HSV1 uncertainty and ongoing symptoms

[AnonymousHSV]

Hi Terri, thank you for all the work you do helping with herpes. Your resources are very helpful for me.
2014 to 2020 I was with my first sexual partner. We had occasional oral and occasional condomless sex. Never noticed any blisters or any other symptoms of HSV on my partner but we didn’t get tested together. She had few sexual encounters before me.
I have noticed my mom with a coldsore before. I have no history of cold sores.

In 2022 I met a new partner and we both got screened she was all negative I was positive for HSV1 IGG 1.34 through labcorp. I am of Asian Indian descent. After educating myself we both realized this wasnt cause for concern and continued, having condomless sex a handful of times.
A month later I got a sore under my foreskin that I found during a session of oral, It hurt only after several minutes and asked her to stop, then saw the sore. It looked like a mucocele is the best I could describe it, not like any pictures of HSV I have seen. Thought maybe due to rough handjob/oral. Hurt only to wash.

After 5 days it was resolving a little. Went to urgent care-said definitely not HSV and said balanitis, did not swab, gave me fluconazole and mupirocin cream. It resolved within a week.

Everything OK but month later I started getting pain in the same area as the original sore, but everything looks OK. Dermatologist said the skin looks great, but I feel burning and pin poking daily. Derm seems to think HSV related because of description of sore and nerve pain symptoms. Gave me hydrocortizone 2.5% but not helping. This is persisting for 2 months almost now.

I dont know what to do and have no idea if any of this is HSV related. Im worried a WB test with positive HSV1 would provide no greater clarity.

1. Do you recommend a WB and if that comes positive is there any evidence that what I experienced or am experiencing is related to HSV?

2. Everywhere I went on short notice only had viral culture swab. Where do I find PCR swab if another sore appears

[AnonymousHSV]

I hope it is OK to add a little more detail since I ran out of characters in the first post.

The sore I originally got was not painful unless being touched or washed. Over the next 4 days it didnt get worse or better, stayed the same, maybe slightly turned red. When I would retract the foreskin after a full day the surrounding was damp barely, but no discharge that I could tell.

Since I was so concerned about HSV at urgent care they offered a swab for my peace of mind but I refused it because they only had viral culture and the sore was already healing a little by this point so I didnt want false security of a negative swab. Everywhere I tried to go had only viral culture and not a PCR swab, I ran out of time and the sore was healed and I still never found a PCR swab.

My current pain is typically not in the morning, and more in the evening. Its on and off and describes like nerve pain. I still enjoy sex but the discomfort is there during normal life and very bothersome. Should my next step be a urologist? There are no physical signs of injury.

[Terri Warren]

1. Do you recommend a WB and if that comes positive is there any evidence that what I experienced or am experiencing is related to HSV?
The skin change you describe is somewhat concerning to me. You’ve never had a cold sore in your lifetime yourself?
If the western blot is negative, you could stop worrying, but if positive, it is correct that you cannot know for certain where the infection is located

2. Everywhere I went on short notice only had viral culture swab. Where do I find PCR swab if another sore appears
Oh, I can’t help you with that really, I don’t know where you live (and don’t want to), you would have to call around and try to find that in your area.
If this lesion was due to HSV 1, you may never have another one.

If this was herpes, normally the nerve sensations go away when the lesions go away, or within just a couple of days. I’m not sure where to guide you next – I doubt urology would be helpful. But without a western blot, we have no idea if you even have herpes. Your index value for HSV 1 was very low

Terri

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