Aa
Oral Herpes
Hi. I was diagnosed with HSV1 about a year and a half ago. Initially I had a very bad outbreak (due to also having mono) with blisters on the roof of my mouth (never on my tongue) and two on my face one above and one below my lip on the right side. I've had maybe 3 minor outbreaks since but they have all been on the inside of my nose on the right side. I know have what I think may be an outbreak on my tongue, is that possible? Last week I had a sore lump on the top middle of my tongue, all the little bumps on the lump turned white and it grew about 3 times it's original size and split open causing another lump. It is now healing. At no time did this ever bleed, nor was there a blister or sore of any kind. It's not a canker sore either. Even when the lump split it was just skin and inflammed taste buds. But now as it's healing it does look similar to when a cold sore heals kind of inflammed on the circular outside but recessed in the middle. Anyway, sorry for the long description, I know it's hard to tell without seeing it but was just wondering if this could possibly be herpes related. I took an hiv test just to be reassured about that and it was negative as I suspected and my last sexual encounter was about 3 months ago. I also thought syphilis but it looks nothing like pictures I've seen and I had a wisdom tooth pulled about 2 months ago and was on heavy antibiotics for a few weeks so even if I did have syphilis I would think that would have wiped it out. It's almost healed so at this point I can't get it cultured so I guess I will have to wait to see if it happens again. Just wondering your thoughts on the matter.
You're welcome doctor. It seems to me that the whole notion of classifying a condition as an "STD" really becomes an exercise in semantics. In my opinion, a condition is an STD if it's acquired primarily through engaging in sexual acts. That said, you are right that oral herpes is not an STD in that sense; the majority of people who have oral herpes acquired it before they even knew what sex was. But a woman who acquires oral herpes by giving fellatio to a man with genital herpes is now someone who acquired a non-STD "sexually," so to speak.
That woman, who DOES NOT have an STD, is now in a position to give another man (if she gives him a blowjob) genital herpes, which is an STD. They both have the EXACT SAME virus, but the woman does not have an STD, and the man does. Sounds crazy, doesn't it?
That woman, who DOES NOT have an STD, is now in a position to give another man (if she gives him a blowjob) genital herpes, which is an STD. They both have the EXACT SAME virus, but the woman does not have an STD, and the man does. Sounds crazy, doesn't it?
MEDICAL PROFESSIONAL
Bowers: 1) You're skirting the edge of getting bounced from MedHelp posting priviledges--not because I take (much) personal offense, but because no ad hominem attacks (e.g., accusing anybody of being dumb, "boneheaded", or whatever) are permitted. 2) You show me your STD credentials and I'll show you mine.
Thanks to ericman for a nice response.
As to oral herpes as an STD: Oral herpes can be thought of as sexually transmissible, but generally not sexually transmitted. The large majority of people infected with HSV-1 acquired it nonsexually. Of course, genital HSV-1 infection is an STD (notwithstanding my favorite president's definition of "sex").
HHH, MD
Thanks to ericman for a nice response.
As to oral herpes as an STD: Oral herpes can be thought of as sexually transmissible, but generally not sexually transmitted. The large majority of people infected with HSV-1 acquired it nonsexually. Of course, genital HSV-1 infection is an STD (notwithstanding my favorite president's definition of "sex").
HHH, MD
Bowers, hold on there man. No need to get nasty. But I do think that the category "STD" is pretty stupid, simplistic, and misses the boat entirely. After all, if you catch oral herpes from giving a guy a *******, guess what? You got the disease "sexually."
That's no different than giving a guy a ******* and giving him genital herpes. That guy just got herpes through oral sex, and therefore, got the disease "sexually."
Think about it: it makes no sense to say that the giver of oral sex who gets herpes did not get an STD, but the receiver of oral sex who gets herpes DID get an STD. They both just got a disease through sex. It's merely the location that is different.
In my opinion, the classification of something as an STD serves only one purpose: it stigmatizes the people afflicted. Herpes should be classified as a "skin-to-skin" disease, NOT merely an "STD." AIDS should be considered a blood-borne or secretion-borne disease, not mererely an "STD." True, those diseases can and often are transmitted sexually, but they can also be transmitted (especially AIDS) in other ways.
That's no different than giving a guy a ******* and giving him genital herpes. That guy just got herpes through oral sex, and therefore, got the disease "sexually."
Think about it: it makes no sense to say that the giver of oral sex who gets herpes did not get an STD, but the receiver of oral sex who gets herpes DID get an STD. They both just got a disease through sex. It's merely the location that is different.
In my opinion, the classification of something as an STD serves only one purpose: it stigmatizes the people afflicted. Herpes should be classified as a "skin-to-skin" disease, NOT merely an "STD." AIDS should be considered a blood-borne or secretion-borne disease, not mererely an "STD." True, those diseases can and often are transmitted sexually, but they can also be transmitted (especially AIDS) in other ways.
"Lack of education about STD indeed is a problem. But of course you don't have an STD; nobody classifies oral herpes as an STD".
Doctor, it's hard to take you seriously when you say such boneheaded things.
Doctor, it's hard to take you seriously when you say such boneheaded things.
MEDICAL PROFESSIONAL
Thanks for the thanks.
Lack of education about STD indeed is a problem. But of course you don't have an STD; nobody classifies oral herpes as an STD.
GlaxoSmithKline loves you! That of course is the whole idea of their direct-to-consumer Valtrex ads.
HHH, MD
Lack of education about STD indeed is a problem. But of course you don't have an STD; nobody classifies oral herpes as an STD.
GlaxoSmithKline loves you! That of course is the whole idea of their direct-to-consumer Valtrex ads.
HHH, MD
Thank you for your response. I guess the problem with me along with other people is just the lack of education when it comes to std's, I really wish more emphasis was placed on it in high school and college.
I know the tongue is an atypical place to have an outbreak which is why I took the hiv test and assumed there must be an underlying condition, thanks for clarifying that.
I was not aware other medication was inexpensive, Valtrex is so publicly advertised that I thought that was the best/only option.
The next time it happens, if it does, I will have it checked out, it may not be herpes related and all of this is a moot point. Thanks for taking time out to respond to my comment, I know you're not obligated to do that. Have a nice day.
I know the tongue is an atypical place to have an outbreak which is why I took the hiv test and assumed there must be an underlying condition, thanks for clarifying that.
I was not aware other medication was inexpensive, Valtrex is so publicly advertised that I thought that was the best/only option.
The next time it happens, if it does, I will have it checked out, it may not be herpes related and all of this is a moot point. Thanks for taking time out to respond to my comment, I know you're not obligated to do that. Have a nice day.
MEDICAL PROFESSIONAL
Nobody knows what triggers herpes recurrences at all, so there is no way to predict what might cause an atypical lesion. But it doesn't usually mean any kind of serious underlying health problem.
But I stress I don't know that's what caused your tongue lesion; it could have been something entirely different. Herpes simply is the statististical best bet, nothing more.
You're right that suppressive therapy isn't used as often for oral vs genital herpes. That's because most people with recurrent oral herpes don't have as frequent outbreaks as genital HSV-2; and oral herpes usually isn't associated with the psychological/social stress of genital, so people's thresholds for effectiveness, cost, and convenience are different. But it works just fine--although the dose for effective suppression is higher than for genital HSV-2.
I can't solve the problem of expensive drugs. But is it really all that big a deal? You probably could get effective suppression for under $1.00 per day, probably less (e.g., generic acyclovir). How does that compare with what you spend on coffee at Starbucks or the occasional glass of wine?
Acyclovir, valacyclovir, and famciclovir do not cause liver damage. These are extraordiarily safe drugs; you almost cannot give enough to a lab animal to make it sick. In 30+ years of using them, I have never once had a patient with a significant side effect.
HHH, MD
But I stress I don't know that's what caused your tongue lesion; it could have been something entirely different. Herpes simply is the statististical best bet, nothing more.
You're right that suppressive therapy isn't used as often for oral vs genital herpes. That's because most people with recurrent oral herpes don't have as frequent outbreaks as genital HSV-2; and oral herpes usually isn't associated with the psychological/social stress of genital, so people's thresholds for effectiveness, cost, and convenience are different. But it works just fine--although the dose for effective suppression is higher than for genital HSV-2.
I can't solve the problem of expensive drugs. But is it really all that big a deal? You probably could get effective suppression for under $1.00 per day, probably less (e.g., generic acyclovir). How does that compare with what you spend on coffee at Starbucks or the occasional glass of wine?
Acyclovir, valacyclovir, and famciclovir do not cause liver damage. These are extraordiarily safe drugs; you almost cannot give enough to a lab animal to make it sick. In 30+ years of using them, I have never once had a patient with a significant side effect.
HHH, MD
What would cause an atypical recurrence, would herpes show up on a persons tongue? I'm upset about this because everything I've read seems to say that hsv1 is no big deal and only hsv2 requires suppressive therapy. I've never heard of anyone being on suppressive therapy for hsv1. I'm very leery of going on Valtrex or anything like that because 1. I have no insurance and it's very expensive and 2. I've heard it causes liver damage.
MEDICAL PROFESSIONAL
The most likely explanation for your oral lesion is an atypical recurrence of your oral herpes, but other than that, I can't even guess. Except in very limited circumstances (certain geographic areas, drug use, eastern Europe immigrants, etc), the odds of syphilis in a woman in the US or Western Europe are almost zero. You might be right about antibiotics suppressing syphilis, but many antibiotics have no effect at all against syphilis--so it depends on what drugs you were taken. But it's such a low risk you really don't need to worry. But if you remain concerned about that possibility, you could have a syphilis blood test; once a primary syphilitic chancre heals, the blood test is positive--so you you can be tested any time.
Otherwise I cannot speculate about the cause of your orla lesion(s). You'll need to see a health care provider if/when atypical outbreaks occur or if you are otherwise concerned. It sounds like you are having sufficiently frequent outbreaks that you would benefit from suppressive therapy. You should ask your provider about it.
Good luck-- HHH, MD
Otherwise I cannot speculate about the cause of your orla lesion(s). You'll need to see a health care provider if/when atypical outbreaks occur or if you are otherwise concerned. It sounds like you are having sufficiently frequent outbreaks that you would benefit from suppressive therapy. You should ask your provider about it.
Good luck-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
