HSV Worry

Hello Doc I have had vulvar irritation for the past 5 months or so. I have been tested for herpes with type specific three times all neg and cult all neg. I recently saw a vulvar specialist who did a biopsy and diagnosed me with lichen simplex chronicus. During my period last week I started to have freq. urination, a slight burning when I went to the bathroom and a slight pain in my abdominal region. I went and got the AZO UTI pills to help with the discomfort till I saw the doc on Mon. They took a urine sample and gave me some cipro 500mg 1 per day 4 a week.  The reason I am concerned is because I also had some slight redness on my the inside of my vulvar where the clitoris and urethral opening is.  I asked the doctor and she said it was the LSC.  That is turns the skin white on the external vulvar skin and red on the internal vuvlar skin.  Since starting the cipro,the burning when I pee has stopped but I still fill the pressure in my bladder but The area has never itched or caused pain, I only saw it cause I am always looking down there worring. I am not going as much as I was.  I guess I am alittle worried cause these can all also be symptoms of hsv also.  Would a vulvar specialist know the diff between hsv and LSC and can they be mistaken for each other.  The red area is very small, has not changed in a week, maybe it is getting a little less red. It's more like a line type shape than a circle or anything. It is not raised or anything. They took a urine sample and I am waiting the results.  If the result is neg for a uti, should I be concerned about hsv again?

[H. Hunter Handsfield, M.D.]

No online provider can compete with the opinion of (and care provided by) in-person health care by a knowledgeable provider, especially a specialist in vulvar conditions.  There is nothing in your story that makes me concerned about herpes, and the negative blood tests rule it out anyway. Continue with your vulvar specialist; I'm sure you can rely on his or her care.

Good luck--  HHH, MD

[worried2007]

Thank you doctor for your response. I guess since I have been thinking I have herpers for so long, it is hard to stop thinking that way. My doctor put me on cholestabol 0.05 ointment(might have spelled that wrong) once a week and for me to come back in 8 weeks to see the progress. I have researched LSC and I don't really sratch alot to me. I guess I do rub the areas since I am check myself like three times a day. Trying to stop that as well. I thinks it's becoming a OCD. They say you can sratch in your sleep so maybe I was doing that and not knowing it. I guess I keep worrying about herpes because they say so many people can have it and not know it or mistake it for something else.

Why are the symptoms so diff. in people?  

And if my UTI comes back neg, what else could be causing my urination irritation?, could it have been my period?
I just had a pap and was tested for Chlamidiya and Ghonoreha and everything was fine.

[H. Hunter Handsfield, M.D.]

The additional information does not change my opinion or advice.  I'm not sure what you mean about symptoms being "so different" in various people.  Herpes symptoms really are not that much different from one person to another.  Vulvodynia or vulvar itching may vary a lot, but I haven't a clue about why.  You need to talk to your own provider about your urinary irritation or any other symptoms.  Most likely it is just due to the underlying vulvar problem.  In any case, no online provider can help; personal health care by a knowledgeable provider is your only option.

I won't have any further replies.  Good luck.

[gracefromHHP]

LSC develops from chronic irritation - not just scratching ( I'm assuming you actually meant lichens simplex chronicus and not lichens sclerosis - the biopsy is the way to tell them apart best ).  I've actually had it myself genitally and it was terribly annoying but it did respond quickly to treatment thank goodness ( there are many treatment options if the current one doesn't work for you - your doctor can help you with that part ).  Mine was from having vaginal infections constantly for over a year.  Make sure you make changes to help decrease the irritation - looser clothes, different underwear, avoid soap on the actual genitals etc.  If you don't eliminate the source of the irritation it will just keep being an issue.  

Not everything that goes on in the genital area is due to herpes. You've had multiple tests that show that you don't have it - now's the hard part - convincing yourself of that!!  You have a cranky crotch which to me is far more annoying than my herpes has ever been!!

grace

[worried2007]

thank you doc and grace. Yes I did mean Lichen Simplex Chronicus.  Before I saw the vulvar specialist I researched the net and saw some things I could do to decrease irritation like all cotton underwear, Dove soap or no soap, I use Dove sensitive skin.  I take a bath once a week in Aveeno Oatmeal packets.  And I started using A and D ointment after showers.  These have all helped.  This is my second week using the cholestabal it seems to be doing fine.  This weekend I was intimate for the first time in over a month and had no irritation afterwards which I was very happy about and almost could not believe.  before I would swell up and be tender for days.  I know I have to get over the herpes thinking.  I have been thinking this way for so long it feels funny to not be thinking about it.  Your words really touched home with me since you have idea of what I have been going through.  thank u so much for taking the time to comment on my post.  If there are any other things that you know that can help with my lcs besides what else I am doing, I would love to know.

Thank you and God Bless.  This site is so amazing.