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Herpes? balanitis? no clear diagnosis since 2012
Had this issue since 2012. Still no clear cut diagnosis/solution. 28yrold male,circumcised, smoker, 3rd grade varicocle, recurrent symptom: irritation / burning of the head of the penis due to friction/rubbing with my underclothes (i.e. when walking/moving), itchiness around/right under the rim of the head of the penis, dryness&redness
Year 2000-01 (Age 15-16): Received unprotected oral sex twice (2encounters),same partner, both times for 1-2 mins. No other sexual activity to date, zero symptoms on penis til June 2012. No idea if she had oral hsv1.
June'12 (Age 26): Rash/reddening on penis head. No obvious lesions/pain; slight itching. Experienced discharge once although after a period of abstinence from masturbation. At approx. the same time, started experiencing frequent urination (whenever i would drink a small bottle of water, I would need to urinate). Probably would urinate 8 times a day without drinking lots of water, full bladder. Would always wake up with a full bladder&urge, sometimes waking up in the middle of the night to urinate. Urine dripping after urination; my penis shrinks inwards when not erect, so it is likely that amounts of urine can remain under the penis head.
1st Doctor visit: Went to a urologist/andrologist a few days after seeing the rash. He saw lesions on the underside/shaft of the penis (below the head) which looked like blisters (I could not see them). He said it looks like genital HSV, prescribed valtrax. I took the igg blood tests for HSV-1 & HSV-2. I took the valtrax for 2 days &then stopped. Once the doctor said the words herpes, i became paranoid, looking up all the symptoms, seemed like i had every symptom including feeling like my whole body was hot/aching/sick; probably due to anxiety. HSV TESTS all negative (very low #s), negative for syphillis, ghonorrea, & HIV.
Additional doctor visits: Few days later went to a dermatologist. He said area was irritated & reddish, no signs of blisters/lesions, no sign of herpes, but that he could not diagnose it as herpes or not herpes, said maybe there were lesions but that the symptoms disappeared. Doc prescribed me with fucicort acid (corticosteroid cream). I started using the cream. The irritation, redness, & itchiness persisted. Immediately went to another dermatologist, saw no signs of a viral infection, just irriation, advised to discontinue fucicort, & use elecom & then just moisturiser. Diagnosed it as allergic reaction. I stopped using soaps with fragrance (started using cyteal). In the next week or two, irritation on the penis increased (which i believe maybe due to the use of fucicort if i was actually misdiagnosed & this was an infection not a basic skin irritation). Main symptom became irritated penis head, especially when rubbing against underclothing (almost impossible for me to jog due to friction).
Aug'12: Main symptom still irritation&burning when rubbing against underwear. Frequent urination did not stop, went to see my personal doctor (top notch; does my regular checkups). Diagnosed me with insulin resistance/prediabetes as i had very high insulin spikes after meals but blood sugar normal. Prescribed me with glucophage, diet low in carbs/no sugars, & said that the redness on the penis is v. likely a fungal infection related to insulin resistance & not an STD. My blood sugar was borderline in 2011.
Aug'12-Oct'12: Penis symptom persisted, penis head continously burn/irritated when rubbed against clothes (i.e. when im walking); very little discomfort if i am just sitting down/lying down. In this period, i was going to 1 dermatologist a week & freaking out as the symptoms started in june & were not subsiding! Every dermatologist said there was nothing clinically, most said issue was psychological. In this period i retook the igg blood tests for hsv-1 & hsv-2 twice, all negative. Still had frequent urination/urine dripping, i was not controlling my diet ( I was not obese, 10kg over optimum weight, but did have a chunk of unwanted fat around the abdominal area).
End of Oct'12: When to see an andrologist in a neighbouring country. Explained history, he saw the affected area, immediately diagnosed it as candidal balanitis (I am circumcised) due to redness and the friction i was experiencing. Prescribed me with anti fungal cream & cortisone cream to be used together for 2 weeks (one of the creams was canasteen). Reaction on my penis from meds was strong, skin peeled off, possible thinning on penis head. After completion of the 2 weeks, penis was almost back to normal & the symptoms subsided dramatically. Started using fragrance free detergents for my underwear.
The symptoms i have described continued for 5 months until the final treatment for candidal balanitis, which sounds inconsistent with hsv. As i understand, with hsv there has to be a period with no symptoms between outbreaks.
Nov'12-June'14: No major issues on penis. Slight redness on the head, travelled to same andrologist in early '14, said there is a very slight infection not requiring treatment, just moisturiser. Still had frequent urination. Frequent urination subsides when i cut down carbs/sugars & vice versa. Tingling in the penis area / increased sensitivity & irritation increases when i go through periods of frequent urination; subsides when i am urinating normally. Became quite evident from monitoring my behaviour that frequent urination was related to insulin resistance/diet, rather than being a symptom of an infection (i.e. hsv).
End of June'14: Started feeling similar symptoms to '12. Woke up in the middle of the night & i was actually urinating while in bed (herpes symptoms? or related to insulin resistence?) The penis area (especially right underneath penis head) was raw/sore. When erect, rubbing with the clothes would feel like the clothes were cutting the skin. Area started itching / tingling sensations. First thought was herpes as it is consistent with the recurrence of genital HSV-1 (average of once every 2 years, with the 2nd time being less intense). Went to 2 dermatologists immediately, diagnosed it as nothing&saw no blisters/lesions.
7 July'14: Travelled to the andrologist, ruled out candidal balanitis/herpes. Diagnosed it as skin irritation,presecribed 1% hydrocoritsone cream. Until this point, symptoms were quite mild. I applied the cream for 7 days in v. small amounts only on areas that i felt were irritated.
After the 7 days, symptoms disappeared. However after 2-3 days, itchiness/tingling sensations in & around the penis head returned, & would feel irritation/burning when the penis rubbed against underclothing (similar symptoms to '12). Penis head looks redder than usual,dry,chaffed. Been feeling these symptoms for approx. 1 week now & still going, similar to the '12symptoms.
My QS's:
1 - Is this hsv? i had 4 blood tests but i am aware of the false negative rate for genital hsv 1, & that hsv & cortisone do not go well together (it causes hsv to flare up). Could my symptoms be explained by the use cortisone on a hsv infection? If so, then could my symptoms in '12 also be explained by the use of a corticosteroid on a hsv infection?
2 - If not hsv then what? How can I ever be sure if i do not get blisters/lesions to do a pcr & if blood tests may be false negatives? What are the chances that this is hsv if i only had 2 encounters of oral sex which lasting 1-2 mins 13 yrs ago? Are my symptoms anything like hsv?
3 - I do not want to take any cortisone / steroid creams, any alternatives? Coconut oil useful/safe?
4 - Does my recurrent issue sound like balanitis? i am circumsied / practice v. good hygiene, although i do have issues with frequent urination & urine dripping
Im lost & doctors don't seem to agree on a diagnosis; Apologies for long post, looking 4 guidance
Year 2000-01 (Age 15-16): Received unprotected oral sex twice (2encounters),same partner, both times for 1-2 mins. No other sexual activity to date, zero symptoms on penis til June 2012. No idea if she had oral hsv1.
June'12 (Age 26): Rash/reddening on penis head. No obvious lesions/pain; slight itching. Experienced discharge once although after a period of abstinence from masturbation. At approx. the same time, started experiencing frequent urination (whenever i would drink a small bottle of water, I would need to urinate). Probably would urinate 8 times a day without drinking lots of water, full bladder. Would always wake up with a full bladder&urge, sometimes waking up in the middle of the night to urinate. Urine dripping after urination; my penis shrinks inwards when not erect, so it is likely that amounts of urine can remain under the penis head.
1st Doctor visit: Went to a urologist/andrologist a few days after seeing the rash. He saw lesions on the underside/shaft of the penis (below the head) which looked like blisters (I could not see them). He said it looks like genital HSV, prescribed valtrax. I took the igg blood tests for HSV-1 & HSV-2. I took the valtrax for 2 days &then stopped. Once the doctor said the words herpes, i became paranoid, looking up all the symptoms, seemed like i had every symptom including feeling like my whole body was hot/aching/sick; probably due to anxiety. HSV TESTS all negative (very low #s), negative for syphillis, ghonorrea, & HIV.
Additional doctor visits: Few days later went to a dermatologist. He said area was irritated & reddish, no signs of blisters/lesions, no sign of herpes, but that he could not diagnose it as herpes or not herpes, said maybe there were lesions but that the symptoms disappeared. Doc prescribed me with fucicort acid (corticosteroid cream). I started using the cream. The irritation, redness, & itchiness persisted. Immediately went to another dermatologist, saw no signs of a viral infection, just irriation, advised to discontinue fucicort, & use elecom & then just moisturiser. Diagnosed it as allergic reaction. I stopped using soaps with fragrance (started using cyteal). In the next week or two, irritation on the penis increased (which i believe maybe due to the use of fucicort if i was actually misdiagnosed & this was an infection not a basic skin irritation). Main symptom became irritated penis head, especially when rubbing against underclothing (almost impossible for me to jog due to friction).
Aug'12: Main symptom still irritation&burning when rubbing against underwear. Frequent urination did not stop, went to see my personal doctor (top notch; does my regular checkups). Diagnosed me with insulin resistance/prediabetes as i had very high insulin spikes after meals but blood sugar normal. Prescribed me with glucophage, diet low in carbs/no sugars, & said that the redness on the penis is v. likely a fungal infection related to insulin resistance & not an STD. My blood sugar was borderline in 2011.
Aug'12-Oct'12: Penis symptom persisted, penis head continously burn/irritated when rubbed against clothes (i.e. when im walking); very little discomfort if i am just sitting down/lying down. In this period, i was going to 1 dermatologist a week & freaking out as the symptoms started in june & were not subsiding! Every dermatologist said there was nothing clinically, most said issue was psychological. In this period i retook the igg blood tests for hsv-1 & hsv-2 twice, all negative. Still had frequent urination/urine dripping, i was not controlling my diet ( I was not obese, 10kg over optimum weight, but did have a chunk of unwanted fat around the abdominal area).
End of Oct'12: When to see an andrologist in a neighbouring country. Explained history, he saw the affected area, immediately diagnosed it as candidal balanitis (I am circumcised) due to redness and the friction i was experiencing. Prescribed me with anti fungal cream & cortisone cream to be used together for 2 weeks (one of the creams was canasteen). Reaction on my penis from meds was strong, skin peeled off, possible thinning on penis head. After completion of the 2 weeks, penis was almost back to normal & the symptoms subsided dramatically. Started using fragrance free detergents for my underwear.
The symptoms i have described continued for 5 months until the final treatment for candidal balanitis, which sounds inconsistent with hsv. As i understand, with hsv there has to be a period with no symptoms between outbreaks.
Nov'12-June'14: No major issues on penis. Slight redness on the head, travelled to same andrologist in early '14, said there is a very slight infection not requiring treatment, just moisturiser. Still had frequent urination. Frequent urination subsides when i cut down carbs/sugars & vice versa. Tingling in the penis area / increased sensitivity & irritation increases when i go through periods of frequent urination; subsides when i am urinating normally. Became quite evident from monitoring my behaviour that frequent urination was related to insulin resistance/diet, rather than being a symptom of an infection (i.e. hsv).
End of June'14: Started feeling similar symptoms to '12. Woke up in the middle of the night & i was actually urinating while in bed (herpes symptoms? or related to insulin resistence?) The penis area (especially right underneath penis head) was raw/sore. When erect, rubbing with the clothes would feel like the clothes were cutting the skin. Area started itching / tingling sensations. First thought was herpes as it is consistent with the recurrence of genital HSV-1 (average of once every 2 years, with the 2nd time being less intense). Went to 2 dermatologists immediately, diagnosed it as nothing&saw no blisters/lesions.
7 July'14: Travelled to the andrologist, ruled out candidal balanitis/herpes. Diagnosed it as skin irritation,presecribed 1% hydrocoritsone cream. Until this point, symptoms were quite mild. I applied the cream for 7 days in v. small amounts only on areas that i felt were irritated.
After the 7 days, symptoms disappeared. However after 2-3 days, itchiness/tingling sensations in & around the penis head returned, & would feel irritation/burning when the penis rubbed against underclothing (similar symptoms to '12). Penis head looks redder than usual,dry,chaffed. Been feeling these symptoms for approx. 1 week now & still going, similar to the '12symptoms.
My QS's:
1 - Is this hsv? i had 4 blood tests but i am aware of the false negative rate for genital hsv 1, & that hsv & cortisone do not go well together (it causes hsv to flare up). Could my symptoms be explained by the use cortisone on a hsv infection? If so, then could my symptoms in '12 also be explained by the use of a corticosteroid on a hsv infection?
2 - If not hsv then what? How can I ever be sure if i do not get blisters/lesions to do a pcr & if blood tests may be false negatives? What are the chances that this is hsv if i only had 2 encounters of oral sex which lasting 1-2 mins 13 yrs ago? Are my symptoms anything like hsv?
3 - I do not want to take any cortisone / steroid creams, any alternatives? Coconut oil useful/safe?
4 - Does my recurrent issue sound like balanitis? i am circumsied / practice v. good hygiene, although i do have issues with frequent urination & urine dripping
Im lost & doctors don't seem to agree on a diagnosis; Apologies for long post, looking 4 guidance
Hmm -- you don't want to get professional advice because you've already decided you won't like the treatment that might be prescribed. But now you want advice about treatment on a community forum, from nonprofessionals who have no way to know your diagnosis. Doesn't make much sense to me....
If its fungal youd need to anti fungal cream. Also if your scratching the itch your not letting it heal.
Thanks you both for the response. Another main symptom for the past few days is itchiness around the head of the penis, its quite uncomfortable. Any ideas of what this points to? Solutions?
I have a strong feeling that the doc will prescribe me with a cortisone/steroid cream, which I want to avoid. Any alternative treatments?
I have a strong feeling that the doc will prescribe me with a cortisone/steroid cream, which I want to avoid. Any alternative treatments?
Life 360 is correct. Herpes never behaves at all like this. I would suggest you stop getting serial doctors' opinions. Pick a dermatologist you trust (only one!) then follow his or her advice. In any case, this doesn't sound serious and for sure it's not herpes or any STD.
Hi.
1. since you tested many times, this would not be herpes related. Cortizone creams are a skin thinner and it may have caused the skin to lose a layer of skin which would be easily irritated.
2. again it could be the cortizone cream thinning the skin.
3. One the skin is lost may take time for it to return.
4. With balantis youd have some fungal related symptoms. Urination issues that your describing may verywell be prostate related. Any pressure on your urethra from an enlarged prostate could cause dripping and the frequent urge to urinate.
1. since you tested many times, this would not be herpes related. Cortizone creams are a skin thinner and it may have caused the skin to lose a layer of skin which would be easily irritated.
2. again it could be the cortizone cream thinning the skin.
3. One the skin is lost may take time for it to return.
4. With balantis youd have some fungal related symptoms. Urination issues that your describing may verywell be prostate related. Any pressure on your urethra from an enlarged prostate could cause dripping and the frequent urge to urinate.
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
