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Tiny pimple on upper lip - cold sore?

Have genital hsv 1 (diagnosed six weeks ago) and have a tiny pimple, almost microscopic, on upper lip. Is it a cold sore or just a pimple? I had a similar spot during my last breakout which never developed into a sore and just went away. I've never had cold sores in my life and the doc reckons I"ve had HSV 1 for years because my husband of 13 years tested negative so I must have got it before we met from oral sex (but never had an obvious breakout before or confused it with a yeast infection). Anyway pls could you let me know if this could be a cold sore. Thanks.
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Avatar universal
It's definitely common for people to freak out about spreading herpes to different body sites, but you really shouldn't worry at this point since your primary OB is most likely over. The only time you usually are at risk for spreading this to other body parts is during the primary outbreak, and even then it's extremely rare. You are able to spread it during your first outbreak because your body has no pre-existing antibodies to HSV-1, doesn't recognize the virus, and your body doesn't know how to fight it off. Once you become infected, antibodies are created that prevent HSV-1 from spreading to other locations of the body, and these antibodies become sufficient enough for most with a few weeks. Some of the experts recommend to be careful for the first 3-4 months and not to touch a sore then touch another part of your body during that time because there are probably few people (very, very few) who take a longer time to produce antibodies and adapt to the virus. With that said, after this time, it is as close to impossible as it gets to become infected with HSV-1 another location; you probably couldn't give it to yourself in another location even if you tried.

To conclude, since you have HSV-1 genitally you will never get it orally unless you contracted it orally during the same oral sex encounter you acquired genital HSV-1 from and your husband will never get it genitally if he ends up being the source since he possibly has an oral infection that was missed by the first HSV-1 igG blood test. Even if he doesn't have it, HSV-1 sheds only 12 days per year and his chances of contracted it are very low.

Below are some stats regarding the prevelence of HSV-1 in society depending on age and race. HSV-1 is extremely common (if you don't get it during your life your not of the norm), and by time we are in our 70s, 90% of us will have HSV-1, so it's most likely you were bound to get this at some point and is definitely not something to beat yourself up about. Feel free to ask more questions!


Caucasian
20-29: 46%
30-39: 56%
40-49: 59%

African American
20-29: 56%
30-39: 75%
40-49: 80%

Latino
20-29: 80%
30-39: 86%
40-49: 89%

If you want to break it down to age, and disregard race, it's as follows:
12-19: 44%
20-29: 54%
30-39: 64%
40-49: 65%

Feel free to ask more questions!
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Avatar universal
Thanks so much for your reply - I think it is just a pimple but your comments and explanation about cold sores helped put my mind more at rest. I have been very freaked out since being diagnosed with genital hsv 1 so I think absolutely everything is herpes at the moment! Thought I had ocular herpes last week but turned out it was just a mild allergy. It's only been six weeks since diagnosis so hopefully I'll calm down soon. Need to think of it as a skin condition and that's that.
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Avatar universal
***EDIT:***
Your oral symptoms DO sound more like a pimple than oral HSV-1, but if you are that concerned about it then you can get it swabbed. HSV-1 usually forms into a painful/sensitive blister then bursts on its own leaving a yellow/brown crust. Pimples or zits are microscopic while cold sores are usually more pronounced. Was there any burning or tingling before the appearance of this bump?
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Avatar universal
It's quite possible that you contracted genital HSV-1 and oral HSV-1 during the same exposure since there is usually kissing and oral sex involved during a sexual encounter. Somewhere between 1/4 and 2/3 of those who contract genital HSV-1 contract it orally during the same exposure.

However, the symptoms you describe seem more like a pimple rather than a cold sore, but I cannot give you a 100% definitive answer. If your pimple or bump appeared within the last 48 hours you can get it swabbed by your doctor to know for sure.

Regarding your husband's negative status, HSV-1 blood tests miss 1 out of every 10 infections, so this could be a false negative. Also, it is possible although unlikely that some people cannot produce the proteins necessary to test positive for HSV-1 via blood. I bring this up because usually the genital primary outbreak of HSV-1 are rather pronounced within 2-21 days after exposure, but that doesn't apply to all cases; some primary outbreaks could be mild.

Your oral symptoms do not sound more like a pimple than HSV-1, but if you are that concerned about it then you can get it swabbed. HSV-1 usually forms into a painful/sensitive blister then bursts on its own leaving a yellow/brown crust. Pimples or zits are microscopic while cold sores are usually more pronounced.
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