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Treatment for extreme pain without GENITAL HERPES outbreak.

Resolved Question:

I have questions regarding genital pain. I have genital herpes and have been experiencing extreme pain even when i am not having an outbreak. It keeps me up at night and it is even painful to walk some days. The pain seems to be mostly in the penis shaft. What could this be and how can i get relief in the mean time? I take Valtrex for my outbreaks. Question #2 i have a cluster of herpes sores on the top of my penis near the base that will not clear up regardless of the valtrex use, why is my medication not clearing that up? #3 I also have genital warts that i was prescribe immiquimod cream for i have been using it for nearly a month with no results. Any help would be appreciated. Thank you

Category: Family Physician-GP

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Thank you for your query at DoctorSpring.com
Can you kindly share a picture that shows the sores, and if possible the warts too?
I can help you further based on that.
Best Regards.

Patient replied :

I am unable to provide pictures but I can tell you the out break I currently have looks very typical for HSV 1

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Thanks for writing to us.
Persistent pain after herpes simplex infection is not commonly seen. Hyperaesthesia or persistent pain is more common in herpes zoster infection. However few cases of persistent pain have been reported with herpes simplex infection. In such cases, adding pregablin, gabapentin, amytrptilline helps. As these are prescription medicines, you need to consult a doctor to get a prescription of these medicines. As far as non healing herpes sores are concerned, it could be due to superceding bacterial infection. Apply a topical antibiotic like fusidic acid cream twice daily over affected area. Hopefully the lesion should resolve. If not much response is seen, a course of oral antibiotic should be added. I hope these sores are examined by your dermatologist as non healing sores could be syphilis, chancroid etc.
Imiquimod works well for genital warts. If not much response is seen, you may ask your doctor for few sessions of cryotherapy for faster resolution.

Dr. Deepu Sebin Sebastian
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MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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