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vaginal shingles outbreak

I am a 25 year old female. I have been having an outbreak on my forehead and scalp almost every year since I was about 12 of what was initially diagnosed as impetigo and later as shingles. Every time I have an outbreak I take valtrex and use zovirax cream and it clears right up. It isn't as painful as most people's so I considered myself lucky. My mother has recurring shingles as well. Also, I am a lesbian. I have NEVER had sex or oral sex with a male. I have been in a monogamous relationship for the past two years and we do not share sex toys or have genital to genital contact. Also, I have not had any sexual contact in that area for over a month. Last week I got shingles on my head again and treated it with zovirax and began taking valtrex on monday. I also came down with a cold. That night I started have pain and irritation in my vaginal area. by morning there were red blisters (which I know from experience looked like shingles) so I immediately went to the doctor. had low fever at doc.
The doc looked and said it looked like herpes simplex. Blood test said wbc indicated viral infectin. After I told him about my sexuality and my recurring shingles he deduced it was herpes zoster. He prescribed a z-pack for my cold, gave me a steroid shot, and valtrex for my "minor" outbreak. it didn't hurt at the time and was the least of problems b/c my cold was horrible and fever had spiked to 102. Over the past two days the cold is better but the pain and the outbreak have gotten 1000000 times worse. There are HUGE blisters along one side of the vulva causing swelling and SEVERE pain. some are black now with scabs. others look like blood blisters and new ones are still popping up and i have been taking valtrex for 4 days.
What should I do? Is there something I can take for the pain? Could this be something else? I know herpes zoster usually settles in one nerve and since it has been on my head for so long I cant figure out why it went down there THIS time? 15 yrs later. help!
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the STD forum.

Most likely you have two entirely unrelated problems here.  The facial/head problem probably is herpes simplex (HSV-1), not shingles (herpes zoster).  Shingles rarely if ever recurs with the frequency you describe.  If your recurrent rash is due to any kind of herpes -- and I believe that it is -- more likely it is herpes simplex, i.e. an HSV-1 infection.  The vast majority of HSV-1 infections of the facial area are non-sexually acquired.  Therefore, your sexual orientation and the lack of sexual experiences with men is entirely irrelevant.  Most likely you acquired this by a nonsexual route, as is usual for HSV-1.

The genital problem may or may not be herpes.  Other medical conditions can cause genital ulcers, although herpes certainly is a possibility.  If it is herpes, most likely it will turn out to be genital herpes due to HSV-2.  That problem certainly can and does occur through sexual transmission between female sex partners.  But whether any sort of herpes is the cause of the genital problem, I cannot say.

If you haven't done so, I suggest you ask your primary care doctor to refer you to a dermatologist or infectious diseases specialist.  You should have a blood test, which can accurately determine whether you are infected with HSV-1, HSV-2, or both.  A separate blood test can also tell whether you have been infected with the varicella (herpes) zoster virus -- but that isn't very helpful, because the same virus causes chickenpox and most people have positive blood test results.  In addition, the next time you have an outbreak either involving the face or genital area, the lesions could be tested for all 3 of these viruses.  That has to be done very promptly, preferably within 1-2 days of onset -- but it has the potential to give exact information about the cause of each problem.  A dermatologist or ID specialist will know how to go about it.

I hope this helps.  Best wishes--  HHH, MD

Helpful - 1
239123 tn?1267647614
MEDICAL PROFESSIONAL
HSV-1 is not primarily an STD.  Oral/facial HSV-1 is usually acquired in childhood, often from other kids -- althought the exact source rarely is known.

I won't second guess your mother's diagnosis.  But I stand by my statement that recurrent shingles is rare and would ask whether any of her outbreaks were tested for HSV.

Genital HSV-2 can be mild (even asymptomatic) or very painful; no reliable education source would ever say that painful outbreaks are rare.  Anyway, I don't know that you have genital area herpes.  There are other viral infections, and other kinds of skin rash, that can cause painful blister-like rashes, both genital and nongenital.

I cannot judge whether your rashes are too far into healing for accurate diagnosis.  Whether or not they are, it will be interesting to hear your dermatologist's opinion and advice; please share it.  Also please talk with him or her about what I have said about recurrent shingles, herpes, and your mom's diagnosis.  Most likely s/he will agree with most or all I have said.  (Consider printing out this thread and taking it along.)
Helpful - 0
Avatar universal
If you think the stuff on my forehead is HSV-1 then how did I contract it at age 10?

My mother has had recurring shingles for 20 years on her back and around her side. So, while I know it is rare, I know that shingles do recur in some people.

As for the genital blisters, as I noted, I have not had ANY sexual contact (with my partner or anyone else) in over a month. And my partner and I do not share toys nor do we have genital to genital contact and we have been together for 2 years. Also, it is my understanding that hsv-2 is not very painful. The blisters I have are hands down the worst pain I have ever had in my life.

With that said, what else could this be?  If I schedule an appointment with the dermatologist tomorrow will it be too late to get the results? The outbreak on my head is cleared up. And the vaginal outbreak has been in full force for 4 days.
Helpful - 0

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