Herpes?

[stressball123]

Doc, on Nov 15th I met with a sex worker for an erotic massage.  In the shower, she gave me oral for about 5-7 seconds before I asked her to stop... I then washed myself.  At another point, on the bed, I let her suck my testicles for about 20 seconds before asking her to stop.  The rest was just touching and feeling.  When I got home, I showered and even put rubbing alcohol on my genitals to clean myself.
I have started to feel a slight burning sensation on my left testicle and it's been there for a few days now.  Tonight, I was looking at my testicles under a direct light and I've noticed a very small red mark that looks like a soar isolated to a hair folicule...  I am worried it might be herpes or something else.
Please let me know what you think...

[Edward W Hook, MD]

Glad I could be helpful.  EWH

[stressball123]

Thanks Doc. You do some amazing work, as you must know. It is really appreciated and makes a difference on many levels. You have helped me and I am in your debt.
Thanks

[Edward W Hook, MD]

If the burning is not better in a week or so, I'd seek the advice of a health professional.  

As for your other question, there have been studies evaluating application of hand sanitizer for HIV prevention – not a good thing to do.   The results were discouraging in that persons who used the sanitizer actually had increased rates of infection.   The explanation may be that soaps and alcohol containing cleansers tend to dry skin, leading to cracks and fissures which may lead to increased risk for infection.

Hope this helps.  EWH

[stressball123]

Thanks very much for the prompt reply. I will try to put this out of my mind and hope the burning sensation subsides. Can you suggest a period of time I should wait before seeing a health care provider if the burning and soar don't resolve themselves?  Additionally, I do have a question I meant to ask in my original post. Has there been any research, or can you provide your thoughts on the use of things like soap, hand sanitizer or rubbing alcohol on areas immediately after contact? I am wondering if these things would be at all effective in lowering the risk if used following exposure. I guess the ultimate question here is, is infection immediate or does the virus sit in your skin for a period of time before truly infecting and can a person kill the virus before it infects?

[Edward W Hook, MD]

This was a very low risk exposure, both because it was brief and because transmission of HSV in this way is uncommon.  If you already have HSV-1 (cold sores) as do over 60% of adults, you could not get an HSV-1 infection form her through oral contact.  If you do not already have HSV-1, transmission remains unlikely.  

Further, for you to have sensations without lesions is not at all suggestive of HSV either and the sore you describe in association with a hair follicle sounds like folliculitis, not herpes.  Herpes lesions tend to be more obvious and multiple.  

I would not worry about this exposure or your risk for HSV or any other STD from this exposure.  EWH