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"Syphilis vs Herpes panic - does Zovirax work on Syphilis Chancres?"
Apr 15, 2012

Hi Erik, really hope you are able to help me because my resources are very limited where I am at the moment and I am in a massive panic.

Background: I am a heterosexual male with genital herpes, 4-5 outbreaks per year. Tested negative for HIV /all other STDs in Dec-2011. Had protected penetrative sex with unknown status woman early Mar-2012, but in foreplay thered been some inadvertent uncovered rubbing of my penis shaft over her labia. Month later (last week), noticed tiny red raised round-ish sore high on side of my penis shaft near the glans which was relatively painless, bit sensitive to touch. Im sure it had not been there for more than a day because I wouldve noticed it. I panicked as it fulfilled the description of a syphilis chancre that I had read, although it didn't quite look like the pictures online, as it was not indented and it was much smaller. I rushed to a skin / STD doctor I know, he looked at it under his magnifier and said it was not syphilis, it was herpes (he did not know I have herpes). I asked him if he was sure as it was not like my previous herpes outbreaks, and he insisted, with no further testing. He told me to apply my Zovirax (acyclovir) cream to it for a few days and come back and see him. It got slightly more sore like conventional herpes that day and started to go down over the next couple of days by the time I went back to see him 3 days later, it had become a flat tiny patch of new skin as happens when the herpes is healing BUT a new outbreak of conventional herpes had also started on the underside of my shaft, close to the base, which is now healing as normal. Again, Dr. insisted the earlier spot had not been syphilis and refused to test further.

Questions because it is really hard to get a second opinion in this country on these matters (e.g. HIV is illegal), and my next opportunity to travel is uncertain: 1) Would a syphilis chancre heal in a matter of few days? The sources say 3-6 weeks 2) if not, could it have been responding to application of Zovirax (acyclovir) ? 3) Is it possible that a mini-isolated outbreak of herpes starts and then the main outbreak occurs shortly after I havent had that before, normally all the little sores appear in 1 cluster or 2 adjacent clusters simultaneously, these ones were a few inches apart (from higher to lower end of penis) and 2-3 days apart.

Very very grateful for your insight in order to have some further perspective on the matter

Response from Mr. Glenn

Thanks for your question,

I'm sorry to hear that you're feeling panicked right now. Luckily it sounds like there's some good information in front of you, despite how hard it is to get a second opinion where you are!

It sounds like you have no reason to suspect Syphilis here. They didn't look like the pictures you've seen online, your doctor could immediately tell that it was Herpes, the bumps responded to the Herpes medication, the bumps appeared after rubbing (irritating) the area, and you already know that you have Herpes.

That's a lot of evidence that this is in fact Herpes! Honestly this sounds like an open and shut case.

It's normal for Herpes to sometimes show up around the area that you're used to seeing them. This is because, in a way, Herpes lives underneath the skin so can emerge anywhere in the area.

I'm not sure where you are or what kind of medical attention you can find, but if possible I'd recommend that you continue to get regular STD check-ups so that you're up-to-date on your health. But it sounds like you've done what you need to in this case!

Hope this helps!

Erik



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