STDs Expert Forum
Herpes recurring?
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Herpes recurring?

10 months post my last "outbreak," I again have sores on my penis.  As on other occasions, these sores follow vigorous masturbation; indeed, red patches on my glans (glands) started as I was masturbating, and certainly were there after ejaculation (I am uncircumcised).  This was Friday evening.  

I ignored the patches of redness as it is not entirely unusual, but by Saturday pm I was feeling a  bit itchy and tender.  The redness had become bumpy, and, on close examination with a flashlight, revealed what well could have been blisters.  As I stretched my skin, two sores bled.

Sunday: the bumps in middle of glans (glands) and on both sides have slightly yellowy discharge.

I have had a battery of tests for herpes over the last two years: capita, herpeselect, Western Blot; two cultures taken within 48 hours (though the poor fast cultures done by Kaiserpermanente): all negative.

What are the chances that this is herpes (most likely hsv1) being missed by the test? Or is it just a vulnerability I now have—some kind of balanitis? It’s hard for me not to believe it’s herpes.
239123_tn?1267651214
Welcome back to the forum.

Nine months ago, we discussed the strong evidence that you didn't have genital herpes.  This sounds like the same thing -- and it still doesn't sound at all like herpes.  There is simply no way that herpes can be triggered by masturbation; and the occurrence of redness after such manipulation could result from herpes.

I don't get why it is "hard for [you] not to believe it’s herpes".  Once again it seems more like balanitis, whether bacterial, fungal, or "nonspecific" -- which is more likely to both behave in the way you describe and to look like your description than herpes does, especially if due to HSV-1.  Do not get hung up on the occasional failure of HSV-1 blood tests to be positive in infected people.  That would be rare in someone with the prominent symptoms you describe, if they indeed were due to HSV-1.  But this is so unlike herpes anyway that if someday you develop a positive blood test for HSV-1, I would still conclude herpes isn't the cause of your apparent balanitis.

So once again I suggest you see a doctoror clinic before it has a chance to heal on its own, for diagnosis and treatment advice.  On the assumption it's balanitis, I would ask whether you are pursuing normal penile hygiene.  Uncircumcised men should retract the foreskin and wash with soap and water at least once daily. Doing that would prevent most balanitis from recurring.

Finally, I assume syphilis was laid to rest.  I trust you had another blood test as discussed last June, and that it was negative.  

Regards--  HHH, MD
4 Comments
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239123_tn?1267651214
That should be "the occurrence of redness after such manipulation could NOT result from herpes".  Sorry for the typo.
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Avatar_m_tn
Thank you, doctor.

The sores took 4-5 days to heal, red patches gradually turning to three small red dots which appeared to have white on them.

I was hoping you could answer this question:

In generally accepted triggers (eg in oral herpes ultraviolet light or facial surgery), what kind of timing exists between trigger and outbreak? Are we talking of a minimum delay time--eg hours, one day--or can initial signs of outbreak start to appear almost simultaneously?

Thank you.

  
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239123_tn?1267651214
I'm not sure whether this question has ever been systematically studied; if so, I don't know what the data showed.  My impression is that 1-3 days is the usual norm for oral herpes (HSV-1) triggers.  Simultaneous or same-day onset is biologically implausible.  No triggers at all have been clearly defined for genital HSV-2.

That will wind up this thread.  You can go forward with confidence you don't have genital herpes.
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