Herpes Scare...Need Expert Opinion

[Carlitos99]

Dear Drs:

Unprotected insertive oral sex with a female CSW the 31st (pretty rough, yet brief, 3-5 mins tops). Next dat panic and took 2 grams of azithromycin. I started washing my penis with soap many times a day and well, my meatus looked slightly reddened and swollen (only one ‘lip). Around day 15th post-exposure I experienced burning and painful urination, Dr. ordered 400mg Cefixime and 14 days of Doxycycline to cover Syph and Gono (symptoms went away in 10 days). May 7th urine check, everything good. I started thinking about HPV and ‘vinegar’… so, on May 18th I grabbed a cotton ball dumped it in vinegar and rubbed it vigorously on my glans. Needless to say, it hurt like mad and it even caused tiny blisters all over the glans and it bleed noticeably from the meatus. Two days later (May 20th) I went to a dermatologist and said I was suffering from Contact Dermatitis due to an acid. Everytime I had an erection, the skin on the glans looked extremely glossy, mildly cracked/with sores and it kind of hurt a bit (expanding), yet after ejaculating with no pain, the glans appeared wrinkly, extremely dry and would even chaff copiously. Being the moron I am, I decided to apply a cream with antibiotic Neomycin, later I found out it also contained Clotrimazol, I thought it was a good thing, I was convinced I had penile candidiasis. I used that cream for 9 days. One day I wanted to masturbate and picked up some lotion (aloe-something) and after using it, I found out it was expired (!)… As soon as I applied the lotion, it stung like hell and irritated my little wounds. June 4th, reputable dermatologist, who heard my story and looked at my penis, examined it and said I had a moderate case of Irritative Dermatitis, she recommended a very mild soap once a day and a lenitive cream 2 x a day for very sensitive skin, it felt good.

Now, THIS IS WHAT WORRIES ME:

[Edward W Hook, MD]

Correct. You do n ot need to test further. There is no need for further follow up either.  Take care. EWH

[Carlitos99]

Hi Dr. Hook,

I did get an HIV test at 4 weeks 1/2 AB (neg) and the same test at like almost 9 weeks after the exposure, also negative. Reading from your response, apparently I don't need any more testing and I'm safely home, correct? Your advice is extremely accurate and I just wanted to clarify those points concerning RPR and HIV testing. Thanks for your knowledge and time, you're doing a great service for many of us.

Best regards.

[Edward W Hook, MD]

The antibiotics you took would have prevented/cured syphilis if you had been exposed. There is no need for repeat testing.

HIV tests are definitive at 8 weeks following exposure.  Earlier tests may miss a very small number of infections.  Your risk of HIV is tiny but to be completely definitive, you should have an 8 weeks test.  I am confidnet it will be negative and at that time you can be confident that you do not have HIV.  EWH

[Carlitos99]

Dr. Hook, thanks for your advice.

After a long and somewhat painful hiatus, things are much better. No pain, there are no lesions, no visible scars on my glans, only slight pinkish areas where the lesions were, the skin looks normal except for a couple of spots where i think the creams did the most damage... well, i have two questions now and won't bother you anymore (sorry it's been so long).

1- Should I test again for HIV, considering the results (see above) and exposure risk I had? Can i be confident I'm in the clear?

2- The same goes for the RPR test, (see above). And finally, how long would it normally take for the skin on the glans or the mucous membrane to heal itself and get back to normal, just like before, an estimate would be appreciated.

Thanks Docs, you do a wonderful job on STD and HIV prevention.

[Carlitos99]

Thanks Dr. Hook,

You're a world expert, so your words are very reassuring. The dermatologist looked at me, said the yellowish-gel like goo was basically the skin healing itself, with dead cells and some white blood cells... mentioned something good about it not having a foul odor or something like that. She said to keep using oatmeal soap twice a day for the weeping and to put on the lenitive cream after cleansing. She also took a swab at the wounds/ulcerated area and sent it to the lab, the report's coming in tomorrow... she said it was to test for fungi/bacteria (as a precaution).

Apparently, it was the neomycin along with the Clotrimazol that burned and ended up wounding my skin (i used the darn thing like for 10 days!), as the affected area is very 'pattern-like' as i told you... and i remember the affected area(s) is where more of the cream used to stay/stick. It's all healing, slowly, but healing. The rest of the penis and glans it's normal.

I will post you my results when they come in, again, thank you very much doctor. I'll let my johnson alone for a while, i'm sure!

[Edward W Hook, MD]

Welcome back to the Forum. You actions and activities indicate that you are not cut out for the sorts of exposures to CSWs you describe- clearly they lead to anxiety and over reaction which drive you to do things that are not in your best interest, not only in terms of anxiety and worry but also with over aggressive self examination, taking unneeded medications and putting yourself at risk for side effects, and silly things like the vinegar application or unwarranted use of neosporin which is famous for causing allergic reactions.  Now this.

For starters, do not try to self treat this. You have proven this does not work for you. Second, this is unlikely to be HSV.  The appearance of the lesion you describe is not typical and it has occurred far too long after your exposure to be HSV.  My guess is that this is part of the healing reaction or, possibly a reaction to the medication you are using for your earlier problems.  I would gently clean the area with warm water and the mild soap.  If the problem persists a or is worse, you should ask the dermatologist to take another look.  This however, is not herpes.  

Hope this helps. Take care.  EWH

[Carlitos99]

Apologies Doctors, in the first line it should read: Unprotected insertive oral sex with a female CSW the 31st OF APRIL.

[Carlitos99]

Day one of treatment, (June 5th) and today, I noticed a yellowish substance (gel-like, not crusty) over the most affected area, the one I have now: it’s like 2 cms above the glans sulcus, bright red and it almost goes side to side (almost a circumference around the glans), there are tiny cracks and little sores in it. The rest of the penis looks fine and I have seen no blisters, sores in the shaft since day one of this ordeal, damage seems confinded to specific areas of the glans. Is this an initial herpes outbreak now? I pass urine and ejaculate with no pain, no fever, no swollen lymph nodes, just very worried about my little buddy. Is this a recurrent outbreak? Little lesions can be seen in the lower part of the glans, almost all the way around, it’s 60 days+ post exposure.

Dr.Hook's advice and you kept me from hanging myself with science-based hope, as i had enough courage to go and get tested for HIV (4 and 8 weeks negative HIV-1/2 AB and Non Reactive RPR at 7 weeks).