Folliculitis or Herpes?

[kram17]

This past Saturday I swam in a lake for an hour and sat in my wet bathing suit until the evening. Throughout the afternoon/evening, I was itching all over my body and scratching in my pubic region. That night I had vigourous sex with and without a condom. My pubic region became very sweaty. I still felt itchy and sore from scratching earlier. That night I was sweating profusely. The next day I felt really sore from the scratching/sex. My pubic area/base of shaft was irritated and red. Monday morning, I noticed that I had what looked like red pimples with white heads towards the top of my pubic region. Each white head had its own red base as if it was a pimple on the face. There were also red pimple like dots in scattered in the hair and there were a few red pimple like dots on the bottom of the shaft. It was itching me and still sore. I got scared and went to see a urologist that afternoon. He told me that he thinks it is probably Folliculitis from being overly sweaty and scratching so much. He said he did not think it looked like Herpes, but said I should get a blood test in case. He also prescribed me Keflex and Valtrex (in case). I am waiting on the results of my blood test. I applied a hydrocortisone twice yesterday and have been taking the antibiotics regularly since yesterday. I have not scratched it nor have I popped any of the white heads. Most of the red pimples have white/yellowish heads at this point. They look like pimples that can easily be popped. There are a few pimples on each side of my body towards that top of the pubic region (close to the underwear lining), there are scattered small red dots in the pubic hair and a few red pimples around and on the bottom of the shaft (a few have white heads). It has been still a little itchy/sensitive and sore in that area. The sensitivity has gotten a little better since yesterday, however. I am wondering if this is just a bad case of folliculitis or if it may be herpes? Also, what can I do to clear this away?

[MNMan]

A related discussion, Same sort of circumstances was started.

[Edward W Hook, MD]

the additional detail you have provided does not change my answer.  There is nothing here to suggest you have herpes.  EWH
p.s.  the blood tests you had will not tell you if this is herpes - they will tell you if you got the infection some time in the past.  You need a culture which will be negative since this is not herpes.  EWH

[kram17]

Thanks for the response. I have the pimples in both the pubic area and base of penis as well as one on the shaft towards the bottom. I was scratching and itching Saturday night after the boat. The sex was Sunday around 4am and I noticed this Monday around 9am. Is it supposed to sting and burn like it has been? I had bloodwork done which I get results on Thursday. Could it possibly be Herpes or it does not meet the pattern?

Thanks.

[Edward W Hook, MD]

This is not herpes.  It is occurring in the wrong location (the pubic area as opposed to the penis); it occurred the day after sex (far too soon) and has the wrong appearance.   What you describe is a classical case of "swimmer's itch" a folliculitis which follows swimming in warm(ish) fresh water.  It is caused by microbes which tend to be found in the feces of ducks and other water fowl.  The topical hydrocortisone is a good idea.  The antibiotics may or may not help but I can promise you the valacyclovir is not doing much.  It will pass.  Hope his helps.  EWH