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Tested positive for herpes. Getting irritation around head of penis and slight itching in scrotal area. Worrisome

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Practicing since : 2005
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I think I may have contracted an STD back on July 8, 2012. I got myself tested on July 23 for Chlamydia, Gonorrhea, Syphilis, HIV, and HSV 1 and 2. All tests were negative except for Genital Herpes, which was positive. I had been tested for all STD's at the same clinic back in April 2011 and all tests, including the one for HSV, were negative.

The doctor informed me that the HSV test he had ordered on July 23 was not the same kind he had used previously and that he suspected that it had yielded a false positive. He scheduled a second blood test for August 4 using the more accurate method he had used previously and that test was negative.

I know, however, that it sometimes takes 10-12 weeks for one's immune system to develop the HSV antibody; and so I think I will need to be tested again in October to be absolutely sure.

Since the time when I think I might have been exposed to an STD; to the best of my knowledge I have not experienced any of the following:

Extreme fatigue
Extreme pain or burning when urinating/ejaculating
Open lesions, sores, or blisters that are in clusters or filled with pus or fluid
Bad-smelling urine, or urine that is red or dark brown.

I have, however, experienced a high-degree of sensitivity in the head of the penis. I have also experienced almost daily soreness and irritation around the edge where the head joins the shaft. Whenever the cotton fabric of my briefs rubs against this area I feel soreness and irritation and experience redness.

I also notice small bumps around the edge and on the head They look like small goose-pimples. During a previous examination of the genitals I was told I have many papules and fordyce spots on the shaft, near the scrotum and on the underside of the penis near the head and tip. These look like small whitehead pimples and the ones along the shaft near the scrotum have pubic hairs growing from them.

I was circumcised at birth and I am careful to keep my genitals clean by washing daily with warm water and mild soap when showering. I am also careful to not let soap get inside the urethra; as that can cause irritation and burning when urinating afterwards. As I said, I have not noticed any blisters or other sores like the type usually seen in cases of genital herpes. I also know, however, that many people with the disease do not always exhibit symptoms.

What I have noticed is that I have a 1-2 small, skin-tags around the edge of the penis head and what also appear to be small clusters of blood vessels near the surface of the skin. Because of my genetic make-up (I am half-Latino on my father's side), I have a dark-colored penis and also circumcision scars on the head near the tip and on the underside of the penis. I've noticed a few small brown spots on the head of the penis, resembling freckles or sun-spots (my genitals have never been exposed to strong sunlight).

I currently live and work in South Korea (since 2009) and the summers here get extremely hot and humid. I recently read an online article by a Korean doctor about a fungal infection, caused by excessive moisture, that when it affects the genitalia can be mistaken for an STD. I mentioned this to the doctor at the skin clinic where I was tested and he prescribed an ointment of 1% Hydrocortizone and 1% Clotrimazole; to be applied twice daily to the shaft of the penis. Since the discomfort I've been experiences has mostly been in the area of the head; I've been applying it there as well, taking care to avoid getting any in the urethra.

When I sit quietly I'm fine. But when I'm walking around during the day I can feel my underwear rubbing against the sensitive areas around the head of the penis. In the last week or so I've noticed a small bump on the left and right side of the head, on the edge where it joins the shaft. Under a magnifying glass, when the penis is erect, the bumps look either like a small, inflamed blood vessel or a small pimple with a whitehead. They do not appear to contain any pus or fluid and are no bigger than a pin-head.

I've had discomfort, off and on, for the end of XXXXXXX The last time I was sexually active was on July 8. I had protected vaginal intercourse while wearing a condom. Prior to that, my last two sexual activities were around March or April 2012 and were limited to stimulation of the genitals by hand. As I said, all tests for STD's that I had done between July 23 and August 4 have been negative.

I'm just hoping that what I have was just simple irritation caused by chafing and not an STD or possibly cancer. I discovered a small, slightly-raised, dark-brown mole on the shaft of the penis recently. It is no bigger than a pin-head and is not itchy, painful, or bleeding.

I just sent an e-mail to the doctor at the clinic where I was recently tested; asking for a follow-up appointment two weeks from today. At that time I'll ask to be tested once more for everything just to be sure. By then it will have been 90 days since I think I might have been infected. If the HSV test yields a negative result again; then I'll know that I don't have the antibody in my blood and do not have Genital Herpes. I have also never exhibited any symptoms of oral herpes; at least nothing that appears in medical textbooks or on websites like WebMD.

Two weeks ago I experienced intense dizziness and nausea. I went to the local hospital ER and was kept overnight for observation. An REM scan of my eyes suggested that I has Vestibular Neuritis; a viral infection of the inner ear. The blood and urine tests that were performed did not reveal anything serious. I had told the attending physician my health history and that I had recently been tested for STD's with negative results. I did not mention the discomfort I had been experiencing with my penis, however. I was given an IV drip and some pills to alleviate the nausea. I was discharged the following day and given a prescription for 7 days. I forget what two of the pills were. I suspect one of them was an antibiotic and I took all of them to completion. One additional pill, a sedative, was prescribed in case I had a recurrence of dizziness; which I did not. I went back to see a neurology specialist a week later and he said that they had ruled out the possibility of a cerebral stroke; based on the tests (touching the nose with eyes closed; stroking the tibia of one leg with the heel of the opposite foot, following the doctor's finger). I had forgotten to mention that I have a history of mild hypertension; for which I take daily medication. I used to take a simple diuretic, but that made me urinate too frequently. My doctor recently changed my medication, but I don't know what kind it is. The blood and urine tests that were done in the ER showed no problems with liver or kidney function. I also take medication to fight a fungal infection of my toenails. Before prescribing this medication, my doctor ordered a blood test to check for liver problems. None were found. Before coming to Korea, I received a series of vaccinations for Hepatitis A and B and for Typhoid. I had my last routine physical exam on May 9. Per the contractual requirements of my job, I was given a drug test for Marijuana and an HIV test. Both were negative; as I do not use recreational drugs.

I'm sorry for the overwhelming amount of information here. I only mention the Vestibular Neuritis I recently had; because I wonder if it might somehow be related to the discomfort I'm having in the penis. Other symptoms I've experienced include an occasional slight itching or tickling feeling in the scrotal area and the anus and an occasional tingling sensation in the genitals. I have never been the recipient of anal intercourse.
Posted Thu, 15 Nov 2012 in Skin Hair and Nails
Answered by Dr. Sudarshan 3 hours later

Thanks for detailed information provided.

Out of all the info provided important positive points i found

-one positive herpes test

-irritation or soreness around head of penis.

-slight itching and tickling in perianal /scrotal area.

- penile pigmentation and few growths.

The irritation and soreness is not related to herpes or std.

Herpes usually manifests with small clear fluid filled blisters or tiny ulcers over the genitals.
Also sometimes herpes presents with burningand irritation but after some time it manifests with XXXXXXX blisters /ulcers.which has not happened in your case.

Also i would like to know which test has came positive for herpes.

Kindly get herpes IgG and IgM for type 1 and 2 done.

Kindly upload the photos of penile head and scrotal area.

As of now you dont seem to have any STD whatsoever .

please upload photos to comment on the penile bumps.

There is nothing to be worried about.

Hope this helps.

Anticipating your response.


Above answer was peer-reviewed by
Follow-up: Tested positive for herpes. Getting irritation around head of penis and slight itching in scrotal area. Worrisome 37 hours later
Thank you for getting back to me. It might be a couple of days before I can send any photos. I'm very busy this week. Can photos be uploaded as an attachment to a reply on this website securely? I'm just looking to protect my privacy.

The most recent test I had done for Herpes (August 4) was IgG and IgM. That was also the same type of test the doctor had ordered nearly a year before and both times the results were negative. The test I had done on July 23 was not IgG and IgM. It was a more routine test that the doctor had said is not as accurate, but I forget the name. I will have to wait until I can speak with the doctor who tested me to find out the exact type of test he ordered on that occasion. It was that more routine type of test that had yielded a positive result.

On all three occasions when I got tested I used the same clinic and physician. It is a South Korean skin clinic. The Korean doctors who run it received their medical training in South Korea and in the USA, and they also provide service to the local US military personnel and their families. They are quite reputable.

One thing I noticed is that after urinating there is always residual urine at the tip of my penis I always have to dab the end of the urethra with piece of clean toilet paper in order to absorb any remaining drops. I'm wondering if maybe the drops of urine are somehow contributing to the irritation. Sometimes after urinating in a public toilet, I will shake the remaining drops of urine from my penis before tucking it back inside my briefs. There are sometimes a few drops left that get deposited into the fabric of my underwear that ultimately comes into contact with my genitals.

The day before yesterday I had the most irritation. I applied some Neosporin ointment which also contains a pain-reliever and that helped quite a bit. After showering yesterday I applied the anti-fungal ointment my doctor had prescribed and I experienced little or no irritation. I was also wearing cotton briefs that had been washed using fabric softener. Over the previous 20 days I had been wearing a brand-new, unwashed pair of briefs each day; often on days when the weather was very hot and sticky.

I notice that when the weather is like that, the skin on the shaft of my penis becomes "tacky" and sticks to itself. When flaccid, my penis is quite small and prone to occasional "turtling"; in which the penis head can temporarily be drawn into the shaft part of the way. This sometimes happens if I've been running briefly.
I have quite a bit of coarse pubic hair. It gets so thick that in summer I have to carefully trim it with sterile scissors (the kind used to trim nostril hairs), so that my genitals don't sweat so much. I'm always careful to not cut so close that I risk injuring myself.
Answered by Dr. Sudarshan 21 hours later

Thanks for the details.

I do not think you have any STD at present.

Tast for herpes may be false positive sometimes.

Please get an IgG and IgM of HSV 1 & 2 .

It will clear the confusion.

Also mail me the photos to have a better understanding of your problem.

Meanwhile you can apply antifungal cream if you get irritation.

Photos can be uploaded securely by using UPLOAD YOUR REPORTS section on right.

Or you can mail me those at YYYY@YYYY .

Hope this helps.

Above answer was peer-reviewed by
Follow-up: Tested positive for herpes. Getting irritation around head of penis and slight itching in scrotal area. Worrisome 6 days later
Hello Dr. Sudarshian,

I took two sets of pictures and have attached some of them here. The first ones were taken on 9/25 and the remaining ones were taken on 10/1.

It was not easy taking the pictures, because I had to try nd take them with one hand while holding my penis in the other. As you can see, my penis is quite small and shriveled when it is relaxed/flaccid. In the last two days I noticed some irritation on the top portion of my penis; just near the base of the head. In one of the photos you can see some redness. When the penis is erect, it appears that I have many tiny capillaries near the surface of the skin that give a "blood-shot" look to the naked eye. When flaccid, the redness takes on the appearance of lesions. I've been examining my penis by looking at the skin carefully with a magnifying glass; trying to see any blisters or open sores.

The picture of my left palm was taken on 10/1. I noticed a few small, flesh-colored bumps there two days ago... and a few days before that I had similar bumps along the side of my right index finger and on the right side of my left hand (when the palm is facing up); halfway between where the "heel" of the palm is and the base of the "pinkie" finger. The bumps do not appear to be oozing or weeping and are spaced apart from each other. They do not itch and are not painful.

Now... I have been examining my penis and scrotum a number of times each day for the past 3 months. After each examination I would wash my hands thoroughly with soap and warm water. So, basically, I've been washing my hands about 7-8 times a day (including those times after urinating/defecating) in addition to the times I would wash before eating. The fact that I have not seen similar bumps along the shaft of my penis suggests that I may have contact dermatitis. The bumps seem to be healing. I have been applying some of the hydrocortisone ointment at night before going to bed for the past three nights, and the bumps seem to be healing without breaking and leaving open sores or crusting over.

In one of the pictures you may notice what looks like a small brown mole, near the head of my penis... actually that is a blood vessel that can be seen more clearly when the penis is erect. In another picture you may notice what looks like a blister with a whitehead, but what in reality is either a blood vessel, a skin tag, or a wrinkle in the skin.

Other symptoms that I've been having off and on during the past three months include a brief, momentary tickling/itching sensation on different parts of my body. Sometimes my left eyelid would tickle... then my nose and then my cheek or my shoulder. Basically a different part of my body will itch for a second or two until I lightly scratch it. It comes and it goes, but seems more prevalent at night when I'm trying to sleep.

On various medical and STD websites, I've read that just prior to an outbreak someone infected with genital herpes may experience a "prodome" in which the herpes virus travels along nerve endings in various parts of the body (but especially the genitals). This usually happens just before an outbreak and can affect any part of the body. Right now, I'm experiencing that slight tickle/itch in my right eyelid and on my chin. I've also read that a number of patients infected with genital herpes do not always develop the classic textbook symptoms of clustered, red blisters filled with clear liquid; which then break open causing sores that eventually heal by crusting over.

As I said previously, I have an appointment scheduled for this coming Saturday at the skin clinic where I was tested in July and August. I will request the specific antibody tests you suggested, in order to be sure. If the test yields a negative result again, then that means I don't have the antibody and therefore do not have the disease, is that right? I have not been sexually active since July 8 and when I was I used a condom that had covered up the head and most of the shaft of my penis. What I can't understand is why I'm feeling the soreness in places that would not have been exposed? Really, the only way I could possibly have it would be if the person I was with was actually infected. I've read that it's more difficult for a man to contract the infection from a woman; or at least that it's more rare than a man giving it to a woman or another man.

Maybe my symptoms are being caused by something else... an allergy, perhaps? Or maybe they're psychosomatic because I've been so worried about having a STD.

Please let me know if you have problems viewing the photos. I had some difficulty uploading them. I apologize for the blurriness in some.
Answered by Dr. Sudarshan 56 minutes later

Thanks for the details.

I must appreciate the details with which you have submitted your query and photos. It shows that you are really health conscious and keen observer.

After going through all the photos of genital area, I could not find any changes related to STD or any other pathology. Some amount of pigmentation and color changes are seen in almost all adults males of your age. It does not indicate any disease or STD.

As your bumps are responding to hydrocortisone cream you may continue it for a week more. You can apply some hydrocortisone on palm also.

Due to repeated hand washing your palm has washerwoman like skin. Infact there is no need for too much hand washing with soap. That much over use of soap may itself give rise to dermatitis.

Regarding prodrome of Herpes, you are right - that it begins with tingling or burning. But later on it develops into XXXXXXX fluid filled blisters or tiny ulcers - Which have never happened in your case. So it is unlikely that you have Herpes infection.

Tickling and itching over eyelid and other genital areas is not related to herpes. It may have some other reason. Merely your knowledge about herpes symptoms and apprehension about STD is perhaps causing these symptoms.

In the end I would like to reassure you that none of your symptoms point towards STD.

Hope this helps.

Dr. Sudarshan
STD specialist
Above answer was peer-reviewed by
Follow-up: Tested positive for herpes. Getting irritation around head of penis and slight itching in scrotal area. Worrisome 7 hours later
Thank you for getting back to me so quickly. I can't tell you how worried I've been about all this. As I said, I'll be going back to the skin clinic this coming Saturday to get re-examined and re-tested for Herpes. I'm keeping my fingers crossed that the test yields a negative result once again; because that will mean conclusively that I have no new or previous infection.

I'm still perplexed as to what can be causing the irritation I've reported having. For the past three months I've experienced a heightened sensitivity in the head of my penis and occasional irritation, redness and soreness in some isolated areas. It comes and goes. I think that my wearing new, unwashed cotton briefs every day for about three weeks may have contributed to the problem. I recently washed all my new underwear using fabric softener... but I notice that even the washed fabric of my underwear brushing slightly against the more sensitive areas will still cause discomfort.

The hot, sticky weather that we were having here in South Korea didn't help matters, either. I'm wondering if the excessive sweating from my genitals also contributed to the problem or maybe even caused me to develop a fungal infection that I was confusing with STD's My doctor never tested me for any kind of fungal infection but rather just prescribed the hydrocortisone ointment.

Maybe I have an allergy to hydro-cortisone or clotrimazole? I had numerous food, plant and animal allergies when I was a child. The majority of these went into remission by the time I had reached puberty; but maybe some of them are returning... I don't know. I would have to see an allergist and arrange to have skin and scratch tests done for different allergens.

As for the bumps on my hands... the bumps in the webbing between the index and middle finger on my left hand have disappeared. I first noticed those about a week ago. The 4-5 bumps on the side of my left hand, near the heel of the palm, are nearly gone. I first noticed about 7-8 bumps on the palm of my left hand; now there appear to be only 4. The bumps never ruptured. I am curious as to why I didn't experience any itching this time. On every other occasion that I've had contact dermatitis from too much hand washing, it would always itch uncontrollably.

The reason I was washing my hands so much was because I was worried that if I do have genital herpes; I might accidentally spread the virus to other parts of my body; including my eyes, which I sometimes rub with my hands.

I do have dry skin on most of my body; but I'm afraid to use most skin lotions because they contain methylparaben and other types of parabens. I had read an article online, not too long ago, which stated that parabens have been linked to skin and other types of cancer.

For the same reason, I'm reluctant to use any kind of bath or baby powder to prevent chafing; because most of them contain talc, which reportedly also has been linked to some forms of cancer.

Because I'm over in South Korea, I don't know what's in most of the skin care products sold here. The labels are mostly in Korean and I'm not fluent in that language. Many American products are sold here, as well; but it's hard to find anything that's paraben or talc free. The ointment I'm currently using is manufactured in the US and is completely free of parabens, lanolin, and fragrances.

You are correct in that I do try to be well-informed about health matters. But then, I feel I have to be; given my family history of cancer and other diseases.

I worry about my health constantly as a result, however... perhaps to the point of hypochondria. Whenever I see something on my body that looks strange I immediately panic; thinking that I have a life-threatening disease. I become frightened because I don't understand what's happening or how to control it.

It's especially frustrating at present because it's sometimes difficult to find a doctor who speaks English over here. Fortunately the doctor at the skin clinic is fairly fluent and wlll hopefully be able to explain to me why I've been experiencing so much discomfort lately. Maybe I'm simply using too much laundry detergent when washing my clothes and if I reduce the amount it might help alleviate the symptoms.
Answered by Dr. Sudarshan 5 hours later
Hi Again,

I can understand your anxiety and problems you are facing in Korea. Irritation and other problems that you are facing can be due to laundry detergent products. Try not to use any detergent. Just, you can use warm water to wash inner garments.

Also try using some paraben free moisturizer with soft white petroleum gel or liquid paraffin moisturizer. Try to avoid wearing undergarments at night time.

Hope this helps.

I will be available for any further skin related queries in future.


Dr Sudarshan.

Above answer was peer-reviewed by
Follow-up: Tested positive for herpes. Getting irritation around head of penis and slight itching in scrotal area. Worrisome 11 hours later
In the past 12 hours I've been experiencing an occasional stinging sensation in two areas on my penis; just under the part where the head is joined to the shaft. I notice that on the left side there appears to be an actual sore. There is a very small, red patch that looks as if a thin layer of skin had been rubbed away, like when one accidentally gets a skin abrasion on the knee or elbow from carpeting . It's very tender to the touch; I applied a small amount of Neosporin antibiotic ointment to relieve the stinging and to prevent infection. I washed my hands immediately after examining myself. I am attaching two new pictures for you to look at. They end in the double-digits 98 and 99.

I know you have told me repeatedly that genital herpes usually manifests itself as a cluster of fluid-filled blisters that break open and form painful sores which eventually crust over and then heal.

However, I've been reading about some people who have been definitely and accurately diagnosed with the disease; but didn't actually experience a classic, textbook outbreak. I believe the term for these peole is "asymptomatic"... Instead of getting the usual blisters in their initial outbreaks; they just experienced burning, stinging and or redness in the infected areas. Have you ever heard of this happening or treated any patients who definitely had the disease but whose outbreaks didn't fit the usual pattern?
As I said in my last follow-up question, I noticed some redness and soreness on two distinct areas on my penis (see the most recent photos I sent).

Looking at the areas in the daytime in bright sunlight with a magnifying glass I could see the following:

1.Numerous, small blood vessels and capillaries near the surface of the skin that look inflamed.

2. In each area where the soreness occurs, I can see what appear to be 3-4 tiny cracks or fissures in the skin surface. What worries me is that when I press a clean, dry piece of white facial tissue against each of the two areas and then look at it, I can see a small wet spot; which suggests to me that the two inflamed spots are indeed weeping to a small degree.

My left eye has also been occasionally weeping. I first noticed this about two weeks ago. It is not consistent and not copious. What I notice is a very small amount of moisture collecting in my lower eyelid. I am not experiencing any pain or itching in either of my eyes and my eyes have not clouded over or are oozing any kind of mucus or pus.

Is it possible that the red spots on my penis could simply be the result of irritation from fabric rubbing against them, or from a soap allergy? On self-examination it's difficult to tell if I have any actual blisters. If I do, they are extremely small.

I was thinking of trying to go to the skin clinic today and ask the doctor to take a swab of the area and test it for Herpes virus. Today is a holiday, however, and all the clinics are closed for the day. I will have to wait until this Saturday to see the doctor. I plan to ask him to do an IgG and IgM test for both HSV 1 and 2. If the redness, soreness, and weeping are still present; I'll also ask him to swab the affected areas and do a culture as well.

Answered by Dr. Sudarshan 9 hours later
Hi again,

Thanks for the details.

I’ve gone through the details. I could not see new images ending in 98 and 99; maybe they are not uploaded.

I still think the sore or red spots you are experiencing are due to allergy and not Herpes.

To answer your question, yes, we encounter such patients who have only burning/stinging /itching to start with. Such patients later on may develop XXXXXXX lesions of herpes in week or two and test positive for herpes. Textbook presentation of herpes is not always seen. However they start with vague complaints but sooner or later they develop XXXXXXX ulcers over genitalia.

Now the only way to confirm the diagnosis is by testing for IgM and IgG in this phase. If your herpes type 2 IgM antibodies come positive in high titre we can say you have acute herpes simplex genitalia. Swab of the area is not much diagnostic; only IgG and IgM antibodies are helpful.

You can get it done when the clinics are open. Till the time you can apply neomycin ointment over the sores.

Do get back to me after you visit the skin clinic.

Above answer was peer-reviewed by
Follow-up: Tested positive for herpes. Getting irritation around head of penis and slight itching in scrotal area. Worrisome 31 hours later
Thank you for your reply. I wasn't able to view your answer until 12 hours later; as I was rushing to get to work this morning.

Since I last wrote, there is still some redness in the areas I mentioned. I have stopped using the 1% hydrocortisone ointment for the time being and have been applying instead the antibiotic ointment; because it also contains a topical analgesic to temporarily relieve pain.

Today the stinging was not as noticeable and the affected areas are not so tender to the touch as they were at the time I sent my last reply. It's difficult to tell, but when I examine the areas under a bright light with a magnifying glass, I can see what look like 3-4 tiny little scabs (not much bigger than the head of a pin in diameter). When I lightly press a clean square of toilet tissue, I'm not seeing any residual wet spots afterward. I'm also experiencing a slight tickling/itchy sensation on the shaft of my penis; as if someone were tickling it with a feather. I occasionally get that same feeling in different areas of my face: sometimes the cheek or chin, or the bridge of my nose closest to my eyes.

At dusk tonight on the bus ride home, I noticed that my left eye was weeping slightly at the corner closest to my ear. I noticed a bit if itching as well. I'm hoping it's just because of the ragweed pollen that's in the air now. I've been trying to be careful not to touch my eyes with my bare hands; but I fear I may have inadvertently done so after touching my penis while half asleep. My biggest fear is that if I do have herpes and have been experiencing an outbreak; that I have inadvertently "auto-inoculated" myself and spread the virus to my eyes or some other part of my body.

The bumps on the palm of my left hand are still there; but are not itching, burning, stinging, or weeping/oozing. Some of them have gotten smaller and a little dark in color. These appear to be healing. The bumps on my right index finger have disappeared. I've tried to reduce the number of times I wash my hands; but I do have to wash them after urinating or having a bowel movement.

The pinky finger on my right hand is slightly itchy and the webbing between the fingers on my left hand is a bit red and chapped-looking. I recently purchased some baby lotion and will apply some to my hands tonight before going to bed. I will also continue using the hydrocortisone on the left hand until I can see the doctor on Saturday.

I will write back after seeing the doctor on Saturday; but I will have to wait at least a week to find out the results of the type-specific Herpes blood test. I will be traveling this weekend; and will not be able to report anything until at least next Monday.

Sorry you couldn't find the photos... The uploading application on this website seems to be temperamental.
Answered by Dr. Sudarshan 4 hours later
Hi again,

You can continue hydrocortisone application on hands.

The chapping you described in finger webs seems to be intertrigo. This usually occurs due to constant moisture and wetting the hands in soap or detergent. Apply some oil like tea tree oil based product over it and see if it improves.

Tingling, numbness and itching may occur due to other causes and not necessarily mean herpes. You can wait till the results are ready - that should clarify all your doubts.

If you are unable to upload fresh pictures, you may send the pictures across to my attention (attn: Dr. Sudarshan) and send them across to YYYY@YYYY . However I would suggest you to wait till you receive the test reports.

Hope this helps. You may write back if you have other enquiries.

Good Luck!!!
Above answer was peer-reviewed by
Follow-up: Tested positive for herpes. Getting irritation around head of penis and slight itching in scrotal area. Worrisome 3 days later
Hello Doctor,

I went to the skin clinic on 10/6 and saw the doctor. I explained the symptoms I had been experiencing and showed him my penis. At the time it was red and there were small lesions resembling chapped skin.

His opinion was that I may have developed an allergy to the neomycin-sulfate ointment I had been using alternately with the hydrocortisone/clotrimazole. He also said that part of my problem may be psychological and I may be obsessing too much over all this.

At my request he ordered a series of tests for HSV-1 and HSV-2; including the IgG and IgM tests you specified. I probably won't have a chance to call him for the results until sometime next week.

In the meantime he gave me a new prescription for the hydrocortisone/clotrimazole ointment and another kind of ointment for my hands. I applied the hydrocortisone/clotrimazole on Saturday evening; as I had 8 hours earlier. During the night I experienced itching on the shaft of my penis. In the morning that itching had intensified; so I washed off any residual ointment with warm water only. I decided to not use any additional ointment during the day on Sunday. On Sunday night, however, I applied some more ointment and then went to bed. The same thing happened: I experienced itching and burning that led me to believe that I actually had developed an allergic reaction to hydrcortisone or clotrimazole.

This morning I washed my penis and scrotum with warm water but again no soap. My penis was sore around the glans and the circumference that joins the head to the shaft. I dried it carefully and then lightly wrapped it with clean, dry toilet tissue (fragrance-free); to try and keep it from getting irritated by rubbing on my underwear.

As of this writing, the shaft of my penis has small red welts in the aforementioned areas. They are painful to the touch and are weeping somewhat. I took a few new photos and will attempt to upload them to the e-mail address you gave me ASAP.

I have been taking Acetaminophen tablets (2 every 6 hours) for the pain and inflammation.
Answered by Dr. Sudarshan 3 hours later
Hi Again,

Thanks for writing back.

Its good to know that you visited dermatologist and underwent the IgG /IgM test.

I feel test are going to come negative and It will calm your nerves that you dont have Herpes.

Hydrocortisone is a mild steroid and clotrimazole is an antifungal.

Allergy to hydrocortisone is extremely rare.Infact it is used as treatment in allergic reaction.However clotrimazole may give rise to allergy.

If the ointment is increasing your discomfort stop using it.

Continue acetaminophen 6 hourly.

Just you use soft wet cotton cloth over the penis to reduce the pain.

Upload the new photos and we can continue the discussion.

There is nothing to be worried about.Just keep your anxiety level down and everything will settle down.

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Follow-up: Tested positive for herpes. Getting irritation around head of penis and slight itching in scrotal area. Worrisome 5 hours later
The last 2-3 pictures were taken less than an hour ago as of this writing. The areas are still red and stinging and it looks like I have a few small cuts in the skin. Right now even if I carefully douse the areas with cool tap water it stings. After I send this e-mail I will call the doctor at the skin clinic and ask if I can see him today for a follow-up consultation.

I doubt that the test results are ready by today; but if a rush was done on them I will write back to you and report the findings.
Answered by Dr. Sudarshan 9 hours later

Ive gone through images.
Some erythema and inflammation is visible in corona of penis.
It can be due to allergy of neomycin or the clotrimazole ointment.

You can apply a plain hydrocortisone cream over the area.Avoiding the clotrimazole cream only hydrocortisone cream is available.You can purchase and apply it.

Avoid any other soap or other things at the area.Use only soft wet cloth to clean.

Upload the reports whenever they are available and we can continue the discussion.


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Follow-up: Tested positive for herpes. Getting irritation around head of penis and slight itching in scrotal area. Worrisome 29 hours later
I called the doctor at the skin clinic yesterday to report my latest symptoms. He said it's rare to have an allergic reaction to hydrocortisone itself; so perhaps a different ointment not containing clotrimazole would be needed instead.

Because I live too far from the clinic to have been able to come in for a follow-up consultation that day; the doctor looked up the name and location of a dermatology clinic in my immediate area and gave me the phone number and hours.

When I called, I was unable to find any staff there who spoke English; so I went instead to a clinic that is about a 20-minute walk from where I live. The doctor there practices XXXXXXX medicine and speaks English.

I explained the various symptoms I had been experiencing over the past three months and let him examine my genitals. My penis was oozing in the areas I had photographed the day before and was still red and raw from irritation.

The doctor felt that it was consistent application of the 1% Clotrimazole, a steroid, which had caused the problem. He described my problem as being a "secondary infection" and an allergic reaction. He prescribed a three-day course of drugs that include an antihistamine, acetominophen (500 mg.) for pain, an antibiotic, and an anti-inflammatory. He also prescribed an anti-fungal ointment that contains no steroids. I have to take the pills 3 times a day and use the ointment 2 times a day. He also recommended using a moist bandage to cover the area and prevent the bandage sticking to the wounds.

The medicine seems to be working; but I think it may take a few days more before my penis is completely healed. On some of the affected areas a sticky, white-yellow substance has formed on the surface of the skin. I've seen this before whenever I've sustained an abrasion on my elbow or knee and the skin was read and raw... the sticky substance, I believe, provides some kind of protective covering over a wound while new skin cells are formed underneath.

To protect my penis from undue irritation by my underwear rubbing against it; I have placed 3-4 absorbent cotton squares around the areas that are affected (after having first applied the ointment). I then lightly wrap a length of surgical gauze bandage around the cotton to hold it in place. This seems to help, somewhat; although I have to be careful when changing it so that I don't inadvertently rip off the scab that is forming. Moistening the cotton with water first makes removal easier.

I will return on Friday to this other clinic for a follow-up evaluation. At that time, the doctor will determine if I need further treatment and if I need to consult a dermatologist as well.
Answered by Dr. Sudarshan 1 hour later
Hi Again,

According to the description provided by you and the photos it looks as you have allergic reaction and secondary infection.

Its better not to apply the steroid antifungal ointment at all.

Sticky yellow substance is the discharge suggestive of infection.Oral antibiotics will take care of the infection.Do not scrape the area.As it will further aggravate the irritation.
Keep the moist gauze for protecting it from the friction against the clothing.

Complete the course given by the doctor.Visit your dermatologist when time permits.Hydrocortisone allergy is rare but possible.

Keep the area clean and dry.

Keep me posted when you visit the dermatologist and get the reports.

Above answer was peer-reviewed by
Follow-up: Tested positive for herpes. Getting irritation around head of penis and slight itching in scrotal area. Worrisome 16 days later

A few minutes ago I called the skin clinic where I got tested for HSV-1 and HSV-2, IgG, and IgM on October 6.

The doctor said that I tested positive for both HSV-1 and HSV-2. The IgG test was positive, but the IgM test was negative.

I asked him what precautions I should take to avoid spreading the virus to others and if I should begin a course of anti-viral medications. He said no, that I apparently have had no outbreak and that I should do my best to keep my immune system healthy.

He said the IgG positive result means that the virus is present in my body. The IgM negative result means that it is not a recent infection. So maybe I already had it before I came to South Korea.

I'm most worried about the HSV-1 because that can be transmitted just by kissing someone. I asked the doctor about this and he said I should avoid kissing anyone if I have lesions around the mouth (which, to the best of my knowledge, I've never had).

After I last wrote to you, I went to seek medical treatment for the symptoms I was experiencing and of which I had taken photos. First I went to see an XXXXXXX medicine doctor. He said that what I had was excema with secondary infection. He prescribed a 5-day course of oral antibiotics, antihistamines, and non-aspirin pain reliever.

This was on Tuesday, October 9. By then there were 3-4 areas on the upper shaft and glans of the penis that were red, raw and oozing; but no clusters of XXXXXXX blisters. The areas were painful to the touch. The doctor had also prescribed an anti-fungal cream that seemed to help alleviate the pain after applying.

On Thursday, October 11, I went back to see the doctor because it looked like the condition was not getting better. At least two of the affected areas had, as I described to you, formed a sticky, white-yellowish, pus-like coating. The doctor gave me a new prescription, continuing the oral medication for an additional 4 days; but this time substituting a petroleum jelly-based hydro-cortisone ointment. The ointment was very thick and difficult to spread at room temperature on the areas that were raw and oozing. I went back to the doctor the next day and asked him if he could prescribe a cream-based medication that also contained an analgesic for the pain.

He decided at that point to refer me to a local dermatologist; who changed my medication. He prescribed a course of oral cortisone tablets and antihistamines, along with a plain, cream-based hydro-cortisone ointment. He told me to apply the ointment two times a day and take the oral medication two times a day after meals; all for a period of seven days. At the end of the seven days, the condition had improved and healing had begun. All during this time the dermatologist said that what I had was due to excema and not an STD.

The dermatologist then prescribed another 7 days of hydro-cortisone cream, to be applied twice daily, and also a topical moisturizer ("Doctors PGA Moisturizing Cream") to be applied each night after applying the hydro-cortisone. He reduced the oral medication to just one time a day (in the evening) and told me to return this past Wednesday.

By then, the condition had improved greatly. There are still two areas that are red. One of them appears to be a tiny cut/crack in the skin that has healed over. Still, the penis shaft and head look much better than they had back on the 9th.

When I went to see the dermatologist this past Wednesday, he told me to limit the hydro-cortisone applications to just once a day (at night) and to increase applications of the PGA cream to twice or three times daily. He prescribed the same oral medications, but this time told me to take them once every other day, at night, for a period of two weeks. I have to return to the dermatologist on Wednesday, November 7 for a follow-up examination.

At this writing, I am not experiencing the pain I had nearly 3 weeks ago. There is no weeping or oozing. I have just experienced some minor irritation due to the skin occasionally rubbing against my underwear. In all of this I have not seen any clusters of fluid-filled blisters that break and form open sores that then crust over. There was one small area on the head of the penis (on the underside) that had been raw and irritated and then formed a scab which eventually flaked away.

So, what do I do now? I've been told that I have both types (oral and genital) of actually has Genital Herpes. I've also read accounts of people who had actual outbreaks; the symptoms of which ranged from the XXXXXXX blisters of which you've written to just redness and irritation.

All three doctors whom I've seen over here seem to concur that my recent symptoms are due to excema and not to Herpes.

Do you agree with the assessment that I should not start a course of anti-viral medications unless I experience an actual outbreak? Is there any chance that what I've experienced over the past three was an actual Herpes outbreak and that the doctors were wrong?

I'm feeling anxious and worried about this. On the various websites I've visited I've gotten some conflicting information. On one site it said that people with Herpes should not share utensils or drinking cups, shake hands, or share bath towels.

On other sites, I've read that when someone has an outbreak and sheds the virus particles; the virus cannot live outside the host for more than a fraction of a second and therefore cannot be transmitted by contact with towels, shower/bath/swimming pool water.

I've also read that someone who is infected with the virus can have what is called "asymptomatic shedding"; whereby they go through the prodome stages but don't have an actual outbreak.

I can't help but wonder how many of my symptoms have been real or imagined. I think I told you there have been times where I experienced momentary bouts of a tickling or itching sensation that comes and goes in various parts of my body. Sometimes I'll feel the tickling sensation in the scrotal area or anus; the I might feel it on one side of my face or my earlobe or some other place. Could these symptoms just be due to anxiety?

What does all this mean in terms of future relationships with people? I'm afraid now to have any physical contact with anyone. If I have HSV-1 I think that means I can never kiss anyone (friends, relatives) because I'm afraid that, even if I don't have any visible sores, I may inadvertently infect someone. I'm not in a relationship with anyone and don't expect I will be anytime soon because my work takes up a lot of my time.

I'm also worried about anyone else finding out that I have the disease. I know that I will be limited in who I can date or marry in the future and that I will have to tell my future partner about my condition. I'm especially worried that my employers may find out I have the condition and it will adversely affect the terms of my work visa.

The Korean government seems to be primarily concerned with people who have HIV, however. I was tested for HIV on May 9, as part of my job requirement for rehiring and again on July 23. Both tests were negative. My last sexual contact involved vaginal intercourse using a condom on July 8. Prior to that I had no sexual intercourse for over a year. I have been tested for HIV six times in the past four years and each test was negative.

During the past two weeks I've developed a cold. I've had bouts of coughing and nasal congestion, for which I saw I doctor yesterday and received a three-day course of antibiotics and non-aspirin pain reliever. The coughing is intermittent with some yellowish mucus being expectorated. To the best of my knowledge I've had no fever, just an occasional sinus headache.

For the past two weeks I've had bouts of frequent urination. The urine is usually yellow or clear in color. It's inconsistent. Some days I may urinate as many as 10 times a day and others only 4-6 days. I tend to drink 2-3 cups of coffee a day and I know that caffeine is a diuretic. I don't know if the medicine I've been taking for the excema causes frequent urination or not. I forgot to ask the dermatologist on Wednesday. I did ask the other doctor about it yesterday when I went to see him about my cold. He said that yellowish or clear urine is normal and that the color is often affected by intake of liquids. The more one drinks the clearer the urine. The frequency of the urination, he said, may in part be due to psychological reasons.

I'm sorry for the lengthy follow-up reply. I have many different questions. I also feel somewhat depressed over the fact that I now definitely have the HSV1 and 2 in my body; even if I haven't had an actual outbreak. I know that the virus is so widespread that in different countries as many as 1 in 4 or 5 people have the disease... which in reality is a treatable skin condition and is not life-threatening.
Answered by Dr. Sudarshan 3 hours later

Thanks for writing back.

IgG antibodies suggest old or past infection.IgM antibodies suggest an acute/ongoing /recent infection.
IgG positivity for HSV 1 and 2 suggests you had an exposure to both and you have immunity against it.Your first episode may have been very mild or atypical so that you wont remember it.As you already know IgG antibodies for HSV are very common all over the world.It is nothing to be worried about. Many people have this and lead a extremely normal life.
Occasional acute episode can be treated immediately with antivirals like valacyclovir.Which can be started by patient at home also.Early starting of antivirals in prodrome can even suppress the episode completely.Patient initiated treatment regimens are available.

At this point you dont need any antivirals.

Excessive emotional /physical stress/illness/ fever can cause recurrence of the disease.It can be treated at that point effectively.

You can lead your normal life like millions of those who have HSV.
Kissing and sexual intercourse is to be avoided only when you have active oral /genital lesions.

Asymptomatic shedding can occur but it is not very common.

You can continue your normal life and have relationship in future.
Your anxiety and psychological issues are related to frequency of urine and nothing else.The rest of the information you can read on patient support groups.

Hope this helps.

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