Herpes affects people differently, and my doctor says that "classic" outbreak symptoms are often not present. It is more likely for people to get minor symptoms that they think is something else, until they find out that they have herpes, then they realize what is causing the minor rash or marks that they get.
For some people, Valtrex helps a lot, but for other people, they keep getting symptoms - whether outbreaks in a "classic" way, or minor outbreaks or tiny lesions or marks, anyplace in the "boxer short" zone.
So what gives? You think small marks can't be herpes related? That is not the medical consensus as far as I know . . .
"recent research that H2 reactivates a lot more frequently than people used to think, just without visible symptoms, or with small marks people don't notice, or with small marks people attribute to something else"
The first part of that statement is correct, i.e. more frequent reactivation than indicated by symptoms. The latter comment about "small marks" etc is mistaken.
And trust me, I am not misinformed on these issues.
But my test was a conclusive POSITIVE for HSV2 . . . so, yeah . . .
And I also read recent research that H2 reactivates a lot more frequently than people used to think, just without visible symptoms, or with small marks people don't notice, or with small marks people attribute to "something else" . . . even in "classic" cases, most of the viral activity does not cause a "classic" outbreak - most outbreaks are what you would call "atypical", but really it is not unusual at all to have minor symptoms frequently . . .
I think you are misinformed about that.
" have read that MOST people get painful outbreaks intermittently, but that some people do get more minor symptoms very frequently with HSV2. "
You won't find that from any professional or expert resources. Herpes is an emotionally stressful disorder, and many affected people end up attributing all sorts of symptoms to it. Usually they are wrong.
You are over-interpreting other things you have read as well. Although herpes lesions indeed can be atypical, the large majority are not unusual, just mild. It's the mildness of symptoms that explains most apparently asymptomatic cases, not that the lesionss look so different. The combination of the non-typical symptoms you have plus your negative blood test is conclusive proof you don't have herpes. You're going to have to look elsewhere for the cause of your symptoms.
Lesions on thicker skin also take much longer to heal, so new ob's may occur before the previous one has healed . .
I had a type-specific blood test and it was + for HSV2 (over 5), negative for HSV1 - they tell me it is definitive, no need for another test . . .
I have read that MOST people get painful outbreaks intermittently, but that some people do get more minor symptoms very frequently with HSV2.
If you do a web search for what herpes looks like on the buttocks or thigh, you will see that it does not look like a lesion that you would see on more sensitive genital skin.
Herpes can be any red blister or lesion, from something the size of a pencil lead, to something larger. On thicker skin, it rarely shows up as a classic lesion, more likely presenting as a small cluster of cuts, blisters, dry skin, or a red rash.
This is why 80% of people with herpes do not know that they have it - but most of these people are not asymptomatic . . . they just attribute the symptoms to something else . . .
If you have HSV2 and you have a suspicious rash on your butt, it is highly likely that it is herpes related - some people have constant symptoms that do not abate with medication, that is just a fact.
I have been to a doctor and they said it is "likely" to be herpes, but the only way to tell is if a swab showed positive, a negative swab may just mean not enough virus was present at the time of the swab . . . so??? I guess I am just screwed?
Herpes does not explain the "outbreaks" you describe. Herpes simply does not cause "constant ... marks - not painful lesions, but red marks on the buttocks that normally [you] might not even notice". Impossible. In addition, the simple fact of your question -- that Valtrex is having no effect -- is further evidence against herpes as the cause. Finally, herpes symptoms never are continuous; your statement " I have never had a symptom-free day" is yet more evidence of a problem other than herpes.
I'm not saying you don't have HSV2. With a positive blood test, you probably are infected. But herpes is not the cause of any of the symptoms you describe.
"What do I do?" Find a doctor you trust and who understands HSV infections. An infectious diseases specialist, or STD expert, or dermatologist. Then follow his or her advice about your genital skin symptoms.
Finally, the HSV blood tests are not infallible. If you would like to report your test results in more detail, perhaps I or others on this forum will have some further advice about it.