STDs Expert Forum
HSV2 Problem on Face
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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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HSV2 Problem on Face

Dear Doctors Hook & Handsfield, I have what seems to be an issue with HSV2 on my face. I spent hours typing out a long series of questions but was stopped by character limit. PLEASE SEE MY LONGER POST IN STD Forum "HSV2 On Face".12/15/12 – Most likely exposed to HSV2 virus on face via oral sex with wife of 20 years. My wife & I both have Genital HSV2. We have never had symptoms on our face. 12 hours later noticed rough dry skin spot on side of lower lip. I also had an area of raised aggravated skin above lip. Also had a very thin linear open crack on crease of skin between eyes on forehead. Started to immediately self-medicate with 400 MG a day  of Acyclovir.  I will be feeling myself for a few day & then I get these attacks pretty much weekly with this strange sore throat, itching in my ear, tight sensation on skin surface around nose creases & below eyes, malaise, irritability & I get  facial acne lesions cracks in the corners of my mouth very small little blister bump in corner of mouth. Though I have not had lab confirm of HSV2 on face, my gut tells me that I do. I do get the the tingle sensations on lips & my eyes & ears get itchy. I can deal with your average cold soar no problem, but this getting sick every week with all these other symptoms are a real nightmare.I am very depressed and wanting to find the answers so I can take them on with everything I've got.  PLEASE READ MY FULL POST AT REGULAR FORUM, MOST OF MY QUESTIONS ARE THERE. PLEASE help me in any way you can.  Sincerely grateful - E
Tags: hsv2, face
239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

There's no need for me to look at your older thread.  You provide sufficient information here for an accurate reply -- in fact, in the opening 3-4 sentences.  If I understand correctly, you and your wife have had genital HSV-2 going back a long time, but you are concernd about more recent onset of facial HSV-2.  Correct?

People are immune (or at least highly resistant) to new infections with the same type of HSV they already have.  Therefore, it is uncommon for someone with prior HSV-2 to acquire a second HSV-2 infection.  Therefore, couples in which on has herpes never "ping pong" their infections back and forth.  For example, it is unnecessary for you and your wife to avoid sex if either of you is having an outbreak (excpet maybe for compfort if lesions are painful).

You may have heard of auto-inoculation, i.e. people self-transferring their HSV infections to a new part of the body, and infected persons are generally advised to avoid touching their eyes, for example when they have an outbreak.  However, for the reasons above, autoinoculation is pretty much limited to the first few months of a new HSV infection.  

As for your facial symptoms, they are strongly against herpes.  For example, no HSV infection ever causes recurrent outbreaks as often as once a week.  Once every 4 weeks is about the maximum.  There are other details of your description that also don't sound like herpes.  I suppose it is possible you have a facial HSV-1 infection, but I doubt it -- and for sure it isn't HSV-2.

So my advice is to not take acyclovir for these episodes and see a doctor, preferably as promptly as possible as new symptoms appear.  (Ideally, consider a dermatologist.)  I am confident that that herpes will not be documented as the cause, especially HSV-2.

I hope this has been helpful.  Best wishes--  HHH, MD
5 Comments
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Avatar_m_tn
Dear Dr. Handsfield,

Please read my longer comment on this link ( I took 4 hours to write it)
http://www.medhelp.org/posts/STDs/Herpes-HSV2-On-Face/show/2037446

I have questions on there I really would like you to comment on.  I have been tested for HSV1 and it was negative. I hve seen 5 different Dermatologist and they can't tell what this is for sure.  I have a lot of strange symptoms that I would like your opinion on.

Thank You very much

Erik
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239123_tn?1267651214
Sorry, I have neither the time nor energy to read such a long essay.  Read my reply above.  Trust me on this:  the evidence proves you do not have facial HSV-2, and you probably do not have facial HSV-1.  An online forum is never a place for a definitive diagnosis, and no online expert can ever come up with a firm answer about any skin problem after a 5 dermatologists have not.  And as for "a lot of strange symptoms", we do not speculate on causes except for STDs -- which clearly is not the problem here.

That will end this thread.  Do your best to accept the scientific evidence and your test results.
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Avatar_m_tn
Dr. Handsfield, Just to conclude so I understand what you are saying correctly. The fact that both my wife and I have had Genital HSV2 for 20+ years, Oral to genital contact can not cause cross-infection to my mouth even if she was shedding or had an active outbreak at the time of contact?

If you would be kind enough to confirm this I would appreciate it.  Thanks
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239123_tn?1267651214
You correctly understand.  I cannot say the risk of transmission is zero, but as discussed above, it is very low  And in addition to the rarity of such transmission, your facial symptoms do not suggest herpes but some other sort of skin problem.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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