Can this be herpes

[wishihadgame]

Three weeks ago I had unprotected sex, vaginal and oral with a girl I knew. The next day after showering I noticed a few nics on the right side of my penis below the head (I'm uncircumsized) from friction during sex. I checked the rest of my penis and didn't notice any other sores, three days later I noticed a 2mm sore on the left side of my penis, it was scabed over, I figured I caught my skin in my zipper as I was drinking the night before and I never noticed anything before, I had been examining the nics in my penis frequently (they had healed). I never really thought anything of it, I picked at it occasionally and it never healed, but it never hurt and I felt fine the whole time I was paying attention to it and saw nothing further develop and though nothing of it as I take a while to heal, a week later I was masturbating rather heavily and after I noticed a number of small blisters(7 in total), much smaller than the initial sore,around the initial sore travelling along the length of the penis, the blisters had a clear liquid in them. During the week after noticing the inital sore and the appearance of the additional little blisters I had been exercising quite regularly and sweating quite profusely as well as masturbating frequently. I'm treating the sores with .5% cortisone and it seems the be helping. I feel fine and I don't have any of the other symptoms of genital herpes, also only a couple of months prior to having sex with my friend I had an extensive physical including std tests wich came back negative, I do suffer form eczema and have sensitive and dry skin. I found a pic of genital herpes on the net and it looked similar however I've found a number of pics that look nothing like my sores. Is it possible that I just infected the area around the sore and that it could look like the pics of genital herpes, if this is herpes is this a typical evolution of the sores or should they all have appeared together?  Thank You

[Terri Warren, RN, Adult Nurse Practitioner]

I agree no cortisone, it can prolong an outbreak for quite a while, but neosporin is for bacteria, this is not a bacteria if it is herpes and secondary infection by a bacteria requiring treatment very very rarely happens.  I'm assuming that if he thinks its herpes, he is treating you with an oral antiviral prescription, right?  

Terri

[wishihadgame]

Thank you for your help.  Regardless of what the results are I'm pretty confidant that its herpes. One last question, the outbreak on the shaft of the penis seems to be growing larger daily wth new blister appearing around the initial outbreak.  Is there anything I can put on the sores to help promote healing?  The doctor saids not to use cortisone creams, rather polysporin, do you agree?

[Terri Warren, RN, Adult Nurse Practitioner]

I hope that the swab test that you had done was PCR, not a culture.  PCR is four times more sensitive than culture and is the test of choice for swabs now.  Given his lack of knowledge about the antibody test, it concerns me that he might still be using culture instead of PCR. If the result is positive, you can count on it (make sure it is typed, if positive - that is, type 1 or type2).  But if it is negative, you cannot fully rely on the result.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

He is absolutely mistaken.  Type specific antibody testing can be very helpful in diagnosing infection if you wait long enough after infection to take the test.  If you would like to update your doctor on the latest CDC recommendation about the use of type specific tests, you can print out the section on herpes testing from the CDC STD treatment guidelines at cdc.gov.  How sad that after many years of availability, some providers are still unaware of this very good test.

Terri

[wishihadgame]

Went to the doctor and he seems to believe from looking at the sores that its herpes, he took a swab of the sores.  I asked him if there were any other tests and he said that this was the only one that gives definitive results.

[Terri Warren, RN, Adult Nurse Practitioner]

Your description does concern me for possible herpes and I think you need to find out more about this situation.  I would like you to go back to the place where you had your full STD screen and ask if it included tests for herpes.  Often STD screens do not,  Check to be sure.  Herpes doesn't always hurt, it often looks much milder than the pictures on the internet, and what you need is a person to take care of you rather than relying on my opinion or the internet for pictures.  If no herpes testing was done as part of your STD screen, I would get an IgG antibody test for HSV 1 and 2.  Have you ever had a cold sore on your lip? If yes, then you are likely to be HSV 1 positive, and unlikely to get that genitally.  If you've never had a cold sore, then you could have gotten that genitally, so we will need to consider your HSV 1 value in this mix.  If your STD screen did include herpes testing and you were negative for both HSV 1 and 2 at the time of the testing, and you've had no other partners than this one, you could consider asking her to be tested.  If she is negative for both, then I would say you don't need to worry about herpes.  

Does this help?  Do you have further questions?

Terri