Possible herpes symptoms

[SOXPERT]

Hello Dr.

Here is my situation.  I am 27 years old living , have been in a monogomous relationship for about 2.5 years with a male of similar age.  Anyway, for the past year we have been long distance, and in 2008 I had unprotected sex with a past partner around 6 times and 2 times with a new partner (once unprotected).  Last time I had sex was in September 2008.  Late August 2008 I had (what I thought was a yeast infection), very intense vulval itch with minimal internal discomfort.  My vulva was very red and inflammed in general, and looked irritated when I scratched.  After 2 or 3 days of discomfort, I applied some monistat external itch cream and it almost instantly got better, completely clearing in 2 days of application.  Fast forward to early January 2009, I noticed 2 bumps on my outer labia (hairy area).  I went to my gyno to have them examined, and she said it looked like ingrown hairs.  Later in January, I got another yeast infection, I took some diflucan which really helped, but I noticed two irritated cracks or tears on my vaginal opening close to my perenium, they stung a little when I wiped but nothing excrutiating.  After 2 days (and 4 days after my dose of diflucan) the cracks went away.

I still have those bumps my gyno thought were ingrown hairs (no change), and a single crack, identical to the ones mentioned before appeared again (2 days ago) painless this time, even through wiping, and went away.  Since I took the diflucan I have had what I can only describe as fleeting vaginal itching (literally lasts seconds) every couple of days.  I have also had pain in my legs/arms that started about 10 days ago (also fleeting) when I got a tetnus shot.  Does this sound at all like genital herpes to you?  I am asking because it has been a while since I had a new partner and I am slightly worried.

[Edward W Hook, MD]

Your symptoms are not particularly suggestive of herpes.  It is not too unusual for a person who has had several sex partners in the not too distant past to wonder if genital lesions are herpes and indeed herpes can commonly be misidentified as other problems.  Having said that, the problems you describe do not sound like herpes. here are some of the reasons:

1.  If you have never had herpes, a first episode of herpes would be expected to last 2-3 weeks and would not responded nearly so quickly to anti-fungal therapy as several of your episodes have.
2.  The bumps on your outer labia are unlikely to be herpes as they have lasted far too long.  Folliculitis (hair bumps) can last a while as can less common problems like molluscum contagiousum. Washing with gentle abrasion ( washcloth/loofah sponge) may accelerate their resolution.
3.  Fleeting pains like you describe - are not a symptom of HSV.

My suggestion.  Don't worry.  None of these findings are particularly suggestive of HSV.  Hope this helps.  EWH

[SOXPERT]

Thank Dr. I have my annual in a month, I'll ask her about.  Velvey is a good description of what I saw.  I will take your advice and not worry, because all in all, I feel fine.  Stressing about these things just makes me hypersensitive to every little change I notice, so I will try to stop that.  My primary care doctor did take a look when I first got the little cracks and saw everything, and said it just looked like irritation from the yeast infection.  I didn't go to my gyno about it, so I just wanted a second opinion.

Thanks again.

[Edward W Hook, MD]

Without the opportunity to examine you it is a bit difficult to say what is going on here.  Part of the skin around the vagina can look almost "velvety" and day to day differences in blood flow can make the appearance change subtley.  What you describe may well be normal and the variation you describe just newly noticed.  I woudl suggest you ask your doctor.  This is not a dodge, I just don't want to mislead you.  EWH

[Edward W Hook, MD]

Glad I could help.  Feel free to return to the site if there are more questions

EWH

[SOXPERT]

Ok, this pertains to my past question, but it was something I forgot.  When I first started experiencing yeast infection-like symptoms in January, I took a look down there with a mirror (magnified).  I noticed when I opened my vagina that I had a strip of skin on the bottom of the opening that looked like finely textured skin.  Not bumpy...no pain/ blistering/ulcer...They've been there the whole time I had the yeast infection until a couple of days ago, and now the same strip of skin looks smoother...does this information change your opinion at all?  Is there any reason why vaginal skin would appear textured like that?

[SOXPERT]

I appreciate your quick response, very reassuring!  It is unfortunate that HSV has such a strong social stigma...I was thinking about it last night (while I was anxiously awaiting your answer) and though it is a nuissance, I do believe that out of all the things that could go wrong with one's nether regions, HSV is probably one of the more harmless...now if we could only get rid of the stigma and put it into perspective...any how, I do suspect my scare will make me a lot more cautious going forward.

Thanks again for your help!