confused about symptoms

[seekingadvice84]

Hello, and thank you in advance.
My question is about symptoms I have been experiencing on my penis, and whether or not these can be herpes lesions.

First off, I was recently diagnosed with Genital HSV 1, having my primary outbreak in April.   So I know that I have HSV 1 already.

However, I am staying with a new girlfriend outside of the US at the moment, and am worried that these may be recurrences, as I do not want to put her at any more risk (she is fully aware of my HSV 1 diagnoses, and I have referred her to this site as well).

So, about two weeks ago I developed a single pimple like bump on the very base of my penis shaft.  Initially I assumed it was a recurrence.  But I soon realized that it had a hair sticking out of the bump, looking much like an actual pimple or irritated follicle.  I plucked the hair, and after a small discharge, the bump just became red.  It stayed that way for several days, in which I refrained from sex just to be safe.  After scouring this site, I convinced myself that this was indeed just an irritated hair, and a few days ago, the red bump cleared up entirely.

BUT, The day before yesterday, I went to the bathroom and noticed a great big pimple like bump in the exact same spot.  I popped it and pimple-like puss came out.  Now I have a slightly painful red bump just like before, there seems to be a small hole or lesion in the center of it.  

Now, If it weren't for my GSHV 1 status, I might dismiss all of this, but I am worried to say the least.  
I should mention that these two bumps are on the opposite side of penis and not in the same area as my initial outbreak.

1. Does this sound like a Herpes lesion?

2. I am worried about the fact that it seems to be recurring int the same spot.  Is it possible for herpes to resolve  itself... and then reappear a few days later??


I really don't want to infect my friend, so I am trying to be as thorough as possible, but am I just over thinking this?

[Edward W Hook, MD]

1.) is it unusual for folliculitis to affect just one pore as it seems to be doing? shouldn't it be a little more spread out through the affected region?

No folliculitis can occur as an isolated lesion.

2.) do I understand correctly that it you feel it is not unusual for the red bump to disappear entirely, only to then reappear very quickly, actually a little larger than the first time?  It seems a bit odd to me that it would behave this way rather than just remaining red and forming pimples...

Correct, this is in the range of things that can and do happen.  

3.)Also, it seems to change color and size throughout the day, with it hurting to the touch at sometimes while not others...

I have no explanation for this.  

4.)  Again, I am outside of the US, so seeing a doctor or Lab is probably not going to happen. Are there any general topical ointments i can apply that would help clear this up if it is indeed an irritated follicle?

The best treatment for folliculitis is with regular washing/soap and water to keep pores open. Use of a wash cloth or loofah sponge helps.

EWH

[seekingadvice84]

Thank you for your timely answer.  You more or less confirmed my suspicions that this is folliculitis.
To answer your initial question - no, these pimples are in a different location than my initial OB, but this is the first year of infection...

Just a couple follow up questions if that is ok.
  
1.) is it unusual for folliculitis to affect just one pore as it seems to be doing? shouldn't it be a little more spread out through the affected region?

2.) do I understand correctly that it you feel it is not unusual for the red bump to disappear entirely, only to then reappear very quickly, actually a little larger than the first time?  It seems a bit odd to me that it would behave this way rather than just remaining red and forming pimples...

3.)Also, it seems to change color and size throughout the day, with it hurting to the touch at sometimes while not others...

4.)  Again, I am outside of the US, so seeing a doctor or Lab is probably not going to happen. Are there any general topical ointments i can apply that would help clear this up if it is indeed an irritated follicle?

thank you again, I appreciate it.

[Edward W Hook, MD]

Welcome to our Forum. I presume the lesion you have asked about is not at the same location as your genital HSV-1 lesion.  This, as well as the description you provide makes it unlikely that this lesion was a recurrence of your HSV-1.  (BTW, HSV-1 in the genital location rarely recurs and if it is going to recur, there are few recurrences with most of them recurring in the first year after acquisition of infection.

The lesion you have described is a classical description of folliculitis.  As you probably know from other posts on our site, folliculitis occurs when the pores in your skin get plugged.  This allows that normal bacteria that are present on just about every-one's skin to grow and cause what is essentially a pimple.  Some of these just appear as red bumps which may or may not be  tender while others go on to actually form pimples.  When you pop a folliculitis lesion it is not uncommon for them to recur as a pimple of the sort you also describe.  



1. Does this sound like a Herpes lesion?
No. if you are concerned you could seek a culture or PCR test of a specimen taken from the lesion but personally, I doubt there is little to worry about.  

2. I am worried about the fact that it seems to be recurring int the same spot.  Is it possible for herpes to resolve  itself... and then reappear a few days later??
No, it would be unusual for HSV to recur in the manner you describe. As I said above, this would be more typical of folliculitis.

I hope these comments are helpful. EWH