense burning sensation I again experienced intense burning sensation for around 8 hrs and then it again subsided to a dull burning sensation in this spot.   Still I have never had any redness or visible sores on penis.   I also did have some sore muscles in the groin which lasted for around 3 weeks.   No other symptoms I'm aware of.    It has now been 8 weeks post meeting and I still have the dull burning sensation on this same spot on my penis.  1)  Does this sound like I contacted genital herpes based upon these symptoms? I am very nervous about this and am still waiting for the 12 weeks post meeting to get my HerpesSelect test done but want an opinion as to what the chances are I should expect a positive HSV2 result based upon these symptoms.  

[H. Hunter Handsfield, M.D.]

Burning alone, without a visible outbreak of red bumps that become blisters, is not likely to be a symptom of herpes.  Further, herpes symptoms are not likely recur as soon as a week; symptomatic recurrent herpes outbreaks just about never occur more often than once a month or so.  It definitely is not possible to have on and off symptoms for 8 weeks.

And looking to your comments below, Valtrex cannot work so quickly.  Even in people with overt herpes lesions, new lesions often continue to appear for a day or two after starting the drug, and symptoms don't start to improve until 2 days at the soonest.

Finally, you describe other very powerful evidence against herpes.  Most important, the only kind of genital herpes you can acquire from oral sex is HSV-1 (because oral infections with HSV-2 are rare); and your own prior HSV-1 infection means you are immune, or at least highly resistant, to catching a new HSV-1 infection anywhere on your body.

So whatever is causing the feelings in your penis, it isn't herpes.  Such symptoms also don't suggest any other STD, and you can be sure they aren't due to any infection you caught during the sexual exposure you describe.  An HSV blood test probably isn't going to sort this out.  It will be positive for HSV-1, given your oral herpes history.  And even if positive for HSV-2, it won't explain your current symptoms; that outcome would just mean you have asymptomatic genital-area HSV-2 plus some other cause of the burning sensation.  On the other hand, perhaps you would sleep easier if you knew you had a negative HSV-2 result.  But the test pretty commonly gives borderline or false positive results, so you also risk ending up just not knowing one way or the other.  However, feel free to follow through with that test if you wish.

In any case, you should stop taking Valtrex for sure and see a health care provider if the symptoms continue or you otherwise remain concered.  But based on everything you say hear you have no worries about genital herpes.

I hope this helps.  Best wishes--  HHH, MD

[Worriedchecker]

Also I want to note that if I take Valtrex this dull burning sensation goes away after a day or so of taking it and then when I stop taking it it will come back after about a day.  Also to note that it seems like if I masturbate that aggravates this burning sensation and for a few hrs to day afterwards it is slightly higher burning feeling that just mild.    I have never had any redness or sores this entire time and have checked daily to ensure.  Only have had this lingering dull burning sensation for 8 weeks now on this spot of skin on the shaft of the penis approx the size of a quarter.   Also for note I do know that I have HSV-1 as I have had cold sores on my lips before.   2) If you think I do have genital herpes how long will the dull burning sensation last?   Is this dull burning sensation some type of damage to the nerves in this area of skin on the penis?   Thanks in advance for any information or opinion you can provide based upon what I wrote here.  

[H. Hunter Handsfield, M.D.]

I saw this and incorporated it into my reply above.