Autoinoculation Oral Herpes to Nose

I've recently been diagnosed with Oral Herpes. I don't know whether it's hsv 1 or 2, but it's on my lips, and I'm having my first outbreak. I was drinking water, and some of the water went up my lip and into my nose as I had my head back. I worried this may spread the sores into my nose. I realize that's a bit silly. Well, then when I was applying aciclovir cream, I finished applying it to my lips and then put my finger into my nose thinking I'd stop it early. Of course, I immediately realized what I did, having gone directly from my lip into my nose with aciclovir on my hand. I'm very worried I may have spread the virus into my nose because of all the soft tissue and it being my primary outbreak. Any comments on this situation would be greatly appreciated!!!!

[Terri Warren, RN, Adult Nurse Practitioner]

The herpes virus from your oral infection is already in the nerves that innervate the nose.  It lives in a group of nerves, and that set of nerves supplies sensation to the chin, mouth, nose and eye, basically the face.  So you could have recurrences of oral herpes in any of those locations.

You are using topical acyclovir?  There is, in my opinion, no reason to be using a relatively ineffective topical medicine when we have very effective oral medicines for the treatment of herpes.  I am also wondering - was your oral lesion not swab tested at all or did they just not tell you if it was type 1 or type 2?

Terri

[MichaelB123]

Thanks for your reply Ms. Warren! That puts my mind at rest.

I've only recently been prescribed this. Two separate general practitioners looked at the sores. They were small blisters across my upper lip, and at the corner of my mouth. Nothing you could see if we were sitting chatting. It wasn't swab tested, they said it was herpes, and when I asked which type, they said I had what everyone calls cold sores. I asked about alternative medicines, and they said the cream was best. If I felt one coming up, I could just put some cream on it from the beginning. I don't know about other medications. What do you suggest, is there good reason to find out which I have?

Thanks,
Seth

[Terri Warren, RN, Adult Nurse Practitioner]

If I couldn't see them, just chatting, then they certainly don't seem like typical cold sores to me  Have they been consistently there or do they come and go.  I do think, since they are not typical in presentation, that they should be diagnosed by a lab test.  If it is herpes, you would be far better off treating at the first sign of an outbreak with an oral (pill) herpes medicine.

Terri

[MichaelB123]

This is the first time I've ever had anything like this, and it's only been four days so I can't comment on the frequency. However, during these four days they've been there and haven't moved or faded and come back. Basically, it's a group of blisters that span my upper lip, a few on my bottom lip, and most noticeably at the corner of my mouth and out on to the skin around my lip, I think that's noticeable because of a change in color. The overall effect seems to be a slightly swollen upper lip. But the doctor said the reason I didn't have any big sores was because I started putting the cream on really early on. Would there be a difference between hsv1 and hsv2? I was told that 1 has a higher affinity of the mouth, and 2 for the genitals, but other than that? Does it sound like I could be dealing with something else?

Thanks a lot!

[Terri Warren, RN, Adult Nurse Practitioner]

It is most likely HSV 1, I agree.  If they are really water blisters, this is likely herpes.  But herpes usually is quite noticeable on the lip, and the blister progress to opening, ulcers, then scabbing.  If yours go through this cycle, then it is very likely oral herpes.

Terri

[MichaelB123]

Yesterday and the day before I noticed some wetness on my lip, the blisters were tiny, but I was pretty sure they'd ruptured. Do HSV1 and 2 go through the same cycle? My blisters seem to be getting better, but I was putting cream on them about 5 times a day before you could really notice they were there. I'll see the doctor again soon and ask about whwy mine seem to be so tame, I don't think they've been noticeable throughout this entire process, but I do feel like a few of them had popped.

Thanks again

[MichaelB123]

My biggest concern now is autoinoculation. I'm worried about the period of time between catching the virus and noticing the blisters for the first time, which I'd imagine doesn't really happen immediately. During that time I'm sure I sat with my hand on my mouth at my computer, or perhaps I bit my nail and then went to the bathroom. I feel like a crazy man running around washing my hands like mad, not using towels twice and all of this. And then, after the blisters appear and then when they begin to go away (all during the primary outbreak) is it still possible to autoinoculate? I just want to know when I can start relaxing, I'm terrified of spreading this anywhere but my lip. Thanks a lot Ms. Warren!

[Terri Warren, RN, Adult Nurse Practitioner]

Have you had a recent new sexual exposure or kissing incident with someone new?

Terri

[MichaelB123]

Yes, I kissed someone new in the past ten days.

[Terri Warren, RN, Adult Nurse Practitioner]

Autoinoculation almost always occurs during first infection.

Terri

[MichaelB123]

Thank you Nurse Warren!

[Terri Warren, RN, Adult Nurse Practitioner]

Your are welcome Mr. Michael.

Terri