While some men may have HSV-2 and not experience symptoms, others experience flare-ups that present at a later date if the virus reactivates. Genital herpes in men can cause blister-like sores on the penis, scrotum and anus.
Herpes on the penis begins with a tingling or itchy sensation, typically associated with the prodrome, or initial stage of outbreak. At the initial onset of infection, HSV-2 symptoms may also present sensations of shooting pain, aches or numbness in the penis shaft, lower back, buttocks, or thighs. Symptoms of genital herpes on the penis may be mistaken for other conditions with similar symptoms, such as genital warts. At times, the prodrome stage of infection will also cause fever, headaches, and swollen lymph nodes. These secondary symptoms typically fade with subsequent outbreaks.
Tenderness or redness in the affected area will eventually manifest as a cluster of vesicles or blisters on the penis, similar in nature to a rash. These lesions will eventually rupture to form lesions or sores, before scabbing over and healing.
Herpes in men can affect the following areas:
Penis head
During the blister stage, small red lesions begin to appear on the top of the penis, often in a honeycomb-like cluster. These sores may also affect the urethra, making urination painful. The time from the sensation of tenderness to the formation of blisters can occur relatively quickly. The formation of lesions often have an irregular shape, or present in a row. Individual blisters may vary in size, from the size of a pin head to a small pea.
Some men will only experience one blister, while others will have many. The tip of the penis is a very sensitive area of the body, and men suffering from an outbreak affecting this area, will usually experience pain and tenderness. Tight clothing may irritate or exacerbate the tenderness, so wearing loose-fitting clothing may be a necessary consideration during an HSV-2 outbreak.
Once the blisters burst, they will ooze a clear-white or yellowish liquid before eventually scabbing over and healing. The duration and severity of the outbreak may vary between individuals, and even between flare-ups. The first outbreak is usually the most severe, with subsequent outbreaks usually milder in nature, and shorter in duration.
Foreskin
Herpes on the foreskin can be particularly painful, due to the increased sensitivity of this area. The area of skin around this area is very thin. Herpes sores can also form under the foreskin. The early stages can often be confused with friction sores; however, herpes blisters will contain fluid, which eventually burst. Herpes blisters under the foreskin take slightly longer to heal, than other areas of the penis. This is due to restricted oxygen levels under the foreskin, which hinders the healing process. Herpes blisters on the foreskin can also make it painful to get an erection.
Scrotum
The scrotum is another sensitive area that can be affected by a genital herpes outbreak. Herpes on the scrotum affect the skin of the sheath of the scrotum, and the seven layers that envelop them. Since the herpes simplex virus travels on the body’s neural pathways to the surface of the skin, each layer from the superficial fascia down to the Peritoneum of the scrotum may be affected.
HSV-2 outbreaks may cause uncomfortable ulcers on the scrotum in the latter stages of infection. As with anal herpes, blisters, and ulcers on the skin of the scrotum may be mistaken for other sexually transmitted diseases (STDs) that cause ulcers, such as syphilis and chancroid.
The Mayo Clinic details the similarities between herpes sores and chancres (syphilis sores). Syphilis generally has painless blisters, which is the major distinction between the two infections.
As reported by the Centers for Disease Control (CDC), chancroid is a disease caused by Haemophilus ducreyi bacteria. It is more commonly found in Africa and Southeast Asia, and causes larger and deeper ulcers than those attributed to herpes. Chancroid causes pain in the inguinal glands, while HSV-2 does not.
Testicles
Often disguised as jock itch or an ingrown hair during the prodromal phase, herpes on the testicles is a common symptom of HSV-2. While a genital herpes flare-up on the testicles could make sexual activity more difficult due to the sensitive nature of the affected area, genital herpes is not associated with causing infertility in men. This news may come as a source of relief for men worried about the infection presenting so close to the sperm-producing testicles.
Although The National Library of Medicine (NIH) has reported a study linking genital herpes to a reduction in sperm count, no concrete evidence of a direct correlation has been found.
