Unraveling Persistent Genital Symptoms: Is It Herpes or Something Else?

I'm not sure if it's herpes (with a picture)?

About a year ago, at the end of March, I noticed something growing in my genital area that was very itchy, and my groin lymph nodes were swollen.
After visiting a urologist, the doctor diagnosed it as pubic lice.
I followed the advice to shave and apply medication, and the itchy wounds disappeared, with the lymph nodes gradually shrinking.
However, two weeks later, it suddenly recurred.
I continued applying the medication, and after about a week, it improved again, but this marked the beginning of a nightmare.
Initially, it recurred every two to three weeks.
I found it strange that if it were pubic lice, the symptoms shouldn't persist after the lice were removed, so I tried not applying any medication to see what would happen.
After about a week of doing nothing, the symptoms eased again, and the lymph nodes swelled in response to the symptoms.
The symptoms have not diminished until today.

The recurrence cycle has changed to once every one to two months, with the location of the recurrence being almost the same each time, but not on the genital organs; rather, it appears in the pubic hair area.
Each time there are symptoms, it resembles a pimple, a raised bump that is very itchy, and sometimes there is a clear fluid (like water) when touched.
It is not painful, just itchy, and there are usually at most two bumps.
Eventually, these bumps turn into ulcer-like lesions and then heal slowly.
This situation has been recurring for almost a year now, and the lymph node condition has never completely disappeared; it has just been fluctuating in size.
Whenever the lymph nodes shrink to the point where they are almost undetectable, it signals that the symptoms are about to recur, and then they swell again.
During this time, I visited a sexually transmitted disease prevention center in Kunming and the dermatology department at National Taiwan University Hospital, but perhaps I went at the wrong times.
Each time I saw a doctor, it was already during the mid-stage of symptoms, and the doctors said they couldn't determine what it was.
They suggested it might be herpes or a cyst, but they were not sure.
Hearing uncertainty from both doctors left me feeling hopeless, as this condition has troubled me for almost a year.
I really don't know what to do; currently, I am only seeing a traditional Chinese medicine dermatologist.
The TCM doctor also said they were unsure what it was but prescribed me medication to boost my immune system.
The TCM doctor also mentioned that it was strange; if it were herpes, the areas touched would typically be contagious, but I have not transmitted it to anyone.
When I first experienced these symptoms, I didn't think much of it, but as time went on, I became increasingly puzzled about what illness I might have.
I researched genital herpes virus online, and it closely resembles my symptoms, including recurrent outbreaks and the same locations for recurrences, as well as lymph node swelling, etc.
So I keep wondering if that is indeed the case.
However, the doctors are not certain, and I don't know what to do.
Moreover, I recently served in the military, and my diet and lifestyle have been normal, but the recurrence every one to two months is really troubling and has caused me significant psychological stress.
If it is indeed the herpes virus, is it truly incurable, and can it only be managed by maintaining immunity? In the future, if I get married and have children, will I transmit it to my child?

KK, 20~29 year old female. Ask Date: 2018/01/25

Dr. Wu Yuxin reply Dermatology

Medical regulations state that "a physician must personally examine a patient before providing treatment or prescribing medication," and therefore, online diagnosis is not permissible.
If you are experiencing significant distress, it is advisable to seek medical attention promptly.

Reply Date: 2018/01/25

More Info

It sounds like you have been experiencing a persistent and distressing condition that has significantly impacted your quality of life. Based on your description, it seems that you have had recurrent symptoms in the genital area, including itching, the appearance of bumps resembling acne, and swollen lymph nodes in the groin. You have sought medical advice from various specialists, including urologists and dermatologists, but have not received a definitive diagnosis. This uncertainty can be incredibly frustrating and anxiety-inducing.

From your symptoms, it is understandable to consider conditions such as herpes, folliculitis, or even other dermatological issues. Herpes simplex virus (HSV) is known for causing recurrent outbreaks of painful sores in the genital area, but it can sometimes present with atypical symptoms, such as itching and bumps that may not be painful. The fact that your symptoms have been recurring every month or two, along with the lymph node swelling, raises the possibility of a viral infection, but it is essential to note that not all recurrent genital symptoms are due to herpes.

Your experience of the bumps resembling acne that eventually ulcerate and heal could also suggest a condition known as folliculitis, which is an inflammation of the hair follicles. This can be caused by bacterial infections, irritation, or even fungal infections. The fact that you have not transmitted the condition to others could indicate that it is not a highly contagious infection like herpes, but rather something that is localized to your body.

It is also worth considering that stress and immune system function can play a significant role in the recurrence of skin conditions. Stress can exacerbate many skin issues, and if your immune system is compromised, it may not be able to fight off infections effectively. This could explain the cyclical nature of your symptoms.

Given the complexity of your situation, it is crucial to continue seeking medical advice. Here are some steps you might consider:
1. Follow-Up with a Specialist: Since you have already seen urologists and dermatologists, consider asking for a referral to an infectious disease specialist. They may have more experience with recurrent genital symptoms and could provide further insights or testing options.

2. Testing for Herpes: If you suspect herpes, ask your doctor about specific tests, such as a viral culture or PCR test, especially during an active outbreak. Serological tests can also determine if you have been exposed to the virus.

3. Consider a Dermatological Evaluation: A dermatologist may be able to perform a biopsy of the lesions if they are present during your visit. This can help in diagnosing conditions like folliculitis, cysts, or other skin disorders.

4. Lifestyle and Immune Support: Focus on maintaining a healthy lifestyle, including a balanced diet, regular exercise, and stress management techniques. These can help support your immune system and potentially reduce the frequency of outbreaks.

5. Mental Health Support: Given the emotional toll this condition has taken on you, consider speaking with a mental health professional. They can help you manage the anxiety and stress associated with your symptoms.

6. Discuss Future Concerns: If herpes is confirmed, discuss with your healthcare provider about the implications for future relationships, including pregnancy and transmission risks. There are ways to manage and reduce the risk of transmission to partners and children.

In conclusion, while it is understandable to be concerned about the possibility of herpes or another chronic condition, it is essential to work closely with healthcare professionals to obtain a clear diagnosis and appropriate treatment. Your symptoms deserve thorough investigation, and with the right support, you can find relief and regain control over your health.

Similar Q&A

Understanding Genital Herpes: Symptoms, Diagnosis, and Treatment

The doctor would like to ask you: I started feeling something unusual when urinating on the first day of my period, and I noticed a large pimple on my vulva. There was also swelling in the nearby lymph nodes. By the third day, I experienced a headache while walking, began to feel...

Dr. Dong Yuhong reply Obstetrics and Gynecology
Hello: Your symptoms need to consider the possibility of a herpes infection. Herpes is an infection caused by the herpes virus, but infection should not be equated with infidelity. In addition to continuing your treatment, you should also attend follow-up appointments regularly t...

Understanding Recurrent Genital Herpes: Symptoms, Treatments, and New Vaccines

Hello Dr. Du, Last March, I had unprotected sexual intercourse, and two weeks later, I developed symptoms. Initially, I experienced itching, followed by redness, swelling, ulcers, and crusting, which lasted about a week before I recovered. I went to the urology department for a...

Dr. Du Shixi reply Urology
Hello: Regarding your skin changes being considered as herpes, please note the following: 1) It may not be herpes. 2) Frequent recurrences indicate that your immune system may be weakened and the virus is active. 3) You should seek medical attention and get checked for any other ...

Understanding Unexplained Genital Herpes: Causes and Solutions

Hello Dr. Chang, Last year, I experienced my first outbreak of herpes near the vulva, accompanied by a high fever of 39 degrees Celsius for 4-5 days. I went to a large hospital for examination, initially visiting the obstetrics and gynecology department. The female physician who...

Dr. Zhang Kunmin reply Obstetrics and Gynecology
Hello, based on the situation you described, I recommend that you consult an infectious disease specialist for further evaluation. Thank you! Wishing you safety and good health. Dr. Chang

Understanding Genital Symptoms: Herpes or Fungal Infections?

Hello, Doctor! I would like to ask whether my symptoms are indicative of genital herpes or candidal balanitis. I have been symptom-free for six months, but recently I have been feeling more stressed, depressed, and anxious. Occasionally, I experience a cramping sensation in the g...

Dr. Du Shixi reply Urology
Hello: Herpes is not something that can be completely cured; it tends to recur when the immune system is weakened. Medication and topical treatments only reduce the duration of the outbreak. Tests primarily confirm whether one has had the infection before. It is essential to obse...