Questions about bumps

[anon1234789]

Hello Doctors -

A couple weeks ago, I had protected sex with a girl I met at a bar. She had what appeared to be some ingrown hairs in the area she shaved. 3 days later, I noticed three bumps spaced through my pubic area. They were left, right, and center along the belt line at least 6 inches apart. They were whiteheaded and the skin was taut. At least 2 out of the three had a hair coming out of the center, and the third may have. One of them had two hairs coming out of the same follicle. I should probably note that I do not shave.

I popped them. They were all filled with pus and possibly a small amount of blood, as a normal zit might be. All three have them have since refilled with pus, one at about 12 hours after being popped, one a few days after, and the last one almost exactly a week later. Sometime within that week period, a 4th "zit" appeared (approximately an inch away from one of the previous zits), also with two hairs coming out of the center.

Having read through a fair amount of these forums. I know that folliculitis is more likely. I know it's unlikely to have an initial herpes outbreak in the hair bearing area (though in this case, there was potentially enough friction in that area to at least make it possible.)

This leads me (finally) to my questions:

1) All things considered, does this present enough risk of herpes that I should abstain from sexual contact for the next 10ish weeks until seroconversion? I was not worried about these bumps when they appeared, and I missed the window for a swab.

2) Is there any data on how accurate the type specific tests are at 6/8/10 weeks?

Thanks for your time, and apologies for the length of the post.

[H. Hunter Handsfield, M.D.]

Thanks for your question.

Your description of the genital area skin problem in your partner doesn't sound like herpes.  And neither does yours.  Herpes does not cause lesions with pus and blood.  Think of herpes lesions as being very superficial, i.e. "on" the surface of the skin.  In contrast, pimples and folluculitis are "in" the skin; they start deep and well up.  And overt pus (thick, yellow), with blood, are not herpes signs. It is conceivable your partner had lesions due to strep or staph, and you were infected with those bacteria. But it is more likely you just have folliculitis or pimples on your own, i.e. that your symptoms have nothing to do with this sexual exposure.

To your specific questions:

1) "All things considered", I am very confident your symptoms were not due to herpes and I see no reason for you to not continue your normal sexual practices with your main partner.  If somehow I had been in your situation, I would not have been tested for HSV and I would never have stopped having sex at home.  I recommend against any testing for HSV.

2) Yes, data are available.  The HSV blood tests detect somewhere around 70-80% reliable by 6-8 weeks and probably 80-90% at 10 weeks.

I hope this has helped.  Best wishes--  HHH, MD

[anon1234789]

Thanks Dr. Handsfield. I think this information will definitely be helpful should this situation arise again. In the present case, though, I'm struggling to remember if there actually was blood, or if the the bumps seemed deep or on top of the skin. There definitely was opaque yellow pus, but it doesn't sound like that alone would preclude herpes.