Could I have given myself herpes through a fever blister?

[bigconcern]

I have had very limited experience sexually. In fact, I'm still a virgin. I have always had fever blisters, but since my adult years, every now and then I will get a strange bump on my vagina. I will usually only get a "bump" about once a year. Although, recently I have had two within the last three months. The location of the bump will always change.  It's only one bump about the size of a pimple.  It's ichy and sometimes sore. It doesn't seem to be red, it kinda just blends in with the rest of the area it's on.  It does have a whitish tip. I'm concerned that it maybe herpes because when I get one it feels similar to a fever blister on my lip. Also, it seems to hang around about three weeks, which I read is the time frame for herpes.  The soreness and ichiness will disappear after about a week or so, but the bump stays about three weeks.  Could I have given myself herpes some how? What else could it be?

[H. Hunter Handsfield, M.D.]

Auto-inoculation of HSV - that is, self-infection from one part of the body to another - is pretty common during a person's first infection.  Some people with brand new genital or oral herpes get herpes lesions of a finger or the eye, for example.  However, auto-inoculation is extremely rare, if it occurs at all, from long-established infection; your immune system protects you from new infection with the same virus type.  So it is very unlikely you transmitted the virus from your cold sores to the genital area.

And there are other reassuring features.  Genital infection with HSV-1 (the type that causes oral herpes) does not usually recur with the frequency you imply; most people with genital HSV-1 have either no recurrences at all, or have an outbreak around once a year.  Finally, recurrent herpes almost always involve pretty much the same spot.  (I'll bet that your oral herpes recurs in more or less the same area of your lips each time.)  Most people with recurrent genital herpes of, say, the left labia minor always have outbreaks there and nowhere else.  And if your recurrent bumps occur on both sides - left side one time, right side another - that is virtual proof it isn't herpes.

The only missing information is what you mean by "limited" sexual experience.  If there has been genital apposition (without penetration), it is conceivable you acquired genital herpes.

Bottom line:  I am quite certain you don't have genital herpes.  But as to what is causing your symptoms, however, I just can't say.  If the lesions are occurring on dry skin, it could just be pimples or hair follicle infection (folliculitis).  You need to see a health care provider right away when you have a new lesion.  You probably can arrange it ahead of time with your own provider, so the appointment desk knows to work you in on short notice the next time it pops up; or you can visit your health department family planning clinic or a Planned Parenthood clinic, most of which are prepared to see patients on a walk-in basis or within a day.

Good luck--  HHH, MD