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Rash on forehead
Approximately 3 months ago I was in Asia and had sex (vaginal, no oral) with a girl there. On my way home I developed an acne like rash on my forehead which I ignored for a few weeks thinking it would go away. When it didn't, I started to worry that it is herpes. I made an appointment with my doctor but got impatient waiting a week to see him and went to urgent care. The nurse practitioner there insisted that it isn't herpes, told me I have acne and gave me antibiotics. A week later, when I went to my doctor, it had improved a bit and he said it didn't look like herpes. However, it did not go away and over the past 3 months it has gone back and forth in terms of severity. I returned to my doctor last week and he said that it didn't look like acne and that he couldn't completely rule out herpes as the cause. He did a bacteria and viral culture and both came back negative. The rash has not spread, it's about the size of a silver dollar and it looks like acne with whiteheads. It sometimes burns and the "whiteheads" sometimes take on a crusty texture.
1) Could it be possible that I innoculated my forehead with HSV 2 if my hands came into contact with the virus?
2) If it is HSV 2 does it mean that I have genital herpes?
3) I asked my doctor if it turns out to be herpes would it mean that I have to start telling everyone about it before becoming intimate. He said that he didn't think so because it is on my forehead. If it is HSV 2 how likely would it be that I could pass it on to another sex partner?
4) I find myself pretty torn over the issue of getting tested for HSV 2. If 1 in 4 have HSV 2 and 90% don't know they have it this suggests that most people are not getting tested. Since having HSV 2 is somewhat medically insignificant but has the potential for creating a huge impact on relationships because of the stigma, quite frankly, if I did have it I would rather be part of the 90% who don't know. Does this sound irresponsible?
1) Could it be possible that I innoculated my forehead with HSV 2 if my hands came into contact with the virus?
2) If it is HSV 2 does it mean that I have genital herpes?
3) I asked my doctor if it turns out to be herpes would it mean that I have to start telling everyone about it before becoming intimate. He said that he didn't think so because it is on my forehead. If it is HSV 2 how likely would it be that I could pass it on to another sex partner?
4) I find myself pretty torn over the issue of getting tested for HSV 2. If 1 in 4 have HSV 2 and 90% don't know they have it this suggests that most people are not getting tested. Since having HSV 2 is somewhat medically insignificant but has the potential for creating a huge impact on relationships because of the stigma, quite frankly, if I did have it I would rather be part of the 90% who don't know. Does this sound irresponsible?
MEDICAL PROFESSIONAL
OK. Clearly not herpes or any other STD, so we can curtail discussions on this forum. Best wishes.
I went to the dermatologist yesterday after he received all the lab results. The results of the culture say I have folliculitis. The doctor said it isn't behaving like a normal folliculitis and he still thinks there is a tropical element to the rash. He took another culture and gave me Minocycline. Hopefully that will clear it up.
He threw out a name but I didn't write it down. Some of the lab tests being done are to eliminate the possibility that it is a parasite, but he said he thinks it will end up being a tropical infection.
MEDICAL PROFESSIONAL
Interesting. What specifically does he suspect? Do you have a name?
I have no more comments about the social aspects of herpes. But thanks for the thanks about the forum.
I have no more comments about the social aspects of herpes. But thanks for the thanks about the forum.
Doctor,
I just went to the dermatologist. He thinks it is an exotic tropical infection. He took another culture to send to a special lab for analysis and took four vials of blood, and a urine sample. He said if it is what he thinks it is he won't even be able to treat it and I would have to go to a special doctor at the university for treatment. I don't think it is anything serious though. It sounded like he thought I would be able to get rid of whatever it is. I guess this is the price you have to pay for a life of adventure. I will post again in a couple weeks when the lab results come back.
In response to your comments about my last question, it is definitely an interesting issue. Until I had an STD scare and did the research I wasn't aware that HSV-2 was so prevalent. It seems that HIV has overshadowed all other STD's, especially for members of my generation who have never lived in a world absent of HIV. Now that I know how common it is, there is a part of me that would like to be tested. I haven't exactly been an angel and I would never want to give someone a disease. On the other hand, I wouldn't want to be the only guy on the block dealing with the ramifications of knowing when everyone else is enjoying a life of ignorance. It's a Mexican standoff, a deadlock situation. Maybe when I'm 70 and sitting in a rocking chair at the old folks home I will decide to get tested, just to know the end of the story.
Thanks for your help. This website is a great resource.
I just went to the dermatologist. He thinks it is an exotic tropical infection. He took another culture to send to a special lab for analysis and took four vials of blood, and a urine sample. He said if it is what he thinks it is he won't even be able to treat it and I would have to go to a special doctor at the university for treatment. I don't think it is anything serious though. It sounded like he thought I would be able to get rid of whatever it is. I guess this is the price you have to pay for a life of adventure. I will post again in a couple weeks when the lab results come back.
In response to your comments about my last question, it is definitely an interesting issue. Until I had an STD scare and did the research I wasn't aware that HSV-2 was so prevalent. It seems that HIV has overshadowed all other STD's, especially for members of my generation who have never lived in a world absent of HIV. Now that I know how common it is, there is a part of me that would like to be tested. I haven't exactly been an angel and I would never want to give someone a disease. On the other hand, I wouldn't want to be the only guy on the block dealing with the ramifications of knowing when everyone else is enjoying a life of ignorance. It's a Mexican standoff, a deadlock situation. Maybe when I'm 70 and sitting in a rocking chair at the old folks home I will decide to get tested, just to know the end of the story.
Thanks for your help. This website is a great resource.
MEDICAL PROFESSIONAL
Welcome to the STD forum.
Your last question is an interesting and important one. I'll come to it shortly. The others can be dispensed with very quickly: There is no realistic chance you have HSV-2 of the forehead. HSV-1 might be a little more likely, but neither one would behave the way you describe or last so long.
As to whether you actually have acne, I am skeptical. Some other dermatologic condition seems more likely, given the sharp localization of the rash. Psoriasis could behave like this, and the form called pustular psoriasis could easily be confused with acne. I suggest you see a dermatologist for proper assessment. In the meantime, don't worry about herpes.
To the specific questions:
1) No.
2,3) Probably irrelevant, for the reasons above.
4) You have put your finger on one of the main issues in the ongoing debate among professionals who specialize in herpes and other STDs, about when and who should be tested for HSV-2. Given your low risk of actually having HSV-2, I do not believe you would be at all irresponsible to not get tested. However, people who specifically believe they are likely to be infected -- and with much higher evidence than you have -- definitely have an ethical obligation to know about their infections so they can warn their partners. Indeed the condition is usually "medically insignficant", but not always. And you should not minimize the psychosocial impact of herpes. Even people who believe that the psychological impact should not be so great should not deny that it is a reality for many persons.
Bottom lines: Testing for HSV-2 is not an issue for you; I see no chance your forehead rash is due to herpes of either type, so don't worry about it. See a dermatologist. After you do, please report back; I'll be interested to know what s/he says.
Regards-- HHH, MD
Your last question is an interesting and important one. I'll come to it shortly. The others can be dispensed with very quickly: There is no realistic chance you have HSV-2 of the forehead. HSV-1 might be a little more likely, but neither one would behave the way you describe or last so long.
As to whether you actually have acne, I am skeptical. Some other dermatologic condition seems more likely, given the sharp localization of the rash. Psoriasis could behave like this, and the form called pustular psoriasis could easily be confused with acne. I suggest you see a dermatologist for proper assessment. In the meantime, don't worry about herpes.
To the specific questions:
1) No.
2,3) Probably irrelevant, for the reasons above.
4) You have put your finger on one of the main issues in the ongoing debate among professionals who specialize in herpes and other STDs, about when and who should be tested for HSV-2. Given your low risk of actually having HSV-2, I do not believe you would be at all irresponsible to not get tested. However, people who specifically believe they are likely to be infected -- and with much higher evidence than you have -- definitely have an ethical obligation to know about their infections so they can warn their partners. Indeed the condition is usually "medically insignficant", but not always. And you should not minimize the psychosocial impact of herpes. Even people who believe that the psychological impact should not be so great should not deny that it is a reality for many persons.
Bottom lines: Testing for HSV-2 is not an issue for you; I see no chance your forehead rash is due to herpes of either type, so don't worry about it. See a dermatologist. After you do, please report back; I'll be interested to know what s/he says.
Regards-- HHH, MD
You are reading content posted in the STDs Forum
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.
