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I went to a dermatologist and here is what he said..

Hi everyone. Wish you a happy Friday.

So I've always had this weird marks at middle of my penis downside. I believe it was there since my late teenage or beginning of my twenties before even I had my first sexual encounter (I'm now in my mid thirties). I've tried all possible home remedies to treat it; banana peels, mandarin peels, you name it, it did get mitigated for a couple of hours or days and then back to its original shape; really tiny 3 or 4 dark-colored pimples close to each other, no pain or puss or whatever (not to confuse it with HPV, because I've had it before and got cured). I thought these formed as a result of excessive masturbation and rubbing, knowing that in most times I do it without any lubrication, I also has a really tiny scar right there. Later on, I started having sex from time to time (CSWs exclusively) all protected, vaginal and anal. Now that I have not come up with any clear answer to my situation, I decided to visit a dermatologist. He checked it carefully and then told me that it might be (Oral Herpes) (HSV1) and asked me to do a blood test, which I did and now I'm waiting for the result. Is it true that (HSV1) can transmit to genital area?
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207091 tn?1337709493
COMMUNITY LEADER
You can get hsv1 on your genitals, but it wouldn't be a mark on your penis that doesn't go away for years.

Genital hsv1 acts much like genital hsv2 does - you get recurrent outbreaks that last a week or two, then they go away, and you have no symptoms and then at some point later, you'll get another outbreak. In between those, you have no marks.

The blood test will only tell you if you have hsv1, and not where you have it. You could be positive, and have it orally, not genitally. Even if you have it genitally, I don't think that's what this mark is.

There is no STD that causes a mark to just be there for years with little changes. Also, you can't visually determine which strain of herpes is causing a herpes sore.

There is something called penile melanosis, which is just dark spots on the penis - https://www.healthline.com/health/penile-melanosis

11 Comments
The test result was produced and it reveals two values within the data in the report:
One of them indicates I'm HSV1 negative in the sense of possibly recent infection.
The other one however, indicates that I already had at some point in my life HSV1.

I've discussed this with my doctor along with other medical staff in the hospital. They all seem to share the same conviction,
which is HSV1 is in my system based on the medical report. I tried to explain that HSV1 once infects the genital area it should not cause any different symptoms from those caused by HSV2, and that what I have seem to be totally different from herpes-related symptoms; (approx. 7 tiny inline colored-dots, no pain, no puss, always there). Anyways, I was prescribed Zovirax 70 tablets Acycovir 400mg, and Elicasal ointment to use them for a week or so t osee if those dots treated or not, followed by another blood test to confirm the virus is cleared away (doctor says HSV1 can be cured, although I looked at WHO and it says it's lifelong, also he says HSV1 is called simplex for a reason unlike the problematic HSV2, in which I amazedly replied to him by saying both types are called simplex anyways).

Should I buy and use the medications? And if supposedly the tablets and ointment help getting rid of the dots, does this mean it was indeed a genital HSV1?

Medhelp experts have always been promoting the notion that oral sex is almost always safe and does not pose any real danger, etc. I do not know now if this is true or misleading. Usually I practice unprotected oral (receiver), so if I ever contracted HSV1, it most likely targeted that area of my penis that is most vulnerable (excessive masturbation leading to damaged skin that later on got HSV1 on that very spot), could it be likewise?
So you can have hsv1 orally, which 3.7 billion people under 50 do globally, and test positive for it on the hsv1 IgG blood test. (That's the test that shows a more established infection.)

Hsv1 can NOT be cured, as you know. It is a virus that stays in your body for your lifetime. The medication is an antiviral, and will help stop replication of the virus, helping the outbreaks heal faster.

You can try the Acyclovir - it won't hurt you.

The Elicasal ointment is used for "chronic lichenified eczema, lichen simplex, lichen planus and plaque psoriasis and atopic dermatitis unresponsive to less potent cortocosteroids."  (https://www.jamjoompharma.com/index.php/products/browse/elicasal-detail)

That is not a herpes treatment. Your doctor doesn't think this is herpes, or he is trying to treat you for both things, and then will tell you that herpes is cured, or something. I agree that this isn't herpes. Herpes sores do NOT last this long, but some of the other possibilities could.

If you decide to try the meds, I would try one at a time. Since they are very different meds, if the spots clear, you won't know which one worked. I'd try the cream first, since it is far more likely  to be helped by that.

I don't think that MH experts have said that oral sex is "almost always safe", just that it's a lot lower in risk than unprotected vaginal or anal sex. You can still get infections from unprotected oral - gonorrhea, chlamydia, syphilis, NGU, genital hsv1 (if you don't already have it) and HPV.

The chances are lower, and most experts don't think a single unprotected oral encounter warrants testing without symptoms.
@auntiejessi
I will abide by your advice which is to use the ointment alone and from that see how things are going on, in fact this was in mind and you reaffirmed it. Another thing that worth mentioning, I did a quick web search about the statistics of HSV1 in my country (despite the the difficulty of gathering data) and it turned out (as I expected) it is common, and most infected people had had the virus before adulthood. Also, I remember in my teenage and early twenties having a frequent occurring of a small red blister in my lip "specially my lower lip" and when it occurs it is usually winter time and it lasts for a week or two, I notice this phenomena in some of my relatives, too. However, I had a history of skin issues, namely Eczema if this means anything. This doctor I recently visited also added that there are actually 3 types of herpes, along with HSV1 and HSV2, he considers chickenpox as one of them and that it can reoccur to anyone who had it earlier in childhood once again at a later time in life in certain circumstances, it's called then "shingles". This made me think that both HSV1 and chickenpox are just inevitable and part of our life. HSV2 is kind of different in terms of how common it is and its contagion, or am I wrong?
I would say that hsv1 isn't inevitable, but it's close. 3.7 billion under 50 globally is 67% - so not quite inevitable, but certainly not unexpected. As you get older, it's more expected, for sure.

Chicken pox is a member of the herpes family, but it's a cousin of the herpes simplex viruses - herpes simplex 1 and 2. Chicken pox is Human HerpesVirus 3, Herpes Simplex Virus 1 is Human HerpesVirus 1, Herpes Simplex Virus 2.

Here's a complete list - https://ada.com/conditions/human-herpesvirus/

There are actually 8. Many are quite common.

I would consider HPV (human papillomavirus) an inevitability. The vaccine is helping, but it's estimated that about 90%, give or take, of us will have it at least once in our lifetimes.

Here is a good article on oral herpes - https://www.ashasexualhealth.org/oral-herpes/

That site also has excellent info on STIs, sex, relationships, etc. Some of it is geared towards teens, so it may sound a little condescending to a grown man, but the info is still good if you've never been able to talk about sex to anyone, or never had the education in a conservative education.

Well, this pretty much wraps everything up.
Thank you from the bottom of my heart for such unconditioned and generous consultation you've granted to me that is worth paying for. I wish you and your family health and happiness.
You're welcome. I wish you the best. :)
Yet another update..

This is not to add any further questions at all but rather to help the community by disseminating all information that might be of help.

The ointment did not do anything, thus I went to two different dermatologists in two different hospitals to gather as many opinions and diagnoses as possible, since the previous dermatologist simply got it wrong. The first one clinically checked me and said it had to with vascular issue causing these bumps, which got me saying to him in reply that I have been suffering from varicose since an early age, he then replied firmly that this was the cause, and all I need to do is have them burned off but the required equipment were not available at the time. The other doctor I went to said it was "Angiokeratoma" and indeed he got it right, so basically both of the last two doctors gave me similar answers, not quite the exact answer but very similar and convincing. He then started treating them by firstly numbing the area and scraping the bumps, then prescribed anti-biotec ointment "Fucidin" to have it used three times a day for one week. Will see how things will go.

My only concern was not the "Angiokeratoma" itself at all but: 1- The varicose that I know I have been having for a long time and still not solved it. 2- The fact that "Angiokeratoma" might be prone to burst and bleed (slightly or considerably) which raises even more risk of STD infections during sex. Although I only practice protected sex (vaginal and anal).
Thanks for the update.

You should post in Urology about your varicose vein. That's not something I know a lot about. https://www.medhelp.org/forums/Urology/show/52 You can also ask your doctor about it, too.

So your doctor scraped the angiokeratoma and is treating it. You are concerned about it bursting and bleeding, but he's removing it, correct? That means that it won't do that. If you ever get more, you can get those treated.

The ones you have didn't burst, and you wear condoms. You haven't increased your chances for an STD.
You are very welcome.

Yes, you are right about everything you said but it's the first time I'm being conscious about having this medical case (angiokeratoma), that's why I asked these questions because back then I never knew I had (angiokeratoma).
Also I'm planning to engage in sexual activity soon, and was wondering if I should wait for a while until it is completely healed or am I just overthinking it. They are now look almost like any other injure that is clotted and being disolved gradually. No bleeding or anything. I'm just being extra cautious, that's all.
I'd probably wait, but if you don't, I'd cover it with a condom. It's broken skin and it makes it easier for bacteria and virus to enter. Even things that aren't normally considered sexually transmitted could enter, and cause infection. Also, the friction could really irritate it.

Yeah, I guess it's my bad luck, gotta wait until skin is restored. Thanks again.
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