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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 years of experience and an award-winning educator.
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I found a small sore near the opening of my vagina. It is

Customer Question

I found a small sore near the opening of my vagina. It is very small and seems to be under the skin, the area around the sore is very red. It does not hurt to touch but it stings sometimes. Any idea?
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. C. replied 2 years ago.

Hi, It's Dr. C. Board certified Ob-gyne. I can help you today.

I'm sorry that you found a sore spot that has you concerned. In order to figure out what it is, it would be helpful to see it. Can you attach a photo using the paperclip icon on your screen? It can be an irritated gland, a skin condition or even herpes for a few examples.

Please reply when you get a chance.

Customer: replied 2 years ago.
I really don't feel comfortable sending a picture and it is so small you can't really see it in a photo. But do you real think it could be herpes? That's what I am most concerned about. There is only one, I thought herpes usually come in clusters. And it has been over three months since I last had sex.
Expert:  Dr. C. replied 2 years ago.

Ok, that's fine. Yes herpes is one of the things we think about when there is a small sore in the genital area. HSV doesn't always come in clusters. It's often just a very small sore spot that comes and goes. Most people who have herpes don't even realize it the symptoms they can be so minor, like a little scratch.

Even though you've not had sex in 3 months, it's still possible. It may be a recurrence from a previous exposure more than 3 months ago. Many many people are not even aware of EVER having a primary outbreak. Sometimes we diagnose the presence of herpes only by evidence of an immune system reaction in the blood. The person just NEVER has a recollection of ever having an outbreak. It's also possible to transmit oral herpes (type 1), from the mouth to the genitals. This is most commonly done by using spit for masturbation. About 50% of people show blood evidence of having had herpes type 1 by the time they are 20 years old.

The next best step to figuring this out if on exam your gynecologist can't tell, is to have herpes blood titers drawn. The proper test is "HSV IgG Type specific titers". That will show if you have evidence in your blood of having been exposed to HSV type 1 (oral) or 2 (genital type).

Sometimes a change in diet can cause previously hidden herpes to come out. The most common food culprit is almonds (or other nuts) and oatmeal. The list of possible food triggers is easy to find on-line. It's foods that are high in the amino acid arginine.

Taking the amino acid supplement lysine can counteract herpes outbreaks.

I hope this information was reassuring and helpful. Anything I can clarify?

Customer: replied 2 years ago.
Can a blood test distinguish between HSV 1 and 2?Given the description I gave you of the sore, and now looking as again it almost look like a cut or scratch, do you think it is most likely herpes or do you have any other likely diagnosis?
Expert:  Dr. C. replied 2 years ago.

Yes, the test can distinguish if you get the right test. For that the "type specific" is what gets the right test done. There is also an option of a "combo" which does not distinguish between the two and only tells if there is evidence of either.

It can be a skin condition or a gland that got irritated. Sometimes time will tell. What happens is that this sore goes away but then in 4 months or 2 years or whenever, you get something again in the exact same spot and your remember because now you will be paying attention more. Many people get suspicious they have herpes but never bother getting tested. They notice over time that once in a while they get a little sore area that lasts a few days in the exact same spot. Over 10 or 20 years maybe it happens 6 or 8 times but they remember it now. That way of having herpes is pretty common and actually more common than full blown easy to recognize outbreaks.

Anything else?

Customer: replied 2 years ago.
if this is herpes, even though my symptoms are mild this would still be considered an outbreak? how long should expect it to last for?
Expert:  Dr. C. replied 2 years ago.
If it is herpes, this would be considered a "recurrent outbreak". They usually last no more than 7 days. Taking 500mg of lysine twice daily may shorten it. Also avoiding foods high in arginine. Applying a product that has lemon balm in it may be soothing and shorten the outbreak. Lemon balm is also known as melissa herb.
Depending on where you live, you may be able to find a similar product at a natural food store such as Whole Foods. Drinking lemon balm tea may also help.
Anything else?
Expert:  Dr. C. replied 2 years ago.
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