Question about possible herpes transmission

[hannahgreen78]

I have not been formally diagnosed with genital herpes, but I am afraid now, that I may have it.
Last December, I had pain at the very top of the vagina- at the junction of the top of the clitoral hood and the upper labia, and a small bump appeared. I thought it was an ingrown hair and it went away  quickly. I take 1G of Valtrex daily because of recurrent cold sores on my face.
Saturday, I felt a few twinges, on and off, in that same area where the bump was before. I noticed my jeans were pressing on that area and by moving the jeans, the sensation stopped.  My partner (started dating in Jan) and I had sex multiple times over the weekend, the last time being early Sunday morning.  After that last time, I showered did not see anything amiss. Later on that day, I felt some aching in my lower abdomen, fatigue
Well on Monday, I noticed redness and what felt like a  bump under the skin in that same area that I had the bump months back.  It was then I started freaking out that maybe I do have herpes and that I possibly transmitted it to my partner.  The bump doesn't hurt persay and in fact its almost gone today. It stayed under the skin for the past two days but today almost seems like it has opened up a touch? Its so tiny, its hard to see it.  It is not really painful, but it feels weird if you touch it. It is high up  like 1/2 inch+ higher than the clitoris
My question here is  what are the risks that if this is indeed herpes, that I transmitted it to him this weekend? I had no visual symptoms as of Sunday morning, but perhaps the sensations  I felt a few times on Saturday were a prodrome?, And if those weren't perhaps the symptoms I had Sunday afternoon with the ab pain were a prodrome? As I said, I take 1G Valtrex/daily without fail-would that have had a protective effect? We did not use condoms at all. It was about 26 hours from the time we last had sex that I felt the tiny bump. I cannot talk to him about this for various reasons so that cannot happen.

[Edward W Hook, MD]

No clinician would endorse or encourage you to experiment by application of alcohol or other substances and it is hard to predict what might occur when you do.  It might well sting but that is hard to predict.

At this point, I see no evidence that you have herpes or that it is unsafe for you to have sex, particularly with a regular partner.

This will be my final comment.   EWH

[hannahgreen78]

I promise this is my last question. I believe whatever this was (recurrence, whatever) is healed up. I still have a hard time understanding that it can recur within days of the other healing. Still taking 1GM Valtex daily.

I can see the area where it was but it appears healed.  I "tested" things by dabbing the area with a cotton ball saturated with alcohol several times and felt not even a trace of pain, stinging, etc... Would one guess that if it were a herpes lesion (or active one if so) that it would sting/burn with the application of alcohol?  Would I be safe to have sex at this point ?

Thanks again and no more questions from me :)

[hannahgreen78]

Thank you very much for your services! You are most appreciated for your prompt, thorough and kind responses :)

[Edward W Hook, MD]

It would be unlikely for a recurrence to occur that quickly but the only way to know is with a test.

Less than 1% of exposures to partners with active HSV become infected.  EWH

[hannahgreen78]

I just tried calling the nurse line again and they said they still have nothing sooner than the 12th of May. :(


So is it really probable that you can have a recurrence in the same spot within 3-4 days of healing of a previous outbreak? I wonder if the 1mg Valtrex I have been on is even working if this is the case! Could it be anything else?

One last question-if one were to have been exposed to herpes, at 9 days out, if no symptoms, how likely is it that they are out of the woods for have contracted it?

Thanks for your help and again I am happy to pay more if needed!

[Edward W Hook, MD]

If this were herpes, this could be a recurrence.  Your doctor should be able to see you and test you now and I suggest you insist that he/she do that or offer an alternative method to get PCR test from the lesion.  the sooner the better.  For them to ask you to wait is inappropriate.  EWH

[hannahgreen78]

Want to add too that the area is now opened up-like an abrasion.  I cannot get into my Dr for till 12-May. I just can't believe it would recur like this in a week?

[hannahgreen78]

Also if I need to pay again, I will. I am not sure exactly how this works. I am just very confused on what could be going on here-to break out in the same  spot just days after it healed seems unusual to me!

[hannahgreen78]

I have one more question. The area in question healed within a few days (presented Monday, basically healed by Thursday) and I noticed last night that it looks red again in that exact area and maybe a little bump again? If this IS herpes-could it possibly recur within days? Just to give you a timeline:
Sunday:lower abdominal pain
Monday: redness, red bump, mild swelling
Wednesday: bump seems to open a little?
Thursday: bump pretty much gone
Monday: some redness again
Tuesday:  a little bit of a bump again but no swelling or anything

I have not stopped taking my Valtrex. Just wonder if it IS herpes, if it would reactivate again so quickly in the exact same area (just days after first spot healed)

[Edward W Hook, MD]

If HSV was transmitted to him he would develop lesions within 14 days of exposure and, in most instances by days 7-10.  EWH

[hannahgreen78]

We are now 4.5 days away from the encounter with nothing showing on him yet (that he has told me) I am assuming this is very good? When can I breathe easy?

I have lost so much sleep over this. Just want him to be OK and not to have caught anything!

[Edward W Hook, MD]

If a lesion is not present, the risk for transmission, IF you have HSV is lower still, probably in the neighborhood of 1 in 10,000. EWH

[hannahgreen78]

I wanted to confirm that the 1 in 1000 risk is the same even IF there are lesions  present. I did not have a lesion, but perhaps was in a prodrome.  Also, if I was infected, it would have been back this past Nov/Dec so does that  make the transmission risk higher even on Valtrex?

[hannahgreen78]

Thank you very much-this is quite helpful!  I started taking the Valtrex about a month before the initial "bump" that I felt-so I have been on it 6-7 months.

I just took a shower and the bump that was under the skin, its now flat/ flush with my skin surface and there is a tiny opening in the skin. Like the size of a pencil point and its slightly sensitive to the touch.

So if I am right, what works in our favor (presuming it IS HSV) it that the general risk of transmission is low, I did NOT have a lesion at the time, and I was on the Valtrex.

Does being on the Valtrex even during a prodrome or OB lessen the risk even further?  

Thanks again!!

[Edward W Hook, MD]

Welcome to the Forum.  I will try to help and add some perspective.  It is appropriate to wonder if a recurrent genital lesion might be HSV and in such situations, diagnostic testing, rather than assuming that the symptoms are due to HSV, is appropriate.  In your own case, for you to have acquired HSV while taking rather large doses of valacyclovir would be quite unusual and the "bumps" you describe are not suggestive of HSV.    If the lesions are still present, my advice would be to have a clinician take a look and, if appropriate, perform a PCR or culture test.  

There are many other processes that can cause the sorts of findings you describe (cysts, folliculitis, other).

As far as the likelihood of transmission to your BF is concerned, IF your lesion is HSV is low.  We estimate that less than 1 in 1000 exposures to infected partners, even with lesions present lead to I fiction.

I hope these comments are helpful.  EWH