STDs Expert Forum
Inital Herpes or something else?
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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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Inital Herpes or something else?

Hi, I'm a 38 year old male. I'm at 10 days post exposure to unprotected oral sex from a stripper. Am very concerned about STDs. First few days, felt some burning (like icyhot) on the head and shaft. Seemed to be hypersensitive to contact with underwear. had some loose bowels, no other symptoms. Day 6: Tried to relax, had a few drinks, masturbated. woke up the next day, no burning. Day 9: Felt irritation along rim of head (R. side) (I'm uncircumscised) It's red and feels diaper-rash-like. I've rubbed a couple creams on it (diaper rash/hand lotion) Looked closely at the head and found a bit of dry skin (scab?) I pulled it off. I also seem to have a bunch of tiny bumps on the head, but I'm not sure if they were there before or not. Are these symptoms consistent with an initial herpes outbreak? ANything else to be concerned about Thank you.
300980_tn?1194933000
Welcome to the Forum.  Without the opportunity to exam you myself I cannot determine what the "tiny bumps" you mention might be however they really do not sound like an initial outbreak.  Because of the varied ways that HSV can present, the only appropriate mechanism for proving or disproving infection would be to have a culture or, better yet, a PCR test performed on suspect areas.  If you do this, I doubt that you will find that you acquired HSV.

Overall the risk of acquiring any STD, including HSV from receipt of oral sex is low.  With respect to HSV, your risk is primarily for infection with HSV-1 and there is a more than 50% chance that you already have this infection, whether you know it or not.  If you do not, and if your partner did (you do not know this either) the likelihood of getting infected is estimated to be less than 1 in 10,000- something that I would not spend a lot of time worrying about.

I hope this comment is helpful.  EWH
8 Comments
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Avatar_m_tn
Thanks Doctor for the quick response. I feel that stress is really compounding the situation, and I'm holding off on sexual activity with my regular partner for fear of spreading something, stressing my relationship.
I noticed the bumps under bright light, which isn't really my normal venue for genital viewing.
I understand the culture/PCR is more accurate than a blood test. Can I get tested sooner with a culture/PCR?...(although I have no real sores to speak of.) When I pulled off that flake of skin, there wasn't really anything underneath it
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300980_tn?1194933000
A blood test has NO ROLE in evaluationg your concerns and will, if anything, mislead you.  PCR/culture can be done at this time, even if the absence of lesions.  Personally however, the more you describe the less I see ANY reason for worrying or abstaining from sex with yoru regualr partner.  Your guilt and related anxiety is driving this, not herpes or any meaningful risk of STD.  EWH
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Avatar_m_tn
Thanks Doctor. I found a pimply-looking bump on the tip near the irritated area, but I'm going to try and sit tight and see what happens with it. I'll try and relax.
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300980_tn?1194933000
Please do.  If it does nto blister, it is not your initial  HSV outbreak.  EWH
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Avatar_m_tn
So my "outbreak" symptoms were: 10 days post exposure, red irritation, some swelling along the ridge of the head. The next day there appeared to be a small bump which was joined by another, maybe a couple more. I would not say they were clustered. The bumps went down within a day, (or burst?) but I could still see where they had been. Felt feverish for about 6-7 hours that thurs. night, woke up in a sweat. Felt sort of feverish Fri night as well. Sunday I felt my jaw glands were swollen. Now I don't have what I would call scabbing, but the areas are too small to really be sure. For the next few days the area below the ridge appeared whitish in color, and some skin's coming off if I rub that area, which now seems to be itchy, along with my scrotum. I had spread neosporin around the area upon first noticing the bumps, which I have discontinued since.
Yesterday I noticed a red spot on the outside of my lip and have 3 small white bumps just inside my lip. (Only oral contact i had there was licking a finger that had touched the outside of her vagina.) That's all I have right now except for an irritated/slightly painful area at the very tip of my penis which has the feeling/look of a scald.
Haven't been home to see my regular doctor yet.
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300980_tn?1194933000
Nothing more to say.  You need to be seen by an experienced clinician who can provide an assessment.  EWH
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Avatar_m_tn
I'd like to update so others can read....I had a freak out where I thought I had autoinnoculated my eyes (burning/watery) and I thought I had infected my throat as well (saw a white bump at the back of my throat. Turns out I had conjunctivitis and my throat was swabbed (negative).... I blame the internet and overly inspecting myself for symptoms.

Otherwise my doctor wasn't that helpful, told me there was no blood test for detecting HSV, and the only way to tell was via swab test of a lesion. But also not to worry because I didn't have HSV anyway, & that I was self-diagnosing.

it's not that I may have something, it's the thought of passing it on that's reprehensible to me.

re: HSV-1, I've never had an oral outbreak that I know of. I do get single "bumps/blisters" in my mouth sometimes, but nothing on the outside, ever. Would there be value at this point to get an IgG test to get a baseline? Any new infection wouldn't be showing up yet, would it? (@6 weeks)

How effective are condoms in protecting my partner in lieu of antiviral therapy until I can make sure I'm not infected with HSV?

I also still have an area at the tip of my penis that becomes irritated when I masturbate.( I described it as a scald in an earlier post) I've had a assumed case of jock itch for the past month, which I've been treating with OTC meds for the past week with some limited success. Maybe the two are related.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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