QUESTION
I've only had seven partners in the last four years. Two weeks ago I had a lot of close contact with one partner, but no oral or penetration. Around nine weeks ago I had sex, once, with someone who I know has had herpes for twenty-some years.

Lately my genitals and anus area have been itching, and I have a small rash on the upper underside of my penis. The rash is about the size of half a dime. I tried a simple anti-itch cream with an antibiotic, but it didn't help after three days of use. I fear this might be herpes, but my rash doesn't match the photos I looked up on the Internet. Not sure what else it could be. Any direction would be helpful.

ANSWER
It's impossible to make a diagnosis without an in-person examination. A variety of conditions cause genital rashes -- some are STDs, others not. If you're in San Francisco, feel free to drop-in to City Clinic for an evaluation. Our address and hours are on the homepage.

In the meantime, here is some information about herpes that you may want to know. The virus is still contagious during the periods before and after symptoms - called viral shedding. Once transmitted, symptoms can show up anywhere from days to years after, or a person can live with the virus in their body without ever showing any symptoms at all. For many people, there is localized itching that occurs at the site of the sore(s) before an outbreak. The herpes then usually manifests as a blister or open sore, although depending on whether it's herpes simplex I or II, it's possible it could look like a small rash. It's best to see a medical professional while the sore is present, so make an appointment or drop-in today.

To your health,
Dr. K