Still can't move on.

[Confused1193]

Hello,
I ambitiously tried to add a follow up on the end of my post a month ago and understandably it was deleted so I'll start a fresh thread.
I understand this post may seem silly and a waste of money however I'm still, months down the line, worrying about my sexual health, especially worrying about HSV.
At the end of the last post I speculated a fungal infection as the cause of my symptoms (all over itchiness, redness of penis head and scrotum, pain in penis tip, cut/broken skin between bum cheeks) and this was confirmed by a DR.
I started applying the cream prescribed to all areas and on my anus and penis it's worked well although I'm still itching on my scrorum and groin area and even today my scrorum was worryingly red. The itchiness is almost like a stinging feeling.

There was also odd symptoms including a discharge after urinating and a spasm feeling in my urethra. I went to the STD clinic and my urethra was swabbed and there was nothing to worry about there and also tested negative for gono and chlamydia. These symptoms seem to be subsiding just as the DR predicted.

1. With how much confidence can I move on without worrying about STDs, most importantly HSV which is my biggest fear which I simply cannot shake. Am I correct in thinking my symtoms aren't at all like herpes? I apologise for asking this again, I'm just feeling a lot of stress still.
2. Do you have any theory or advice on the thrush like symptoms which are persistent? Should I stop using the cream and pursue a different cause for those symptoms? Is the most likely scenario that he fungal infection is affecting the areas which are still causing me problems and if so, do you have any advice for me on getting rid of it?

Thanks Doctors, this forum is a blessing

[H. Hunter Handsfield, M.D.]

I deleted your inappropriate follow-up comment.  I'll just say no, what you describe is not a "red flag" and does not change my opinion or advice.  The large majority of genital area symptoms and rashes are not herpes or any other STD and you cannot go through life with herpes worries over every twitch and tingle.  See my advice above about professional counseling.

I said this thread is over and I meant it.  One more anxiety-driven comment will result in immediate deletion of the entire thread, and will also put your MedHelp priviliges in jeopardy.

[H. Hunter Handsfield, M.D.]

Sorry, no further comments.  You came here, repeatedly, for reassurance you don't have herpes.  You have had that, in spades. There are NO symptos you will ever have that should make you worry about herpes, until and unless you have new sexual exposures that could have infected you.

My final comment is in response to your closing sentence:  Whenever a person suspects s/he has a psychological issue that would benefit from therapy, almost always s/he is correct.  Do it.

That wil end this thread -- and we'll expect no more.  Do your best to suck it up  and move on without worry.

[Confused1193]

Dr HHH, I apologise for coming back to this thread. I imagine this must be frustrating.
After reading your responses I was truly ready to move on with a clean head however a mere couple of hours after this and I noticed red skin on my leg where it attaches to my groin. Essentially it looks like several small red patches which are raised, looks like hair follicles. I decided to squeeze one and it just bled and now looks like the skin has a little tag.
The soonest I can get this looked at is Wednesday.

Any thoughts at all? I'm totally at the end of my patience. I don't know if the thrush is causing this or the hair follicles are just red or if this could be herpes. I have had inflamed hair follicles but usually only one where it comes up like a boil almost, which isn't like this red skin.

I read that outbreaks are unusual in places where there is hair? Is this true?
I did also read that outbreaks can affect the legs, is that rare?
If this were caused by herpes, would it be painful and how long would it take for proper blisters to show?

I think it's likely I'm yet again freaking out about nothing but Wednesday feels like a long way away and I'm hopeful for some reassurance.

I also think maybe I should seek therapy over this entire thing. Would you agree?

[H. Hunter Handsfield, M.D.]

I'd be very surprised if HSV blood tests aren't available in larger cities like Glasgow or Edinburgh.  Also it's hard to believe the Aberdeen NHS clinic really believes there is no blood test for HSV, although they may not offer it.  Perhaps you spoke with a nurse clinician with suboptimal training and experience.  A certified GUM physician would know otherwise.  But I agree there's really no need for testing anyway, for the reasons we have discussed.

"Can a persistent red or itching scrotum be caused by ANY sexual infection?"  Nope.

"Is asymptomatic HSV a small concern for me...?"  Under the circumstances described, no.

Thanks for the thanks about the forum.  But I agree it is time for you to move on.  There's no additional information you can provide that is likely to change my opinions or advice.  Best wishes.

[Confused1193]

Thanks for the quick response DR. I think I've heard enough to try and convince myself I didn't get herpes from my exposures.
In response to your comments about the GUM clinic, when I asked the DR there (in an Aberdonian NHS gum clinic) why I couldn't get tested for HSV she said there is no test, which I know isn't true. I was told by 3 or 4 doctors there that they only swab lesions.
I guess I could make a trip somewhere else however your response and Dr Hooks last month have really helped me put this into perspective.

Just a couple of follow up questions if I may

Can a persistent red or itching scrotum be caused by ANY sexual infection?

Is asymptomatic HSV a small concern for me given that any long term partner I've been with has been a virgin and the partners which were not virgins were just single exposures?

I'm not going to drag this thread out unnecessarily. Those are my last questions. Thanks again for the response DR. Like I say, this forum is brilliant for people in my position.

[H. Hunter Handsfield, M.D.]

Welcome back to the forum.  But I'm sorry to hear you remain so concerned about herpes, which is not consistent with your symptoms or your partner's.

I don't have time to read all your other threads in detail, but I scanned the ones in this and the herpes community forums and agree with the responses you had there.  The additional information provided here doesn't change the virtual certainty that neither your nor your partner has genital herpes.  And that's obviously the opinion of your clinic doctors.

I assume "STD clinic refers to one of the NHS GUM clinics, right?  If so, I'm a little surprised by one of your statements on another thread that you can't get an HSV blood test if there are no genital lesions.  HSV blood tests are done quite frequently in many if not all GUM clinics, and certainly they are readily available in the private sector, such as London's Freedom Health Clinic, a highly respected sexual health clinic.

Even though I am confident your symptoms are not due to herpes, this seems a situation in which an HSV blood test is warranted, in the hope that negative results would help convince you of the obvious truth.  But before tesitng, you must understand that if positive for either HSV-1 or HSV-2, almost certainly it will mean that you have an asymptomatic HSV infection plus whatever is actually causing your symptoms.  That's probably why your doctors recommend against testing.  Still, if you're willing to take the risk of a positive result that will just confuse and perhaps upset you, without solving things, it may be worth that risk if in fact you have a negative test result.  I recommend you discuss these aspects with your clinic doctor(s).

To your specific questions:

1) There are no STDs that cause symptoms of the type, timing, and pattern you describe.  Most of the problem may be anxiety or stress, magnifying and heightening your awareness of trivial or entirely normal body sensations.  Whatever the exact explanation(s), you can be absolutely sure you have nothing that will ever harm you or your current or future sex partner(s).  Even if you have to just learn to live with your symptoms, knowing it's nothing serious should help you move along in your life.

2) No distant expert can compete for an accurate assessment with an experienced provider like the ones you probably have seen, especially if you indeed are getting care at a GUM clinic or private STD clinic.  If you are not under such expert care, that would be a logical next step.  In any case, I have no additional thoughts or suggestions.

Best regards--  HHH, MD