genital itching cannot explain

Dear Dr.,

I have been reading this forum for over 2 years now.  I need your advice and your help on this problem.

About 2 years ago I had a sexual encounter with a girl who gave me unprotected oral sex twice within 3 days of each other.  About a week later I had terrible itching in my genital area, especially the scrotum, in-between the thieghs and the scrotum(the flaps) and the bottom part of the shaft of my penis that lasted for about 3 weeks.  Within that span of time I saw 2 doctors (one a doctor and one a dermatologist) and a nurse who all told me it wasnt herpes and that it was skin irritation/jock itch.  I never took medication and it went away natually.  I also had a herpes antibody specific test after 4 weeks, which came back negative and also at 6 weeks which came back negative.

Thinking I was ok, this summer I had another enounter with a girl, having unprotected oral sex.  About a week later the same thing happened....I had a severe itch in my groin....she said she was clean and was tested a month later and everything came up negative.  I also went to see a doctor and he told me that if I had herpes there would be blisters and told me I did not have to get tested.  From what I read on websites all the time is that some people just get genital itching and thats it and that many people dont have any symptoms at all.

About 2 weeks ago the terrible itching returned. This was the 3rd time within 2 years.  I have never had a blister or a sore.  Just itching and many times tenderness.  It has since gone away after one week with no medication whatsoever.  I am willing to think it was jock itch, but I did nothing and it went away with no creams or anything.  This is leading me to believe I could be getting slight herpes outbreaks.....I have no idea.


Here are my questions
1.  Was my test after 6 weeks accurate at all?  Should I go back and get more testing?

2.  Is it true that people can JUST get genital itching during an outbreak?  My itching is almost always in-between my thighs and my scrotum, under my scrotum and sometimes on the bottom part of the shaft on my penis.

3.  Why is it that all the doctors I go to give me such different information than the information that is on the internet? The doctors always say if I dont have blisters I dont have it and dont get tested until I have symptoms.  I constantly read that many people do not get classic symptoms.....and only get mild ones.  Are these doctors wrong, or am I out of my mind?
This has ruined my sex life.  Help me please!

[H. Hunter Handsfield, M.D.]

Whatever the explanation for your symptoms, you can be sure it isn't herpes or any other STD.  Herpes simply doesn't cause the sort of itching you describe or a skin rash with the distribution you state (scrotum, groin, etc).  No STD causes such symptoms.  
Whether you actually have tinea cruris (jock itch) or not, I cannot say.  Your own docs' evaluations are more reliable than mine can be based on just your description.

1) You don't say what test was done.  I assume you mean an HSV blood test, which I would not have recommended anyway.  In any case, I see no need for further testing if the first result was negative.

2) Itching alone is rare as a symptom of herpes; and when it occurs, it is localized itching at the exact spot of the herpes recurrences, like a small (1 inch) patch on the penis, labia, or wherever.  The diffuse genital itching and rash you describe cannot be herpes.  In other words, even if your HSV-2 blood test had been positive, I would conclude you have asymptomatic genital herpes plus something else causing your symptoms.

3) There indeed is controversy about when and how to use HSV blood tests diagnostically; and frankly the quality of physician training and understanding about genital herpes is generally poor (of course with some notable exceptions).  Any time there is controversy combined with variable knowledge among health care providers, there is bound to be different advice from one doc to another.  That said, your docs are partly right:  Although asymptomatic herpes is common, when people do get symptoms, those symptoms generally are quite typical.  Yours are not.

"This has ruined my life??"  I say get a grip.  Even if you had genital herpes, that's not a condition that should ruin anybody's life.  And you don't.

Best wishes----  HHH, MD

[sparkeler]

Genital itching isn't a sign of herpes.  Sometimes reoccuring outbreaks can cause trivial symptoms, however there would have been a sore at least one time.  You can contract genital herpes 1 through oral, but it isn't that common.  I don't think your symptoms suggest herpes at all.   I'm sure the doctor will have some more insight.  Good luck!