Herpes from hand job? Burning tingle in thighs and pubic region

Doc,
In the beginning of November I received a massage that turned into a handjob. After it happened I looked at the ladies hands and didn't notice any visible sores. A few days later I started to experience a burning tingle sensation on my inner thighs and around my pubic area. Not on my penis. It went away after a week or so. My worry became less. Then on Christmas night that same feeling came back in the same general region. I never noticed any sore or lesions. Just a painful burning sensation. I still feel it to this day. Could this be herpes but with no lesions? Could it be something else? How long after should I get a blood test for HSV 2? And am I at risk for any other STD from this hand job? Should I get checked for HIV too?

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

Sometimes the title of a new question contains all the information necessary for an accurate reply.  Genital herpes is rarely if ever transmitted by hand-genital contact (neither Dr. Hook nor I has ever seen such a case in our combined 65 years in the STD business); and genital herpes doesn't cause "burning tingle in thighs and pubic region".  So I'm quite certain you did not catch genital herpes.

Now I have read the question itself.  There is nothing there that changes my initial belief.

Herpes lesions can burn, or a tingle can precede an outbreak by a few days.  However, these symptoms by themselves are never due to herpes.  In addition, the burning and tingling due to herpes is not so widespread, i.e. canot involve the entire genital area, pubic region, thighs etc.  By far the most common explanation for such sensations is genitally focused anxiety.  It's not that mental stress or anxiety actually cause such feelings -- but these factors definitely can magnify normal, trivial body sensations that would normally not be noticed, sometimes to the point of severe pain.

And to reinforce my original comment, there is no realistic chance you caught herpes or any other STD from the happy ending of your massage.  You definitely do not need testing for herpes, HIV, or any other STD.

So try to stop worrying about it, and most likely your symptoms will fade away.  But if they continue, for reassurance I would advise you to see a health professional.  You can expect that s/he would agree with my evaluation.

I hope this helps.  Happy new year--  HHH, MD

[Used71]

Thank you for your timely response. So just for a piece of mind Im gonna get tested. How long should I wait? And what is an accurate test to be done to check for HSV 2?

[H. Hunter Handsfield, M.D.]

I strongly recommend you not be tested for HSV-2 on account of this exposure or your symptoms.  If positive, it will be from some past exposure other than this one.  And if positive, it will not explain your symptoms; it would only mean you have asymptomatic HSV-2 plus another cause (still probably anxiety).

But if you insist, you should be tested twice:  now and again in 3 months.  Ask for testing by Quest labs, which does the Focus HerpeSelect IgG test, the most commonly used and most extensively studied test on the market.  Also, ask your doctor or clinic to request that the HSV IgM test NOT be done; it's often done automatically, but is highly unreliable.  (Search this forum for HSV IgM for lots of discussion about it.)

Still would emphasize it is silly to be tested for HSV on account of your exposure and symptoms.

[Used71]

Thank you for the information. So these symptoms do not sound like that of genital herpes, but more like genitally focused anxiety. One last question if you can answer. Would some type of jock itch or fungal infection or ringworm cause tingle burning thighs and pubic region? Can jock itch come without any viable rash or swelling?

[H. Hunter Handsfield, M.D.]

No skin infection, including jock itch, ringworm, or any other, is likely to tingling or any other symptoms in the absence of visible redness of the skin.

[Used71]

Hey Doc. Thanks for your time. I took the LabCorp herpes IgG. I knew my HSV 1 would come back positive since Ive had them on my lips before. Can you help me interpret these results?



Test Description                          Result   Range Units
HSV 2 IgG, Type Spec.           <0.91   0.00-0.90   index  
Negative 1.09
.
Note: Negative indicates no antibodies detected to
HSV-2. Equivocal may suggest early infection. If
clinically appropriate, retest at later date. Positive
indicates antibodies detected to HSV-2 coinfection
with HSV-1 cannot be excluded without type specific
testing.
HSV 1 IgG, Type Spec164899 2.37   0.00-0.90   index  
Negative 1.09
.
Note: Negative indicates no antibodies detected to
HSV-1. Equivocal may suggest early infection. If
clinically appropriate, retest at later date. Positive
indicates antibodies detected to HSV-1 coinfection
with HSV-2 cannot be excluded without type specific
testing.

[H. Hunter Handsfield, M.D.]

Your result is negative for HSV-2 (as I expected) and positive for HSV-1 (as you expected).

[Used71]

Sorry it cut some of the ranges off.

So their ranges are
Negative 1.09



Test Description Result   Range Units
HSV 2 IgG, Type Spec163153 <0.91   0.00-0.90   index  
Negative 1.09

My HSV 2 IgG Results read as <0.91

[Used71]

Doc,
Thanks for the rapid response. So my test was taken at two days shy of eleven weeks from this exposure. Should I repeat testing in a month or so or are these numbers pretty solid?

I thank you for all your help, Doc.

[Used71]

Damn those ranges I wrote are misleading here are the correct ranges

Negative is less than 0.91
Eqivical is from 0.91 to 1.09
And positive is greater than 1.09

My results read less than .91 so it's negative right

[H. Hunter Handsfield, M.D.]

This was clear in your original message, and in any case I am intimately familiar with the cut-off values.

This negative result is definitive.  As we discussed, it was an unnecessary test anyway.  Had it been positive for HSV-2, I would have concluded you had an asymptomatic HSV-2 infection, plus some other cause of the symptoms you had after your zero-risk sexual experience.

But glad to have helped.  Thanks for the thanks. Stay safe.

[Used71]

Hey Doc,

Last night I noticed what appeared to be a black head or black spot on the line of my penis like a half inch below the penis head. I messed with it and popped it and a stringy white substance came out as well as the black spec. Could this be the initial herpes symptoms?
Also let's just say I was exposed to herpes through the handjob, would my 10.5 week test be reliable. I'm still experiencing burning thighs off and on. I also got an HIV test done last week two days shy of 11 weeks. How reliable is that?

I know my anxiety is killing me but if you can please answer I would greatly appreciate you response to my questions.

Thanks

[H. Hunter Handsfield, M.D.]

Obviously it was a blackhead; herpes lesions don't look or behave at all like this.  My advice is that you stop examining your genitals.  If you had herpes, you would know without looking; and 90% of what anxious self-examiners find are normal or inconsequential -- like a blackhead.

The HSV antibody tests are probably around 90% reliable at 10.5 weeks.  If you insist on testing against all need, why not wait until 12 or even 16 weeks for maximum reliability?

That will end this thread.  There is no circumstance or skin finding you can find that could change my opinion or advice.

[Used71]

Hey doc I know you ended this thread but I have one last question if you can help? I've read one a form by gracieHHH that the labcorp herpes specific test can't be used befor 16 weeks. Is that true? That's where I got my test through

[H. Hunter Handsfield, M.D.]

I'm sure Grace didn't say that; or if she did, it was in response to a specific question and you have taken her reply out of context.  See paragraph 2 of my reply yesterday.

In any case, you obviously are laser-beam focused on the test result, as if that's where the answer lies.  It is not.  My judgment that you don't have herpes is based on the totality of evidence -- exposure history and symptoms, in addition to blood test.  I am so certain you don't have herpes that if your HSV-2 test someday is positive, it will NOT explain your symptoms.  It would only mean you have asymptomatic herpes plus another cause of the tingling etc.

Please accept the scientific evidence and the reasoned reassurance I have tried to give. I'm attempting to reassure you with the good news that you don't have herpes, yet you're fighting it -- almost as if you hope to prove me wrong, that you really are infected.  You are not, and you'll just have to accept that fact and live with it.

This thread is definitely over.  This isn't a debate and I'm not going to discuss it further.

[Used71]

I am not trying to prove you wrong Doc. You have a great amount of years of experience and I'm not going against your word. I'm just OCDing out the tingle in my thighs. I thank you for all the information.

[H. Hunter Handsfield, M.D.]

I was being rhetorical; I know you don't literally want to prove me wrong.  But the fact remains that your need for an answer about your symptoms is probably (subconsiously) hoping for a definitive answer, even if it's the "wrong" one.

Just know this:  nobody with symptoms like yours ever turned out to have herpes (or if they did, it was just a coincidence, not the cause of the symptoms); and nobody ever turned out to have anything serious, or anything that would ever harm them or a sex partner.  Try to accept these realities.  When you are able to do so, my prediction is that your genital itching will fade rapidly.