burning and itching on scrotum

[xmj]

I have been treated for prostatitus for about 10 yrs off and on. It has been 3 years since i have had enough symptoms to see doc. about 5 weeks ago I started getting intense itching and discomfort from scrotum to groin area. I had trouble urinating in the week previous because i was taking decongestants for head congestion. I have since stopped and realized I can't do those any more. Seems the effect my prostate. Anyways about a week after this started my doc put me on a anitbiotic and i have now been on them for 4 weeks. over this period the symptoms have increased and decreased from itching to discomfort (especially sitting) to intense burning (like a sunburn scrotum and groin). I have been sexually active of late but always use condoms, although i know herpes can still be transmitted. I check my scrotum out closely and don't see any blisters or sores. I do see a lot of redness and the hair folicels seem rather big.  I was tested for herpes about 3 weeks after symptoms started and + for herpes 1 and neg for herpes 2. Although my symptoms as i seem to remember are like when i was diag with prostatitus, I am concerned that it could be more.  My doc says when I asked lets treat what we know.  The burning is gone, but redness on scrotum and itching still present although not as intense. I have found two pimple like places on srotum but only a hard white substance comes out, like a whitehead.  
Should I be concerned or see doc again and ask what else this might be?

xmj

[H. Hunter Handsfield, M.D.]

You don't provide enough information for me to judge your STD risk--age? multiple partners? sex of partners?  Not many STDs affect the scrotum; STDs that affect skin are much more common on the penis and in the pubic area.  Expression of a hard white core suggests sebaceous cysts, blackheads, or folliculities, all of which which are common on the scrotum; none are serious.  You almost certainly do not have herpes, based on all of the above plus the blood test results.  If you are at risk for HIV, I would be concerned about almost any skin rash; immune deficiency often first shows up with various skin problems.

I am not especially concerned about your symptoms, but the standard advice applies:  see a health care provider if they worsen or if they continue for another week or two.

Best wishes--  HHH, MD