so confused

[worriedrlbd]

The problem on my genital area is that im not sure if its herpes or not, i've read a lot about herpes and i kind of think it is and then i kind of think its not. maybe you can help me. First off its only one sore, and its really big and you can feel the core of it so i thought it might be a boil. However, the other day i popped it and just lots of blood came out of it and thats it,a very small amount of clear fluid almost like a pimple but no puss. But it is still really hard, and i can still feel the core of it. It seems like in the past i have had the same problem and it was in the same place, but its only one big pimple looking thing. The look of it doesnt really look like herpes because there isnt a "fluid filled blister" on the top of it, but then again doesnt herpes occur in the same place over and over? I've been tested for herpes before, i had a lesion and i went to the doctor and they did a culture and it came back negative, but my blood test came back positive for HSV1, so could this boil like thing that i get every once in a while be herpes or just a boil? Does herpes always pretty much have the same characteristics, such as occurring in clusters, many fluid filled blisters, painful urination? Because i have none of that, just this stupid sore and this isnt the first time. please help

[H. Hunter Handsfield, M.D.]

You give a great description of a sebaceous cyst or similar problem, fairly deep in the skin, that periodically gets infected.  As you say, it is like a boil.  It doesn't sound like hperes.  If in doubt, see a dermatologist.  If the problem continues to recur, a minor surgical procedure to lance the cyst, or perhaps to remove it, should prevent further recurrences.  In any case,  I'm sure this has nothing at all to do with your positive HSV-1 blood test.  Your description of typical genital herpes is pretty good--and I agree it's nothing like the symptoms you describe.

Good luck--  HHH, MD

[worriedrlbd]

Just one more question, does herpes ALWAYS look like a fluid filled blister? Is there any way that if you dont have a blister on top with clear fluid in it that it could be herpes? And if you do pop a herpes blister what would happen? Because every time i pop it, just lots of blood keeps comming out and thats it, but theres no puss or cheesy like goo comming from it. Do herpes blisters secrete lots of blood when they are popped?

[H. Hunter Handsfield, M.D.]

Herpes never causes the amount of pus you imply in your original question and no, herpes lesions don't bleed.  Herpes lesions always are superficial.  Think of them as being "on" the skin, whereas pimples and infected cysts are "in" the skin, just like you describe.  Herpes lesions never have large amounts of pus, just (sometimes) a tiny drop.

HHH, MD