Aa
Concern of herpes over a rash
Hello Doc, I posted a few months ago about a rash around my perianal area that I got after using Aldara on a genital wart. I had a rash for about three months, and it turned out it was some sort of fungal or yeast skin infection. My gyno gave me cream that cleared it up in a few days.
What I’m worried about is that ever since then I still get a reoccurring rash in that same area. The rash is a little burning and a little itchy, but not painful or debilitating (other than psychologically, cause I worry about it a lot). I never see lesions, cuts, blisters, clusters, ulcers, or scabs. No broken skin. It’s just a red, blotchy, sometimes spotted, rash. It always occurs on both sides of skin around my anus. It is only uncomfortable if I’m sweating or being physically active when I have it. I treat the rash is hydrocortisone, and it generally goes away within 2-3 days. But this rash has reoccurred every three weeks or so for the past number of months. I’ve been terrified that I have herpes ever since these rashes started.
Questions:
1 Could this be herpes?
2 What else could be causing this?
3 Are herpes blisters/ulcers painful to the touch? Would they burn if soap on them, like a cut? (this does not happen to me. I only ask because they say herpes burns during urination)
4 Is it possible to get reoccurring herpes outbreaks every three weeks with symptoms that never last longer than a few days?
5 Can hydrocortisone cause herpes symptoms to subside?
6 Can herpes occur without blisters or other tell-tale symptoms?
7 Could the blisters/ulcers be too small for me to see (I use a magnifying mirror in good lighting)?
8 Do you think I’m being paranoid or should I get tested?
9 What is the surest way not to get herpes? If I always use condoms during sex and if I always try to get a good look to check for lesions, what are the chances of getting herpes from a protected encounter with someone who potentially has herpes but no active lesions?
Thank you so much, MA
What I’m worried about is that ever since then I still get a reoccurring rash in that same area. The rash is a little burning and a little itchy, but not painful or debilitating (other than psychologically, cause I worry about it a lot). I never see lesions, cuts, blisters, clusters, ulcers, or scabs. No broken skin. It’s just a red, blotchy, sometimes spotted, rash. It always occurs on both sides of skin around my anus. It is only uncomfortable if I’m sweating or being physically active when I have it. I treat the rash is hydrocortisone, and it generally goes away within 2-3 days. But this rash has reoccurred every three weeks or so for the past number of months. I’ve been terrified that I have herpes ever since these rashes started.
Questions:
1 Could this be herpes?
2 What else could be causing this?
3 Are herpes blisters/ulcers painful to the touch? Would they burn if soap on them, like a cut? (this does not happen to me. I only ask because they say herpes burns during urination)
4 Is it possible to get reoccurring herpes outbreaks every three weeks with symptoms that never last longer than a few days?
5 Can hydrocortisone cause herpes symptoms to subside?
6 Can herpes occur without blisters or other tell-tale symptoms?
7 Could the blisters/ulcers be too small for me to see (I use a magnifying mirror in good lighting)?
8 Do you think I’m being paranoid or should I get tested?
9 What is the surest way not to get herpes? If I always use condoms during sex and if I always try to get a good look to check for lesions, what are the chances of getting herpes from a protected encounter with someone who potentially has herpes but no active lesions?
Thank you so much, MA
Thanks doc. My worrying is my worst symptom, so I'll make an appointment next time it happens and have it looked at.
MEDICAL PROFESSIONAL
As we discussed last May, your symptoms then didn't suggest herpes. They still don't. Of course herpes is always a consideration with recurrent genital area symptoms. But your description contains strong evidence against HSV as the cause.
Here are some facts about recurrent genital herpes. The rash/outbreak is always very limited in size, usually one to a few blister-like lesions occurring in an area no bigger than a quarter. Each outbreak is in the same spot every time, give or take an inch or so. Outbreaks almost never occur on both sides of the body's midline -- they limited to one side or the other. Herpes rarely if ever causes a diffuse, blotchy rash; although people who don't inspect themselves closely might miss the blister stage or open sores, careful inspection generally reveals such lesions (as your wording suggests you know). Finally, recurrent outbreaks almost never last more than 1-2 weeks at a time and recur no more often than once a month, usually 6 weeks to 3 months; and between those outbreaks, there are no symptoms at all. I think you will agree that these characteristics don't match what you have.
Those comments answer questions 1, 4, 6, and 7. To the others:
2) It is hard to speculate on the other causes; there are too many: fungal infections, other dermatitis, some sort of ongoing reaction to the previous Aldara treatment, and others. You'll need to see a health care provider, preferably a dermatologist, to sort it out.
3) Any open sore or inflammatory rash can be painful to touch. Herpes burns during urination only when urine passes over open sores.
5) Hydrocortisone can make almost any inflammatory rash improve, at least temporarily, including herpes. Over the long run, though, it often makes things worse and it can delay herpes healing. You shouldn't continue to use it unless advised by a health care provider.
8) It isn't "paranoid" to want a clear answer to a bothersome medical problem, and it is quite natural for you to be worried about herpes. When you see a health care provider, preferably a dermatologist, s/he might recommend an HSV blood test, to settle your fears about it.
9) Consistent condom use is highly protective, but not perfect. You can directly ask prospective partners -- althought that only helps a bit, since so many people have undiagnosed infections. Aside from insisting that all potential partners have blood tests -- which I do not recommend -- there is no sure way to prevent genital herpes. But my main advice is to not worry so much about it. With common-sense choices about partners plus condoms, the chances are low; and if you get it, effective treatment is available. While nobody wants genital herpes, generally the bark is worse than the bite; the actual impact on people's health, sex lives, etc generally is less than might be assumed from all the hype about the disease. Don't let fear of an impersonal, usually mild virus overly affect your romantic and sexual life!
I hope this helps. Best wishes-- HHH, MD
9
Here are some facts about recurrent genital herpes. The rash/outbreak is always very limited in size, usually one to a few blister-like lesions occurring in an area no bigger than a quarter. Each outbreak is in the same spot every time, give or take an inch or so. Outbreaks almost never occur on both sides of the body's midline -- they limited to one side or the other. Herpes rarely if ever causes a diffuse, blotchy rash; although people who don't inspect themselves closely might miss the blister stage or open sores, careful inspection generally reveals such lesions (as your wording suggests you know). Finally, recurrent outbreaks almost never last more than 1-2 weeks at a time and recur no more often than once a month, usually 6 weeks to 3 months; and between those outbreaks, there are no symptoms at all. I think you will agree that these characteristics don't match what you have.
Those comments answer questions 1, 4, 6, and 7. To the others:
2) It is hard to speculate on the other causes; there are too many: fungal infections, other dermatitis, some sort of ongoing reaction to the previous Aldara treatment, and others. You'll need to see a health care provider, preferably a dermatologist, to sort it out.
3) Any open sore or inflammatory rash can be painful to touch. Herpes burns during urination only when urine passes over open sores.
5) Hydrocortisone can make almost any inflammatory rash improve, at least temporarily, including herpes. Over the long run, though, it often makes things worse and it can delay herpes healing. You shouldn't continue to use it unless advised by a health care provider.
8) It isn't "paranoid" to want a clear answer to a bothersome medical problem, and it is quite natural for you to be worried about herpes. When you see a health care provider, preferably a dermatologist, s/he might recommend an HSV blood test, to settle your fears about it.
9) Consistent condom use is highly protective, but not perfect. You can directly ask prospective partners -- althought that only helps a bit, since so many people have undiagnosed infections. Aside from insisting that all potential partners have blood tests -- which I do not recommend -- there is no sure way to prevent genital herpes. But my main advice is to not worry so much about it. With common-sense choices about partners plus condoms, the chances are low; and if you get it, effective treatment is available. While nobody wants genital herpes, generally the bark is worse than the bite; the actual impact on people's health, sex lives, etc generally is less than might be assumed from all the hype about the disease. Don't let fear of an impersonal, usually mild virus overly affect your romantic and sexual life!
I hope this helps. Best wishes-- HHH, MD
9
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
