Herpes Type 1 in Strange Location

[Texas99]

Dear Doctor,
I have had cold sores since a young age in grade school; also in my late 20’s, I also experienced a type 1 lesion on my lower front leg near the kneecap; it looked like a small line of blisters, and according to my dermatology doctor, he brushed it off; as something acquired from when I was a kid. It came back once and that was over 17 to 20 years ago (this 2ed occurrence happeded when I was taking Cypro for a severe sinus infection), Again, this only happened twice many years ago, however since I was curious about the herpes virus, and concerned how this got on my knee; I also took a Western Blot test for herpes a few years later, it showed positive for type1 (somewhat expected due to my cold sores) and negative for type 2. I am in my fifties now and would not want to pass my type 1 infection on to my future wife. She does get cold sores as well but, I really do not know what to tell her or what precautions we should take. I have never had an outbreak in my genital region that I know of, and have had herpes on my lips, nose, and this atypical leg location although this has been many years ago. I became concerned since I heard herpes can move through out the body and was afraid that herpes would move to my genitals, despite when I had this on my knee, I had no symptoms of genital herpes.  I would not want to give her my lip, nose or leg herpes through what I’ve heard as “shedding”, What precautions should we take; I am very confused. Thank you for your help.

[Texas99]

My wife does get cold sores; I was asking since we are looking to have a child and would not want to expose are baby to this virus even though it does seem very common. Again, how do we prevent this from transmission given my history of the virus as well as my wife. Again we are afraid we will "shed" our virus because we know we already have the HSV1. For example will we give this to our child unknowing since we do not know we have symptom's. Thank you doctor for your help!

[Bhupinder Kaur, MD]

Hello,
Thanks for posting your query.
If your wife is also showing cold sores then even if you have unprotected intercourse, there is no fear of transmission because she already has the HSV1 virus. But you need to get her investigated to first confirm whether she has the HSV1 virus.

HSV-1 infection of the genitals is caused by mouth to genital or genital to genital contact with a person who has HSV-1 infection. So during intercourse, avoid indulging in oral sex and use condoms. However no 100% protection can be there because the virus is spread by skin to skin contact or kissing even. Also abstain from sexual activity with partner when sores or other symptoms of herpes are present.

Hope that this information helps and hope that you will get better soon.

Wishing you good health.