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Genital herpes, pus-filled boiled in buttocks, pigmentation sinus. Surgery?

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initially it was genital herpes problem with puss filled boils now it ha come on the crevice of the buttocks please help with a correct diagnes and remedy age 30 female Ht 5 feet 62 Kg. Had a severe bout of herpes on the lower back since then it was occuring in the genital area from time to time now it is onthe buttock I dont know what to do a local Dr suggested surgery please advise and was telling that it is pigmentation sinus
Posted Sat, 28 Apr 2012 in Skin Hair and Nails
Answered by Dr. Deepak Anvekar 35 minutes later

Thanks for posting the query.

It seems that you are indeed having recurrent episodes of Genital Herpes.

Once infected with the Herpes virus, it can infect you for life as it attains a latent phase in the cranial nerves, ganglions and causes recurrent episodes due to reactivation of the virus.

When the herpes virus reactivates, it travels down nerve fibers to the skin producing sores, Bumps, or Redness along with burning, itching, and pain in the affected area. The frequency and severity of recurrent Genital Herpes outbreaks can vary. The average number of outbreaks is 4 to 5 a year.

There are some trigger factors that may cause the Genital Herpes virus to reactivate. These Trigger factors vary from person to person and usually can't be avoided.

Some triggers are believed to be:
1. Emotional stress.
2. Physical stress.
3. Injury.
4. Sunlight.
5. Other associated illness (especially with fever).
6. Surgical trauma.
7. Poor diet.

Managing and reducing such trigger factors may help to reduce the severity and frequency of recurrences.

Recurrences tend to be less severe and shorter than the first episode. It is more usual to have 7-10 days of symptoms with a recurrence, unlike the 10-20 days of symptoms that may occur during the first episode.

Antiviral medications to treat recurrent herpes are effective in reducing the symptoms if they are started within 6 hours of either onset of symptom or lesion appearance. Medications are able to stop or shorten an outbreak with just a single day of treatment. If started after 6 hours of onset, the treatment may not be effective.

In addition to the antiviral medications, the symptoms can be reduced by medications like antidepressents, gabapentin or duloxetine, which help to relieve the neuropathic pain caused by the herpes infection.

With respect to the current issue, in the "crevice of the buttocks" , you might be referring to a condition called as Pilonidal sinus.

A pilonidal sinus is a sinus tract which commonly contains hairs. It occurs under the skin between the buttocks (the natal cleft) a short distance above the anus.

A pilonidal sinus can become infected by bacteria, causing pain and swelling. A pus-filled abscess can then develop within the sinus. You may initially be treated with antibiotics, but you will also need to have the pus drained out of the abscess by a procedure called incision and drainage. The other option is surgical removal of the sinus (usually recommended) to open the sinus up and drain away any pus, bacteria or other waste materials.

I would suggest you to consult your doctor who can address your concerns and initiate proper interventions and treatment.

I hope this helps to answer your questions.

Please feel free to consult me for follow ups if any.


Dr. Anvekar.
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