Worried

[Cookie995]

Hey Dr. I'm going to be as thorough as possible so you can give me a well informed opinion. Ok so first of all I have only been with one girl, my girlfriend of over a year now. She said she has only had sex about 8 times prior with 3 guys and that protection was used each time. Anyways this past October I had a couple bumps in the hair region of my groin with a swollen lymph node. The first doctor to examine it suspected herpes but couldn't do a blood test. I went to another doctor who said it looked more like infected hair follicle and the resultant blood test was negative. 6 months later I have localized bumps in the hair area again with swollen lymph node. They aren't painful and there is nothing on the shaft. They scabbed and crusted over and neospirin might have helped but I can't tell. Another important fact is that my girlfriend says she has never had a single symptom of any STD as she shaves regularly so she inspects it often. She is confident she doesn't have anything and to prove it got tested on Tuesday. If all her tests come back negative can I finally put my mind to ease? Would she still test positive for herpes if she had it but didnt show any symptoms? I have just heard so many discrepancies about herpes tests and how reliable they are. I have been worrying that the blood test I got could have been for  IgM and could have showed a false negative. If all her tests come back negative what could these recurring bumps be? Oh the doctor that tested me in October said that everyone has low levels of the virus in their system and that my values were indicative of this. Is this information accurate? Thanks

[Edward W Hook, MD]

It sounds to me as though your real concern is about these bumps. My guess is that they are a problem called folliculitis.  Folliculitis occurs when the pores 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.  That something causing the swollen node could be folliculitis, an STD, or even athlete's foot).  In some instances, if you look closely you can see a hair coming out of, or nearby the bump- this too is typical of folliculitis).

What you describe really does not sound like herpes.  

Could you clarify the situation with your blood test please?  Did you get tested or not?  If so, with what test and what was the result?  I will comment more if you can clarify this.

Thanks.  EWH

[Cookie995]

Yes I did get tested back in october and the doctor said it was negative. I'm not sure which blood test they used because I didnt know there were multiple ones and that one is unreliable. This is why I didnt ask for copies either. Is it common to get herpes only in the hair area or common for a parntner to have it and transmit it and never show symptoms. I know its possible just wanted to know if its common. But yeah if you could comment on some of my other questions in the previous post I would greatly appreciate it. Thanks doc

[Edward W Hook, MD]

thanks for the additional information.  

No, herpes is quite uncommon in the pubic hair, folliculitis is common.

A negative test for herpes at the time you got tested means that you did not have herpes.  The problems with blood tests are with IgM tests (which are meaningless) and tests that are not-type specific and therefore do not tell HSV-1 from HSV-2 well.  If your test was negative, you did not have herpes.  If your GF's test is negative, you are not at risk.  

Finally, it is not the case that "everyone" has low levels of virus in their system.  Many (over 60%) persons have HSV-1 but that is not everyone.  Hope this helps.  EWH

[Cookie995]

thanks for the info doc. I dont wanna take up much more of your time but answering a few more questions would help. Are you saying that even though my gf has no symptoms of herpes that the blood test she took is still valid and should come back positive if she has it? Also if the clinic that tested me did an IgM test (I don't know which test they did) would that mean that my negative result meant nothing and could actually be positive? One last question, is it normal for folliculitis to recur in similar areas like this? Thanks a lot

[Edward W Hook, MD]

Many people with herpes do not have symptoms.  If the blood test is clearly positive, it means she has herpes, whether she has noted symptoms or not.

The IgM tests are of no use to me.  I would not bet on the meaning of any IgM test result.

Yes, folliculitis can recur where it has been before.  EWH

[Cookie995]

ok so all my gf's test results came back negative and the clinic that she got it is the same one I used to get tested before. She asked them and they said the only tests they are able to perform are ones that aren't type specific. However if the tests came back negative, wouldn't that mean there is no need for concern because she wouldn't have type 1 or 2?

[Edward W Hook, MD]

You are correct.  The non-specific tests do not differentiate one type of herpes from another but they do detect herpes reliably.  Her test results indicate that she does not have herpes, thus you have not been exposed.  End of story.  EWH