strong burning sensation

[robford3]

I had protected sex 11 days ago with a woman I didn't know.  After 10 days I began to feel a strong burning sensation in my penis, scrotum, inner thighs and anus.  This burning sensation continues and lasts all day long and feels like someone applied icyhot on the area.  A few times a day I also have sharp shots of pain in my penis and some that run from my pelvic area to my leg.  Currently I have no visual symptoms of herpes, nor do I have burning during urination.  Blood tests and urine tests 7 days after the incident came back normal.  

I read that such symptoms may be a prelude to an initial outbreak.  Are these herpes symptoms? When will I know if I have herpes if doctors can't do anything if there are no visible sores?  If sores do develop, when generally do they appear?  

[H. Hunter Handsfield, M.D.]

There is no such thing as herpes lesions so subtle you have to work hard to see them.  And your description doesn't sound like herpes, only like a pretty good description of normal skin.  A sore is a sore, just as apparent as a cut following a knife wound or a blister after excessive friction.  But show the area to a health care provider if you remain uncertain or concerned.

And sorry to disappoint you, but there is nothing you can do to "boost the immune system" -- and if there were, likely it would make no difference in your symptoms or your susceptibility to herpes.  Of course it can't hurt to do common sense things, like a balanced diet, a decent night's sleep, and some exercise.  

[robford3]

First, thanks very much for your reply. As to your question, my doctor took blood and urine work for a 'base' number 7 days after the incident.  He wanted to make sure I was healthy and to compare the data to blood work that will be done in mid-March.  

Your clarification on my strong burning sensation was very helpful.  I feared it was a prelude to the visual symptoms.  However, because the burning feels so 'real' my concern is now that I have visual symptoms but I am not identifying them as such. For example, I have white bumps on my scrotum and penis.  Admittedly these could have always been there.  Many appear to be foundations for hair follicles, but some have no hair attached to it.  They look potentially menacing but do not hurt to the touch.  So how do I know if a sore is a sore?  Also, is there a magic number in terms of days after potential exposure that visual symptoms - sores, blisters, puss, burning during urination - most often appear?  Could symptoms begin 30-60 days after exposure, or are you generally in the clear after 14?  

Lastly, do you recommend I do everything I can to boost my immune system to fight off any potential harmful viruses?  I would like to go out with friends to get my mind off this, but I would get extra sleep, stay away from stressful assignments at work and refrain from drinking and smoking if this would improve the likelihood of my body fighting off any painful symptoms.  

[H. Hunter Handsfield, M.D.]

I will try to help.  The bottom line is that I doubt you have herpes or any other STD.  First, since the exposure was condom protected, you can be pretty sure you didn't acquire any STD.  Second, and more to the point, you read wrong.  Burning is a symptom of herpes only because herpes causes sores that are acutely painful, tender, and, well, burning.  A burning sensation in the skin, without blisters or sores, does not suggest herpes.  I'm not sure what's going on here, but sensations like this -- unexplained burning, tingling, itching (without rash), or similar sensations of the genitals -- are among the most common symptoms that people ask about on this forum.  All I can say is that no STD causes such symptoms.  In many people, it's a symptom of anxiety or other emotional origin -- but that's something of a cop-out when doctors can't figure out another explanation.

Presumably you saw a health care provider when you were had the blood and urine tests a week later.  What did s/he say about your symptoms?  (The urine tests, which were to check for gonorrhea and chlamydia, are reliable at 7 days.  But no blood test for any STD can become positive in only a week.  Had a blood test been positive, it would have indicated an infection -- e.g., syphilis, herpes, or HIV) that you caught at least 3-4 weeks earlier.

Whatever is going on, it pretty surely isn't an STD and it probably has no connection with your sexual adventure 11 days ago.  If the symptom continues, of course return to your health care provider for further evaluation.  But I see no serious concerns about herpes or any other STD.

Best wishes-- HHH, MD