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Ask Alan Gibstein, M.D. Your Own Question
Alan Gibstein, M.D.
Alan Gibstein, M.D., OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 1833
Experience:  Assistant Professor of OB/GYN with 40 years of experience treating patients. Fellow of The American Congress of Obstetricians and Gynecologists.
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What could paper cut like tears on my vagina be?

Resolved Question:

I have paper cut like vaginal tears in my vaginal area, mostly vulva, now one just appeared on the perineum. They started last Friday.

I had thought I was getting a yeast infection last Wed & Thurs (itching & white discharge) and then these started on Friday.

I Monday I went to my gynecologist and he immediately said herpes and took samples and cultures and all that to have tested. He won’t have an answer for me till Friday. Everything I have researched on vaginal tears/vulva tears on the internet has not said anything about herpes. He gave me Zovirax cream and pills. The cream burns when I apply it, to the point of I nearly want to faint because it takes my breath away. Online info about herpes says it starts w/ blisters and then turns to sores within a few days. I have not had any blisters or sores, just these tears and they hurt of course because it is raw skin.

I have a lot of swelling and have been sleeping with an icepack applied to that area. I get shooting pains every once in a while and I've totally lost my appetite. I'm consuming large amounts of water so that when I urinate it does not burn on the open tears.

Now this morning it appeared I may have blood in my urine. After I urinated the toilet water was a bit pinkish, the last three times I've gone. I hoping and praying that it is not herpes or any other type of transmittable disease, but I would like to know what is wrong with me and be able to start treating that issue because this is absolute hell. My gynecologist seemed bound and determined that it is herpes.

Any thoughts?

Submitted: 6 years ago.
Category: OB GYN
Expert:  Alan Gibstein, M.D. replied 6 years ago.

I think your gynecologist is wrong. Cracks and fissure of the vulva and perineum is classical for vaginal yeast. It may not be the common Candida albicans type that causes the cheesy discharge. Herpes requires a recent (48-72 hours) exposure to someone shedding the virus. It causes initial stinging, burning, redness, and then pimples that become blisters and intense local pain as well as swollen regional lymph glands. Often there is fever and malaise, your bottom doesn`t sound like Herpes. Either get a second opinion or do this; stop the Zovirax cream and the tablets. Get any of several over-the-counter vaginal anti-yeast creams and insert daily for seven days. Get any OTC cortisone cream, maximum strength, and apply externally as often as you need. Use mild soaps when bathing. Soaking tubs are not a good idea, showering is better. Stop the vinegar and baking soda and the Neosporin; this is for bacterial skin inflammations. Good luck

Customer: replied 6 years ago.

Okay, so will try the over-the-counter Cortisone cream. Is there anyone in particular such as hydrocortisone cream?

Expert:  Alan Gibstein, M.D. replied 6 years ago.

Yes, try hydrocortisone 5 or 10 or Cortaid. If you have any further questions, please let me know.

Customer: replied 6 years ago.

I was just informed by my gynecologist that I tested positive for herpes. He said I have antibodies showing as I have had the virus for years, not just recently. I don't understand because I have never had blisters or sores. I have had itchiness, air bubbles, and discharge such as a yeast infection and these cuts.
I have not noticed anything that looks like the pictures I've searched online of herpes cases.

How is it possible that I have just now had an outbreak?

Expert:  Alan Gibstein, M.D. replied 6 years ago.

The gold standard for the diagnosis of Herpes is positive cultures form a blister or other lesions. The earth is coated with the Herpes virus and 65% or more of all adults have Herpes antibodies. The only way to tell whether those antibodies represent a current or distant infection is by repeating the antibody titer two weeks apart. Those are called acute and convalescent titers. If there is a significant drop from the present titer to a test two weeks later, that would suggest that what you have is Herpes. But it is only suggestive. A culture is the only proof. You may be a Herpes carrier for many, many years without an obvious outbreak until now. That is a possibility, but again, only a culture tells the actual facts. What the doctor meant, but apparently does not understand, is that the titer proves nothing about your present discomfort. Perhaps a second opinion is needed. Be well

Customer: replied 6 years ago.

Thank you very much for answering me. I appreciate your advice and responses.

I have taken your advice and have just finished the 3 day Monistat last night and today I'm trying the Cortisone 10 and I can tell you that it was less painful to apply. I have noticed that the cuts seem to be healing a bit and I'm not in as much discomfort today as I have been for the last week. And the best news is there doesn't seem to be anything new appearing. Hopefully I'm on the road to recovery. It freaked me out when I read that an outbreak of herpes can take up to a four weeks to heal. I don't think I could have handled 3 weeks more of this.

At this point my husband believes that I have a bacterial infection that the doctor is treating w/ nightly suppository medicine. I had asked my gynecologist to give me the paperwork to have my husband tested for herpes along w/ all the other STD's out there just so that we can see if he is also a carrier. But I told my husband that the dr. had suggested he be tested for everything at the same time I was being tested because he was unsure of what exactly I had. And I'm requesting that when my gynecologist not tell my husband that I had an outbreak of herpes and that if his results also come back positive (which I'm guessing they would if mine showed that I've had the virus for years. and we've been together for 19 years) that he be very explicit in explaining that his results show that he has had it for yrs. as well (if that is the case) so that he understands this isn't something I just got.

He will not believe me if I tell him that I tested positive for herpes and that I’ve had it for years unless he is given the same results and knows that he has never had an outbreak.

Do you think it will be ok for me to be in my pool this weekend or should I avoid the water? Is it likely that I should expect to experience another outbreak? Do people ever just have one and then never again or not for years? If they do have more outbreaks how long do they generally last? I so appreciate everything from you. You have been wonderful.

Expert:  Alan Gibstein, M.D. replied 6 years ago.

The swimming pools are okay, no special precautions except to sharing of towels. I would not expect further outbreaks. When herpetic recurrences happen, they always occur in the exact same location, never somewhere else. Recurrences can be like milder initial outbreaks or can be very mild, occasionally nothing more than a few days of mild itching, always in the same spot. You did not address my challenge of the diagnosis by blood alone. It is insufficient. I have no criticism of sexual transmitted disease (STD) testing for either one of you, whether absolutely necessary or not, except for the time and expense. Your blood tests do not show that you have had the virus "for years", only that you have been exposed at some time in the past. Finally, some people do have one outbreak and never again. Once again, your description of the fissures and cracks are not seen with Herpes.

Customer: replied 6 years ago.

Sorry, he did take a culture of one of the cuts. But truthfully I did not ask him if he was stating I have the virus based on the culture or just the blood test alone. Time for the blood testing was not an issue it was a walk in and out, 10 minutes max and my insurance will pay for all of the testing. My husband only took the blood test yesterday so he will not be notified until sometime next week. And truthfully I hope his results show that he has the virus as well so that I cannot give it to him. If it does show that he has it do I have to worry if in the future I have one of these small cracks and abstain from sex because of it? I have had small individual cuts in the past and with some Neosproin and a few days they have gone away, never any itching and never anything like this. I'm hoping and praying you are correct in thinking that this was not a herpes outbreak and I am hoping and praying that if it was that I never do have another outbreak this has been miserable and very mentally draining. I've read that taking daily doses of Lysine has been effective in people with herpes as to helping with recurrences. I've also read about a few products on, Red Marine Algae, Vir-L-Lysine, H-Balm and Aerua. Are these any products that you have heard of and if you have is there any validity to the claims of help? Thank you again!

Expert:  Alan Gibstein, M.D. replied 6 years ago.

Please get the culture results; they are the only pertinent facts. The only two over-the-counter supplements that are of value, potentially are lysine and citrus bioflavinoids. All the rest are worthless. If you have Herpes, so does he, even if he never has had an outbreak. Some carriers never get an outbreak. Therefore, you two are in a stable state. Nevertheless, if the culture grew Herpes from a crack, you abstain until the cracked heals.

Alan Gibstein, M.D. and other OB GYN Specialists are ready to help you
Customer: replied 6 years ago.
Thank you so much for your help.
Expert:  Alan Gibstein, M.D. replied 6 years ago.

You are welcome; be well