Constant burning around anus for 3 weeks - herpes or something else?

[hsv1male]

I was diagnosed with genital HSV-1 about five years ago and have had maybe an outbreak a year since - my primary outbreak had severe burning pain when peeing, a couple of small blisters on my penis, and a large painful sore around the anus. The recurrent OBs have only ever involved the anus, but generally much smaller and less painful, although six months ago I had a larger than usual anal sore which took quite long (two weeks) to go away.
About three weeks ago I started getting a burning sensation around my anus but no sores and no tingling or other symptoms. I thoght this might have been hemorrhoids at first, however I started taking a five-day course of aciclovir after a few days which didn't make much difference, so I continued taking it for another five days with no real change in symptoms. About four days after stopping the aciclovir I did get the typical anal sore in the usual place, and the tingling and cold sensations I normally get with recurrent OBs. I have heard you can get OBs when stopping a longer course of antivirals, so thought this might be the trigger for the OB. I went back on the antiivirals (another five day course) and the sore is now slowly healing (about 10 days later) but I still have the burning pain around the anus but not at the site of the sore (sore on the right, but burning on the left). Has anyone else experienced these symptoms? Could the burning be due to herpes even though it started two weeks before the sore? Any advise appreciated.

[hsv1male]

Thanks, I've had a checkup to rule out any STI s but will have it looked at by my regular doctor if it doesn't clear up the next week or so. Burning does seem to be receding slowly though

[auntiejessi]

Good. Let us know what happens if you go to the doctor, and hope you feel better. :)

[hsv1male]

STI tests all clear and I started using hemorrhoid medication (Preparation H) which does seem to be working - the burning is much less than before and only really noticeble when I sit down for extended periods. So it seems like hemorrhoids I guess, but will have it looked up all the same just to be sure. I suppose I expected hemorrhoids to always bleed, not cause this kind of burning painn, but it seems to be a common symptom.

[auntiejessi]

Yes, you're right - burning is common, and while they can bleed, it doesn't always happen.

This explains why you might have burning from it - https://www.medicinenet.com/hemorrhoids_piles/article.htm#what_are_symptoms_and_signs_of_hemorrhoids (It's about halfway down the page.)

Hope you continue to get some relief!

[auntiejessi]

I'd doubt it would be herpes. You could have an anal fissure, a pinched or entrapped nerve, etc.

Yes, it's not uncommon to get an ob after stopping a longer course of antivirals. It doesn't surprise me that you had an ob after that.

Since the burning hasn't subsided, it would be worth a trip to the doctor to make sure nothing else is going on.

Hope you feel better!