Question: Hello. I have a question about HSV2. 5 years ago, I tested positive for genital HSV1 via a swab/culture test. I tested negative to HSV2 and HSV1 at the blood tests at that time but know I had the HSV1 because I had received oral sex from a woman who had HSV1 orally (and I used a condom for vaginal sex with her). At that time, I had a small bump that broke and left a small sore which then dried out and went away over a course of 7-10 days. I have used condoms the majority of the last 5 years since except during two 1-year relationships, the last of which ended 1 year ago.

15 days ago, I had sex with a woman I've been seeing without a condom. I did so 2 days later and then 2 days later again. Then I got nervous about STDs so I've used condoms with her since.

My concern- 1 week after we first had sex, I got a small (a bit larger than a pinhead) very faint flesh colored and just a bit pinkish raised area around the area where my initial HSV1 outbreak was (left side of the shaft of my penis maybe an inch from the base over a vein or blood vessel). As I write this, it is almost totally gone and if I pull on the skin a bit, I can see a tiny pore/cyst there- very tiny. I maybe could describe it as a tiny mole but it's not a mole.

When I brought up my concerns to the woman, she said she was "clean" and had had cultures done at the gyno 2 months ago where they "tested for everything." She did not have bloodwork so I know she was probably not tested for HSV2 despite what she said or thought.

Question 1: I'm fearful of having contracted HSV2 now because I developed the tiny bump a week after I had sex with her. Other than getting a blood test in 4 weeks to see if I've developed the antibodies for HSV2, is there anything in my description that clarifies whether I had a minor HSV1 outbreak or a newly acquired HSV2 outbreak? Or since the small area didn't scab or break and just went away, is that indicative that it is neither and was just a pore that got irritated through sex?

I do recall a bit of tingling at the head of my penis on the day or 2 around when I first saw the bump, But I don't know if this was psycho-somatic due to the mental focus I was putting on the area all of a sudden or due to the fact that I was touching and looking at that region a lot over a couple days. I did not have any swollen glands/nodes in my groin as I had when I originally contracted HSV1. I felt generally pretty good health-wise.

So question 2: Wouldn't a new acquisition of HSV2 have given me swollen glands in my groin even if I already had HSV1 there? And wouldn't it have become a sore and scabbed over if it were either of the 2 viruses?

Question 3 : Since I have genital HSV1 and have built up antibodies over the last 5 years, would this mean that, if I did contract HSV2 2 weeks ago, I would have fewer and less severe outbreaks than would typically be associated with HSV2?

I've read that HSV2 outbreaks can be 4/5 times a year whereas in 5 years I've never had another outbreak of HSV1. I am very nervous about all this and having to wait 4 weeks to take blood tests is a long time to wait and be extremely stressed. Hope you can assist.

Ok for my below follow up questions, let's assume that I contracted HSV2. (I'm hoping and praying this isn't the case, but based on the timeline in my mind, I find it too coincidental that this could be an HSV1 recurrence. Hopefully I'm wrong.)

Question 1: Is it too late to get this cultured since it is 7 or 8 days since it appeared and almost gone? Or is there still material that could be cultured? Waiting 4 weeks to get blood tests will be very trying mentally.

Question 2: When you say "presence of antibodies to Hsv type 1 already would make an episode of new infection with genital Hsv type 2 less severe because most of the antibodies are cross reacting between type 1 & type 2 Hsv" what does that mean for me going forward in terms of severity and frequency of outbreaks? Does my having HSV1 genitally already "tame" the HSV2 a bit? I ask because I viewed the HSV1 as minor based on never recurring and I read that HSV2 recurs 4 or 5 times yearly. So does my having genital HSV1 antibodies for 5 years predispose me to a less aggressive HSV2?

Question 3: If I do test positive for HSV2, what would daily suppressive therapy do as far as reducing the frequency or severity of future outbreaks?

Thank you in advance. I'm 39 and was hoping to be married and have children within a couple years and I feel that if I contracted HSV2, that will throw a monkey wrench into all of that. I'm very stressed and depressed and that is the reason for all the questions.

Ok thanks Doctor. So I have two final questions. I wasn't able to get an appointment with my doctor to culture or PCR and now the irritation is gone. So I figure to try to culture or PCR it would be a waste of time.

1.) When would antibodies show up in a blood test so that I can schedule my bloodwork accordingly? 4 weeks after exposure or 6 weeks after exposure to an HSV virus?

2.) Lastly, I'm quite sure that this new irritation (not sure what to call it) appeared within centimeters or less of where my original HSV1 occurrence was located. Does it's occurrence at the same exact skin location make it more likely that it was a recurrence of the HSV1 that I already had? Or would a new infection of HSV2 follow the same path and nerve endings etc as the initial virus and manifest at the same location as well?

Since I won't know the verdict for another few weeks until I can have bloodwork, I'm trying to give myself a bit of hope that it's a recurrence rather than something new.. Thanks in advance.