Do I have a pimple/boil or Herpes?

[Andy720]

I received protected oral sex from a sex-worker in Canada. She had no visible signs of anything on her mouth. The oral sex only lasted about 1 minute. About 3 days later I discovered a bump on my lower inner buttcheek. Her mouth was never near this area at all, only  on my penis shaft. There was no tingling, burning or itching before the bump appeared. The bump was red and looked and felt like a regular pimple. However over the next couple of days the bump got larger and seemed to flatten out. At its biggest it was the size of a penny, just more elongated. I never felt any headache, or flu-like symptons at all. The bump never itched, or burned or tingled or anything. It was just a little painful to the touch. After about a week and a half it got a little white film over half of it and then that half scabbed over. The scab has shrank to just a little dot and the rest of the bump is getting less red and fading quickly two and a half weeks after the encounter. I felt like the condom would protect me but the time-frame of this bump is suspicious. Also I can't recall ever having a cold sore on my mouth so I doubt I had antibodies built up before the encounter. Thanks in advance for your time.

[mo0foo]

A related discussion, I don't know what this is...please help was started.

[kimmy32]

A related discussion, Is it possible for me to get herpes? was started.

[herby31]

A related discussion, boils, std or not was started.

[Andy720]

Doctor, I have one more thing to ask you...

It has been 24 days since my sexual encounter ( received 1 minute protected oral sex, no visible sores) . I feel like I am probably stressed over nothing but my anus has been itchy. When I wiped today there was even a little blood. The toilet paper at University is real rough so it could just be chafing. I feel like it wouldn't still be itchy 24 days after the fact but I don't really know. Thanks again for your help before and I promise this is my last question...

[H. Hunter Handsfield, M.D.]

From your description, this really can't be herpes.  Although recurrent genital-area herpes outbreaks sometimes are on the buttocks, upper thighs, etc, the initial infection always directly involves the genitals, anus or rectum.  Also, herpes does not cause the sort of bump you describe.  One way to look it is that herpes lesions are "on" the skin, that is, quite superficial; lesions "in" the skin--that is deeper lesions, like pimples--almost never are herpes.  Yours sounds much more like that.  I'm sure the timing of its onset with the sexual exposure you describe is purely coincidental.

Lack of having cold sores is meaningless.  At least half the population over age 20 has been infected with HSV-1, and that proportion is the same in people with and without histories of cold sores or other symptoms of oral herpes.  So regardless of that history, there is at least a 50% likelihood you are immune to catching genital herpes due to HSV-1.

Anyway, relax and put herpes out of your mind for this event.  

Good luck--  HHH, MD