Herpes?

[Dan890]

thanks so much for doing this, Doctor,
I have developed a reddish rash on my upper thigh (near the testicles) - it is made up of a bunch of smaller red marks that If I look closely have white skin around them.  No pain at all.  Does this sound like herpes?   Can you even get herpes on your leg like this?  
I am very worried about it especially because 6 weeks ago I had unprotected sex.  the girl (20 year old female) told me she, or her former boyfriend, had never any STD symptoms, but I am still really worried I have caught something like herpes. Even If this rash on my leg is not herpes (I think it is more likely a sweat rash/chafing from the beach last weekend) since it is now going away) I will still be really worried about herpes, and so is six weeks time enough to get a blood test?  Also, I thnk I have been epxosed to herpes-1 before (both my parents get cold sores on their lips) so how will that affect my herpes blood test results? I just want to see if I picked up genitel herpes in the encounter 6 weeks ago.  
Finally, I am in France for the next month, so do you know if there is anything different about their STD/herpes testing?  or is it same scale and what exactly is that scale?

thanks so much

[H. Hunter Handsfield, M.D.]

No, your symptoms don't sound at all like genital herpes.  Both the description and location (upper inner thighs) are wrong.  Both those factor are more in favor of the chafing explanation you suggest than herpes.  On top of that, genital herpes is relatively uncommon in younger sexually active persons in industrialized countries.  Although the reasons aren't fully known, genital herpes is more frequently aquired in sexually active people age 25-35 than in younger persons.  In other words, relatively few 20 year old women have it, so the chance is low that your partner was infected.

So I recommend against HSV testing in this situation.  If you insist, wait until 3 months have gone by, when the blood test will be more reliable.  Although most people with new HSV-2 infections have positve results by 6 weeks, some do not; 3 months is safer.  

Half of all adults in the US have positive tests for HSV-1.  Your parents' history probably doesn't have much bearing on the chance that you are infected.  There is controversy as to whether HSV-1 infection interferes with HSV-2 testing.  It's an additional reason to wait until 12 weeks, to minimize the risk of confusing results.

There are some excellent STD experts and clinical services in France, but I cannot vouch for where or how to be sure you're getting expert care there.  The respected experts I know about are in Paris, but surely there are excellent options in other cities as well.

Bottom line:  I see no concerns about herpes here, and I recommend against testing for it.  The chance of a confusing (e.g., false positive) test result is greater than the chance you are infected. so I suggest just dropping it.  But if your anxieties end up outweighing my judgment, at least wait 3 months before getting tested.

Best wishes--  HHH, MD

[Dan890]

I should add that for the past few days I can feel the tip of my penis, not pain or anything, just I am more aware of it - of course that could just because I am so worried about it and examining it too much

[H. Hunter Handsfield, M.D.]

I agree you're thinking about this too much.  Most likely your anxieties are magnifying normal body sensations.  In any case, herpes does not cause the kind of symptom you are describing.