Herpes or Yeast Infection (or something else?)

i went to the doctor a few weeks ago, complaining of pain/itchiness/red spots on the head of my penis.  i originally thought it was a yeast infection but i am circumcised and the doctor said it was more likely herpes, and that there wasn't much to do other than wait it out.

it has not gone away.  in fact, it seems to be getting a little worse.  the affected part is almost completely in the area where the head meets the shaft of the penis.  it looks very red, maybe a little swollen, and can be itchy or painful.  sometimes the same area is unusually moist and covered with a whitish substance, which i've never experienced before.  and it can get irritated in the shower and is quite painful after masturbation-- it feels like rug burn and looks even redder and more inflamed.

before the diagnosis, i used otc yeast infection cream for 7 days and it seemed to respond somewhat, but definitely did not cure the problem.

i have scheduled another doctor's appointment for next week but i'd like any advice i can get, as this problem is (obviously) really impacting my quality of life.

thank you

[H. Hunter Handsfield, M.D.]

First, consider a different doctor for this problem.  Any HCP who believes there isn't much to do about herpes except "wait it out" clearly doens't know much about the disease.  If s/he really thought it was herpes, you should have been tested and probably treated for it; a rapid response to one of the antiherpes drug would have helped with the diagnosis.

That said, it probably isn't herpes, which would not persist more or less unchanged for a few weeks.  Infection with yeast or another fungus sounds possible, but also atypical.  I'm wondering about a "fixed drug eruption".  Are you taking any other medications?  FDE is a very localized rash due to drug allergy and the genitals are a common site. FDEs often look like a burn and sometimes peel like a burn would.  Atypical syphilis?? (Depends on your sexual risks).  Atypical psoriasis? Many other possibilities.

All this is speculative, and herpes remains possible if unlikely.  Follow through with your plan to see a health care provider, but rather than your (family medicine?) doc, consider asking for a referral to a dermatologist.  Or go to your local health department STD clinic.  Wherever you go, make sure you have a blood test for HSV-2 infection.  See numerous other posts and the FAQs about the proper herpes blood tests.

Good luck--  HHH, MD