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HSV-1 Genital Autoinoculation with Symptom?!
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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HSV-1 Genital Autoinoculation with Symptom?!

I am a 21 year old female who is in a monogomous 2 year relationtionship. We were both tested going into our relationship for STD's (despite the fact that we were both virgins) and have both had cold sores since child hood. (I've even had HSV scrrening done in the past and I was HSV-1 positive) The other day I gave him a blowjob  (2pm) and then we continued to have protected sex with my saliva as lubricant (I know... sorry for the details..). Then at around 11pm my lip started to tingle and I woke up the next morning with a cold sore. In the evening three days later I noticed a pimple looking thing on my genitals (a few centimeters above my clitoris, but not red and looking superficial rather than deep), I woke up the next morning and it now looked like a white head. I went to the doctors just to get an opinion to ease my nerves and she said it was a pimple, or "folliculitis". Later that day I took a nap, woke up and the white head was gone and it just had a small crust (assuming it popped while I was sleeping). The crust came off in the shower the next morning only to leave a small red spot that looked slightly raw. I went back to the doctors where she looked at it, said again it was a pimple, knew I was still upset and grabbed a swab to see if she could culture it for me, but she couldn't get any moisture off the swab and therefore couldn't test it. (This really freaked me out that she even thought to grab a swab...) After that she looked at me again and she said "its a pimple, stop worrying and go do something fun".
1) What are the chances that I did autoinnoculate myself and that this pimple really could be HSV-1 gone south due to the initial presentation of a superficial pimple (which the doctor didn't see)?
2) What are the chances my boyfriend who gets cold sores, but has never been HSV screened could get HSV-1 down south?
3) What would you reccomend for us to do in the future? Never have oral sex? Only no oral sex from prodrome until scabs are gone?
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For starters, if you have been tested for HSV in the past and were negative and your partner was not performing oral sex on you, I suspect what you thought was a cold sore was not but instead was something else like an aphous ulcer or some other non-infectious process.  In fact, it would be more typical for an aphous ulcer to show up on your palate that HSV.  If it was a new, first episode cold sore, it would be quite unusual for you to inoculate yourself from your mouth/lips to your genitals.

Further making this unlikely to be sexually acquired is that it appeared within hours of your oral exposure to him. It typically takes HSV at least 3 days to appear after acquisition of infection.  Rather the time course or your genital lesion is, indeed, VERY typical of folliculitis is as what happened after it burst.

My advice, there is nothing to worry about (including increased risk of HIV exposure at this time).  Should the oral or palate lesions recur, see a health care provider and get a culture ASAP after it appears to help resolve your question as to whether it is or is not.  Hope this helps.  EWH
9 Comments
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Avatar_n_tn
I forgot to mention that the entire pimple thing from the time i noticed it to the time it was unnoticable was about 2 days. Maybe that helps..
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Avatar_n_tn
sorry i keep thinking of these things as my panicy mind wonders...How would a genital HSV-1 infection increase the risk of aquiring HIV if an exposure were ever to occur? Thanks.
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Avatar_n_tn
I forgot to mention that not only did I have the cold sore on my lip the day after giving head, but I also got one on the hard palate of my mouth at the same time. ugh...
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Avatar_n_tn
I'm sorry I must have written the story confusingly. Let me try again. I am HSV-1 positive (I've had cold sores since I was little) and my boyfriend has gotten cold sores since he was litte (so I'm assuming he is HSV-1 positive too). I gave him head and then we had protected sex with slpit at lubricant sunday at 2pm, then i noticed tingling around my lip at 11pm. I woke up the next morning and had a cold sore on my lip as well as on the hard palate of my mouth. Then wednesday 5pm I noticed a bump on my genetials, thursday it looked like a whitehead (and the doctor said it was a pimple) and then later that night it tunrned to a scab, friday that scab fell off of the shower and a small red raw skin area was left.

1) Could I have given my BF genetal HSV-1?

2) Could I give HSV-1 to myself knowing that I definatly get it around the lips and have been doing so for 10+ years?

3) How should I keep my boyfriend and I safe in the future if we continue to only have ther HSV-1 infections we have now?
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300980_tn?1194933000
Sorry, I understood that you did not have HSV-1 - I now appreciate that both you and your BF get cold sores.  This just makes it even less likely that your genital lesion was HSV and sitll suggests to me that the lesion on your palate was an aphous ulcer.  As for your questions:

1.  Not from what you describe.  Since he too already gets cold sores, it is very, very unlikely that you would give him genital HSV-1 though oral sex.  That he already gets cold sores will protect him through the immunity developed to his own infection.
2.  As I said before, most unikely
3.  Not a concern.  

I think I got it right this time.  EWH
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Avatar_n_tn
I looked at where the pimple was and there is still a small scab, i picked it off and it bled a little (the spot where it bleads from is about the size of the ball of a pen). Its sunday afternoon and the bump first appeared wenesday night. It never hurt and started as a superficial flesh colored pimple. Also, it does not appear to be in a har follucle since there is no hair coming from it. Still a pimple? Thanks.... from a girl with OCD
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Ok... OCD again but... the spot where it bleads is slightly smaller than the top of a ball point pen and I've picked the scab like three times...so maybe thats why it hasnt healed..., still a pimple huh?... sorry i'm freaking out!!!
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300980_tn?1194933000
Still a pimple.  the more you pick, the more slowly it will heal and the more likely it is to get infected and become a bigger (non-STD) problem than it already is.  Please stop picking and let it heal.  EWH
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