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Saliva-cold sore-pimple-fear
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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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Saliva-cold sore-pimple-fear

I have a lesion under my nose that I thought was a pimple but which I am now realizing may be a cold sore.

Here's the background of the lesion:

- It had a head that I popped, and then the soreness went away.
- The sore never developed a yellow or brown crust.
- The lesion was never several blisters that came together.
- But it did start out as a sore spot that eventually became a sore pimple that eventually had a head.
- The whole process took about three days (but this is NORMAL for pimples for me).
- The lesion was mostly healed and flaky and a little itchy (also normal, since I'm lately using salicyclic acid for acne), having already formed the hypopigmentation that all of my healing cuts develop (I'm black), by the time I had the sexual encounter.

And here's the worrying part (for me):

The sexual encounter was this -- I gave someone a hand job that I lubricated with my saliva. There was no mouth-on-penis action, just hand and saliva...and possible healing cold sore. My hand did not touch the possible cold sore when I was wetting it with my tongue.

And the question:
I'm freaking out. I don't want to give anyone genital HSV1. It didn't occur to me that the lesion might be a cold sore until I looked in the mirror the next morning and saw it looking all flaky and dry under my nose. I've never had a cold sore right in the opening of my nose before, so I wasn't as careful as I perhaps should have been.

So I guess I'm asking if this encounter sounds like I have given this guy I like herpes. Do I just have to wait for two weeks and hope for the best?
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Welcome to the STD forum.  Bottom line:  if this is the first time you have had a pimple like sore in this particular location, herpes is unlikely.

Half the population has HSV-1, mostly oral.  Most don't have overt lesions, i.e. no recognized cold sores.  But in those who do, the recurrent oubreaks are usually in pretty much the same spot, give or take an inch or so.  Therefore, if you have had similar lesions in the same area (usually but not always occurring in a cluster, i.e. not usually only one lesion), herpes might be a possibility.  However, it sounds like this healed too quickly for herpes.  HSV lesions can't heal in less than 7-10 days.

For those reasons, it seems unlikely that your facial lesion is herpes.  But even if it is, hand to genital HSV transmission almost never happens.  In 30+ years in the STD business, I have never seen such a case.  That doesn't mean it can't happen, but it's very rare.  Further, there is a 50:50 chance your partner already is infected with HSV-1.  If so, he is immune to a new infection with HSV-1, anywhere on his body.

Considering all aspects of your story -- the nature of your facial lesion and the sexual contact -- there is no realistic chance you transmitted HSV to your partner.  I wouldn't worry about it.  As for the oral lesion, it sounds like it's clearing up.  (And by the way, herpes lesions cannot heal in under 10 days.)  But if it persists, or if something like it reappears in more or less the same spot, see a health care provider promptly -- when the lesion is less than 2 days old, so HSV diagnostic testing can be done.

I hope this helps.  Best wishes--  HHH, MD
2 Comments
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Thank you for such a super speedy reply! I expected to at least wait a full day to hear back. I appreciate your diligence. You must have so many of these to answer!

You might as well know that I'm a gorgeous black female in her early 30s who's been phobic about her own damn hsv1 for years. Truly phobic ever since I was turned down for the Herpevac trial years ago because of my status.

Thus I'm glad to hear It's unlikely that I have given this boy ghsv1. But of course, there aren't any absolutes here. So after how much time can I rest assured that he is most likely in the clear and won't have a genital hsv1 outbreak from our encounter? It's been about four days since it all happened. I know you think I should stop worrying now, but when can I DEFINITELY stop worrying and go back to feeling good and not guilty about this guy I'm really digging?

Also at what cold sore stage does the sore stop being contagious? I read somewhere that it's no longer contagious during the crusting stage. Not that I plan on having anyone interact with my cold sores in the future, but I just want to reassure myself even more about this encounter. Maybe I was in the crusting stage. My lesion just didn't look or act like herpes is supposed to act. But it was near a mucus membrane. And it's been about a week, and it's almost all hypopigmentation now.

Ramble ramble ramble. One more reassurance is all I ask.
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