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Suggest Treatment For A Herpes Outbreak On The Buttocks
Question: End of May 2016 i was diagnosed with genital Herpes. Initial outbreak occured in my buttocks after 4 to 8 weeks of feeling flu like symptoms. I went to a local dermatologist who told me it looked like genital herpes. He made some prelevment to put a name on his diagnosis and lab results were negativ, twice.
After the initial outbreak he prescribed me 5 days of Valtrex(Valaciclovir) twice 500mg a day. It went away but 1 week after it came back again in my buttocks. Again he prescribed me 5 days of Valtrex twice 500mg a day, it went away but came back after 1 week. After the 3rd time of 5 days treatment it came back in my buttocks. So now im taking 500mg a day of Valaciclovir for 1 year. Im taking it since 4 months on a daily basis.
My concern is the following, I have a sexual partner and have always insisted on using condom with her. She's always insisting on having sex without condoms. One day we were in bed an we had an unprotected sex. It happened and i didn't told her that i have this virus. Since 1 month we have now unprotected sex. Im feeling guilty and bad now because i don't know how to approach the situation now. I also read on herpes website that there's small risk of spreading the virus if i'm taking valtrex and my outbreaks are located in my buttocks not near my genitals regions. What are the risks of spreading the virus if there is no outbreaks and that im taking valtrex, and that the outbreaks are in my buttocks ?
After the initial outbreak he prescribed me 5 days of Valtrex(Valaciclovir) twice 500mg a day. It went away but 1 week after it came back again in my buttocks. Again he prescribed me 5 days of Valtrex twice 500mg a day, it went away but came back after 1 week. After the 3rd time of 5 days treatment it came back in my buttocks. So now im taking 500mg a day of Valaciclovir for 1 year. Im taking it since 4 months on a daily basis.
My concern is the following, I have a sexual partner and have always insisted on using condom with her. She's always insisting on having sex without condoms. One day we were in bed an we had an unprotected sex. It happened and i didn't told her that i have this virus. Since 1 month we have now unprotected sex. Im feeling guilty and bad now because i don't know how to approach the situation now. I also read on herpes website that there's small risk of spreading the virus if i'm taking valtrex and my outbreaks are located in my buttocks not near my genitals regions. What are the risks of spreading the virus if there is no outbreaks and that im taking valtrex, and that the outbreaks are in my buttocks ?
Brief Answer:
As you are on suppressive therapy for genital herpes, transmission unlikely
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
First of all, you are having Genital Herpes lesions manifested over the buttock region. It is unusual to have genital herpes lesion occurring over buttocks following a peno-vaginal sex. Have you ever had anal recipient sex at anytime? Chances of transmission of HSV infection to your female sex partner is less likely when your lesions are confined to buttock region, that too, in the absence of any fresh lesion.
You had mentioned that you had 3 recurrences when you are on treatment with a just an interval of one week apart. That is also not very common to have the recurrences with such a short intervals. This indicates either to review the diagnosis or you might require a slight higher dose of Valcyclovir. The curative dose and suppressive doses are not the same. Curative dose of Valcyclovir for HSV 2 infection is 5oo mg twice daily (higher than suppressive dose).
Moreover you are on suppressive therapy for HSV infection by taking Valcyclovir 5oo mg daily since 4 months. So viral shedding is unlikely, so also the transmission to your partner.
So nothing to worry for the past and not to have any guilty feelings. But it is always safer to play safe sex in future.
Dr S.Murugan
As you are on suppressive therapy for genital herpes, transmission unlikely
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
First of all, you are having Genital Herpes lesions manifested over the buttock region. It is unusual to have genital herpes lesion occurring over buttocks following a peno-vaginal sex. Have you ever had anal recipient sex at anytime? Chances of transmission of HSV infection to your female sex partner is less likely when your lesions are confined to buttock region, that too, in the absence of any fresh lesion.
You had mentioned that you had 3 recurrences when you are on treatment with a just an interval of one week apart. That is also not very common to have the recurrences with such a short intervals. This indicates either to review the diagnosis or you might require a slight higher dose of Valcyclovir. The curative dose and suppressive doses are not the same. Curative dose of Valcyclovir for HSV 2 infection is 5oo mg twice daily (higher than suppressive dose).
Moreover you are on suppressive therapy for HSV infection by taking Valcyclovir 5oo mg daily since 4 months. So viral shedding is unlikely, so also the transmission to your partner.
So nothing to worry for the past and not to have any guilty feelings. But it is always safer to play safe sex in future.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor thanks for your reply.
"It is unusual to have genital herpes lesion occurring over buttocks following a peno-vaginal sex. Have you ever had anal recipient sex at anytime?"
I never had anal sex in my life. That's why i don't understand why the initial outbreak appeared in my buttock region...
Approximately 4 to 6 weeks before this inital outbreak my girlfriend waxed my buttock area with hot wax. I remember that it was hurting and that we applied some sun cream(only cream on our hand at that time) after the wax was finished. This sun cream contains alcool and it really burned my buttocks . Is it possible that i got infected because of this wax that was used on someone before me ? Or the inital outbreak occured in this region because of this waxing episode who hurted and weakened my body in buttock area instead of my penis ?
"You had mentioned that you had 3 recurrences when you are on treatment with a just an interval of one week apart. That is also not very common to have the recurrences with such a short intervals. This indicates either to review the diagnosis or you might require a slight higher dose of Valcyclovir."
During this period i was still having unprotected sex with my ex-girlfriend.
It may be because she was contagious at that time that recurrences occured that fast ? I learned later that she sheated on me, so i am suspecting her of having transmitted the herpes to me. Im now taking Valcyclovir 500mg daily in the morning since 4 months and no outbreaks ever occured. As for reviewing the diagnosis i'm waiting for detailed blood tests in the next days.
"It is unusual to have genital herpes lesion occurring over buttocks following a peno-vaginal sex. Have you ever had anal recipient sex at anytime?"
I never had anal sex in my life. That's why i don't understand why the initial outbreak appeared in my buttock region...
Approximately 4 to 6 weeks before this inital outbreak my girlfriend waxed my buttock area with hot wax. I remember that it was hurting and that we applied some sun cream(only cream on our hand at that time) after the wax was finished. This sun cream contains alcool and it really burned my buttocks . Is it possible that i got infected because of this wax that was used on someone before me ? Or the inital outbreak occured in this region because of this waxing episode who hurted and weakened my body in buttock area instead of my penis ?
"You had mentioned that you had 3 recurrences when you are on treatment with a just an interval of one week apart. That is also not very common to have the recurrences with such a short intervals. This indicates either to review the diagnosis or you might require a slight higher dose of Valcyclovir."
During this period i was still having unprotected sex with my ex-girlfriend.
It may be because she was contagious at that time that recurrences occured that fast ? I learned later that she sheated on me, so i am suspecting her of having transmitted the herpes to me. Im now taking Valcyclovir 500mg daily in the morning since 4 months and no outbreaks ever occured. As for reviewing the diagnosis i'm waiting for detailed blood tests in the next days.
Brief Answer:
As you are on suppressive therapy for herpes, fresh recurrence is unlikely.
Detailed Answer:
Hi,
Welcome back.
Herpes Simplex infection can be caused by HSV 1 and 2. HSV 1 infection is usually a non sexually transmitted infection. HSV 1 infection rarely could have transmitted through Waxing. Skin over buttock could become weakened than penile skin and made buttock skin more susceptible for Herpes infection is not correct. There is no such possibility.
When you are on suppressive therapy you will not get a fresh recurrence. Your test reports will throw more light on your condition.
Dr S.Murugan
As you are on suppressive therapy for herpes, fresh recurrence is unlikely.
Detailed Answer:
Hi,
Welcome back.
Herpes Simplex infection can be caused by HSV 1 and 2. HSV 1 infection is usually a non sexually transmitted infection. HSV 1 infection rarely could have transmitted through Waxing. Skin over buttock could become weakened than penile skin and made buttock skin more susceptible for Herpes infection is not correct. There is no such possibility.
When you are on suppressive therapy you will not get a fresh recurrence. Your test reports will throw more light on your condition.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
What will happen when my suppressive therapy will be finished ? What will be the risks of spreading the virus in my case ?
What will happen when my suppressive therapy will be finished ? What will be the risks of spreading the virus in my case ?
Brief Answer:
Recurrence is less likely after a year
Detailed Answer:
Hi,
Welcome Back.
As the infection becomes older the Chance of Recurrence is also less likely.
Dr S Murugan
Recurrence is less likely after a year
Detailed Answer:
Hi,
Welcome Back.
As the infection becomes older the Chance of Recurrence is also less likely.
Dr S Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello again Doctor,
I am really concerned because i asked this same question about my herpes problem to another doctor on this same website and he has a complete opposite answer as yours. This is his answer :
Detailed Answer:
Hello, and thanks for your question.
1. Your risk of spreading genital herpes to your partner during unprotected sex is very high, >80%, even if there is no active outbreak. You need to tell your partner that you have genital herpes immediately. They need to get tested and may need to take medication immediately.
2. Once herpes has been contracted, it can travel to several different parts of the body. You probably initially contracted in on your genitals, and it has since spread to your buttocks.
3. It is not possible to catch herpes from wax. It must be spread through sexual contact.
Dr. Sheppe
Replied by Dr. XXXXXXX H. Sheppe , 53 minutes ago
Can you tell me why ?
Thank you
I am really concerned because i asked this same question about my herpes problem to another doctor on this same website and he has a complete opposite answer as yours. This is his answer :
Detailed Answer:
Hello, and thanks for your question.
1. Your risk of spreading genital herpes to your partner during unprotected sex is very high, >80%, even if there is no active outbreak. You need to tell your partner that you have genital herpes immediately. They need to get tested and may need to take medication immediately.
2. Once herpes has been contracted, it can travel to several different parts of the body. You probably initially contracted in on your genitals, and it has since spread to your buttocks.
3. It is not possible to catch herpes from wax. It must be spread through sexual contact.
Dr. Sheppe
Replied by Dr. XXXXXXX H. Sheppe , 53 minutes ago
Can you tell me why ?
Thank you
Brief Answer:
During suppressive therapy of Herpes, partner transmission is unlikely.
Detailed Answer:
Hi,
Welcome back.
I feel that it is not correct.
Herpes simplex infection most often confined to the site of inoculation and near by only. Unless the individual is an immunocompromised individual, he need not afraid of a generalized or disseminated manifestations. I had not come across any such manifestation in my 40 years of experience in the field of STD management. Moreover most of my patients are free from recurrences after years and especially after suppressive therapy. Unless you are not having genital lesions partner transmission is unlikely through genito-genital contact. When you are on suppressive therapy viral shedding is unlikely.
DR S.Murugan.
During suppressive therapy of Herpes, partner transmission is unlikely.
Detailed Answer:
Hi,
Welcome back.
I feel that it is not correct.
Herpes simplex infection most often confined to the site of inoculation and near by only. Unless the individual is an immunocompromised individual, he need not afraid of a generalized or disseminated manifestations. I had not come across any such manifestation in my 40 years of experience in the field of STD management. Moreover most of my patients are free from recurrences after years and especially after suppressive therapy. Unless you are not having genital lesions partner transmission is unlikely through genito-genital contact. When you are on suppressive therapy viral shedding is unlikely.
DR S.Murugan.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for your follow up doctor.
Brief Answer:
You are most welcome
Detailed Answer:
Hi,
You are welcome.
I knew hundreds of people who had been affected by Herpes Simplex are living happily with their spouse without any difficulty. So you need not worry unnecessarily.
Dr S.Murugan
You are most welcome
Detailed Answer:
Hi,
You are welcome.
I knew hundreds of people who had been affected by Herpes Simplex are living happily with their spouse without any difficulty. So you need not worry unnecessarily.
Dr S.Murugan
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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