Spreading Herpes - Clarification

Dear Terri, I have some questions regarding Herpes  type 1; I actually spoke with you a few years ago during a “call in” appointment at your clinic.. I got to thinking about your consultation, and I was reading on the internet and I got somewhat confused. Perhaps you can clarify.I will give you some history. I have had cold sores as a child and growing up, I do not see them much any more. Many years ago my doctor saw a line of blisters on my right side top of knee, he said this was herpes and cover it up. It appeared once more and never have seen it again and this was a very long time ago over 15 years ago. You indicated that this was most likely "wrestlers herpes" and a very strange location. I did take a western blot herpes test a few years later and it came back positive for type 1  and negative for type 2; One question I failed to ask you, and is the reason for me posting this to you. Question, will this herpes travel to my genitals or back and forth to different areas?
I have had jock itch, and any itching has been confined to my scrotum area;  my scrotum did sting in the shower once when I had a small crack on the side of it but it cleared quickly and my Derm. doctor said that skin is thin in this area and can crack, it was a single small crack, and would have not noticed it except in the shower. It did sting when water was directed on it. I have used hydrocortizone before in this area and on certain places where I have gotten soap rashes,somewhat sensitive skin.
Could I pass cold sores to my wife,(however she also has cold sores occasionally on her mouth too.) Do I need to be concerned about Herpes moving around my body; knee to genitals, or mouth to genitals? I know I scratched myself before and perhaps did not even know I had cold sores.  When I read all these things on the internet I became worried, and though I should ask for more clarification. I have been told that I might never know if I had genital herpes, again more confusion. Thank you again!

[Terri Warren, RN, Adult Nurse Practitioner]

It is correct that you might never know if the rash on your knee is herpes or not.  It is unlikely that you would contract HSV 1 in a new location (your knee) after having it for years on your mouth (the cold sores).  So the cold sores on the outside of your mouth, not the inside of your mouth?  

This is the problem with someone just looking at skin lesions and saying that something is herpes, you just never really know for sure unless it comes back and a clinician can do a swab test to see for certain.

The areas of the scrotum that you describe doesn't sound like herpes.

We are making quite a few assumptions here, the biggest of which is that the thing on your knee really is herpes.  If it is herpes, then it is possible that you could have it genitally also, but I think that's a long shot.  If you only have HSV 1 and your wife has it also, I would not worry about transmitting this to her.  

Terri

[confguy]

Thank you Terri, I just was concerned on how the virus spreads; which we did not discuss at length; in our "last office visit". If you already have cold sores, from a long time ago, does that make it difficult to get herpes in other locations? Are mouth herpes prone to be spread to different locations? Can herpes just spread, from one area to the next; I have gotten stuck on this issue since I would never want to pass this to our child. I would not want to have my child to touch my knee and give them Type I herpes. My Dermatologist doctor indicated is was the strangest location he had ever seen....and he said that this was not normal. Should this be something I share with my wife's doctor, in case we have more children. Thank you so much for your additional information.  I could also make another office "call" appointment so you could explain this further to me if you like, thank you again.

[Terri Warren, RN, Adult Nurse Practitioner]

The virus spreads from skin to skin contact.  However, once you have herpes in one location in the body, it is highly unlikely for that same type virus to move to a new location due to the immune response that you've produced.  We did talk on the phone, and I hope I reassured you somewhat about this issue.

Terri