std testing question

[inz421]

A little bit of background information: I've only ever had 2 male sexual partners (I'm a female) and they were both one night stands in a very similar time period--we are all college age (this was in the early fall).  I didn't have any signs of discomfort for a few weeks after the encounter except for anal irritation.  I had 2 small bumps in the genital region where my legs rub together on either side that were red but they did not have any fluid (I was told these 2 small bumps could be the result from wearing tight jeans or that they could be the result of my method of hair removal).  A month later I was diagnosed with hemmerhoids and fissures so they were the culprit of the discomfort.  While I had this embarrassing anal discomfort, I used an epilatee (a hair remover machine) all in the bikini and around the genitals.  My dr gave me a hydrocortisone cream to help with the itch and after using that i got blisters/bumps all in the genital region and then very painful bumps in the bikini area.  I thought this was herpes but my gyno told me that it was a severe case of folliculitis and prescribed me with mupirocin.  After using the medication, all of my bumps/discomfort went away and I felt fine.  2 weeks later my lymph nodes on my left side of the bikini area started to swell and it turns out that was a reaction to the bacterial infection I had. Since then, I have had one or 2 pimples in the genital region (always one isolated pimple).  Two nurses specialized in ob/gyn told me that I shouldn't worry about herpes and don't need to keep checking for abnormal bumps.  They also said that I should not get a blood test because I have never had herpes symptoms and because of the possible 5-8% chance of getting a positive IgG blood result. In my case, do you think I need a blood test? I am struggling with what to do because I have been diagnosed with OCD and thinking that I have herpes when I don't is a way that my OCD manifests. Am I being careless to not get tested?

[Edward W Hook, MD]

I would urge you to move to closure. There is no evidence that you have herpes and the chances to do are miniscule. It is time to move forward.

I certainly see no benefit to be gained from a blood test at this time.  EWH

[inz421]

Again, thank you very much for your response--I did not know that there was an option to get a swab test when the sore was closed.  However, what I meant to ask was that because, as you said, since it seems so unlikely that I have herpes, the likelihood of getting a herpes outbreak now (3-4 months after last possible exposure) would also be slim to none and therefore would you advise that I should definitely not be on the look out for herpes? Since the blood test cannot provide closure with this issue, I am trying to come to terms to rationalizing my own closure.

[Edward W Hook, MD]

Hair removal is just one cause of folliculitits.  If the bump is white or pus-filled, it is most likely that.  On the other hand if it has fluid in it herpes is a possiblity. If you desire testing you should see a health care professional as quickly as is reasonable and get a PCR or culture test for HSV.  Though some doctors are not aware, either of these tests can be done on bumps an do not require that there be an open sore or fluid to be taken.  PCR tests are about 3 times more sensitive than culture and increasingly available.  EWH

[inz421]

Thank you very much for your response.  It was very helpful.  One more quick question-- what should I do if I ever find a small bump in the genital region?  I have not been using hair removal anymore so if I were to get one it probably wouldn't be from hair removal.  Would the responsible thing be to get checked up?  Since my chances of herpes are basically slim to none, should I just assume that causes could be from friction of wearing tight pants or clogged pores?

[Edward W Hook, MD]

Welcome to our Forum.  I will try to help which, I believe will take the form of telling you what you already know, perhaps along with adding a few facts that you may not aware of.  All that I am about to write however can be summarized in a simple statement- It does not sound as though you have herpes and you do not need testing, nor should you continue to worry.

It sounds as though you have a tendency to develop folliculitis.  Folliculitis occurs when the pores an hair follicles in your skin get plugged.  This allows that normal bacteria that are present on just about every-one's skin to grow and cause what is essentially a pimple.  Some of these just appear as red bumps which may or may not be  tender while others go on to actually form pimples.  In either case, they can be accompanied by swelling of nearby lymph nodes (FYI, swollen lymph nodes are a totally non-specific indicator that your body is reacting to something.  In your case, the ways to avoid folliculitis will involve care with hair removal an washing with a wash cloth to keep your pores open.

The lesions you describe do not sound like HSV. Further, you have been examined by a clinician who not only felt that the lesions were not HSV but offered an alternate diagnosis (folliculitis).  Further, I also agree  with the nurses you spoke with- in your case, your risk of having a falsely positive IgG test for herpes is higher than your risk of having HSV.   Even if one of your partners did have HSV (and you have no reason to think they i), most exposures to sex partners with HSV do not lead to infection.

I hope you find my comments helpful.  Take care. EWH

[inz421]

sorry to add more but the only reason i mention the initial irritation is because i thought that was herpes and my dr said that was very unlikely...perhaps that is how i got the whole "herpes" idea stuck in my head.

thank you for any help.