Herpes or folliculitis

After reading many Q & A's I have some additional questions.  First I have had unprotected sex with a woman who has gential (genital) herpes and has been on medication for it.  We did not have sex when she had any flare-ups.  I have a new girlfriend and we have had unprotected sex.  After the first time, we did did not sleep together for a few weeks. On that second occasion she bled a bit after and she has subsequently as well - she has gone to her Gyn for tests.  The gyn said her cervix was a little friable.  Could she have a friable cervix from having a lot of sex - probably not your specialty but I'll through that out there. I have recently noticed a small red bump on the shaft of my penis towards the pubic area. It is red, shiny, and had a hair in the middle which I plucked. It does not look like a water blister but it is shiny - I think much of the skin in this area appears shiny when stretched. You can still see where the folloicle was and it does look a bit like a volcano. The imflamed portion is not perfectly round - if the hair was still in the bump the inflamed portion lookes like it did not inflame as much on the side where the hair was growing (meaning the direction the hair was lying/growing.  I have had this bump about a week with not much change.  There are a few other bumps but none like this one.  I did pluck a few other hairs in the general vicinity and they have produced bumps but not as large. Is it common to just have one hair follicle inflamed like this.  We did have vigorous sex and there would have been a lot of friction in this area.  I have never had any symptoms of herpes.  I am also worried that I may have infected my girlfriend - she has no symtoms (symptoms) of herpes but just bled a bit after sex.  I am concerned because herpes can be so asymtomatic.  Also, if it was folliculitis does that generally come back to the same areas - would the same follicle tend to get inflamed more than once. Thanks and I have scheduled an appointment with my doc.

[Kevin Pho, MD]

Hello - thanks for asking your question.

Please understand my limitations over the internet as I have neither met nor examined you. It is also impossible to diagnose without seeing the lesion myself.  This information is for patient education only. Please see your personal physician for further evaluation.

Followup with your personal physician is essential.

Folliculitis is a possibility.  The lesions of folliculitis are often multiple and measure 5 mm or less in diameter. They are erythematous (inflamed) and may have a central pustule at the peak of the raised lesion. Lesions usually cluster in groups and often are itchy.

There are many causes of folliculitis, including bacterial, fungal, viral (i.e herpes or molluscum), or syphillis (syphilis).  The treatment would depend on the cause (i.e. antibiotics vs antivirals vs antifungals).  It is possible that areas of foliculitis (folliculitis) are more prone to future infections.  

Another consideration may be molluscum.  Molluscum causes a chronic localized infection characterized by firm, dome shaped papules with an umbilicated center. The lesions may appear anywhere on the body except the palms and soles. They are single or multiple 2 to 5 mm papules with a shiny surface and a central indentation or umbilication.  Skin lesions due to cryptococcosis or histoplasmosis may clinically resemble molluscum lesions.

The infection is usually self-limited and spontaneously resolves after a few months in immunocompetent patients.

You may also want to consider genital warts.  Lesions are flesh- to gray-colored and have either a smooth or jagged surface and may vary in size from less than a millimeter in diameter to several centimeters when lesions coalesce.

Without seeing the lesion, I cannot be sure what it is.  

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

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