Spreading of HSV to genitals

[worrywart1983]

I have had a history of cold sores in my past and have had blood work to ascertain that I am HSV type ONE positive.  I get occasional cold sores from time to time.  Yesterday, I noticed a small red spot beneath my nose, but not on my lips that was red and I thought it was a burn from warm wax.  Later that same day I was with my boyfriend and we kissed and I performed oral sex on him and we kissed and he performed oral sex on me.  After all this happened, later that night I began to see that perhaps this was a cold sore.  It started to look like a cold sore but it was right below my nose and not on my lips like my usual ones.  Now I am so scared. Given what I have said:

What is the likely hood that I could have HSV infection to my genitals after my boyfriend kissed me and then performed oral on me?  Like I said, it didnt look like a cold sore because it wasnt on my lips but later that day it became more apparent it was a cold sore but beneath my nose.  

secondly, how likely could it be for my boyfriend to have been infected???  he doesnt ever remember having a cold sore in his life.  

Please help!

[Edward W Hook, MD]

Most exposures to herpetic lesions, whether cold sores or genital lesions, do not lead to infection.  Thus, you may not have transmitted infection to your partner (actually, a more accurate statement would be that you are unlikely to have transmitted infection to him).  You should mention your concern to him so that should he develop a lesion, he can get checked and know if he has become infected.  If he is going to develop lesions, they would be anticipated to show up between 3 and 10 days following exposure.  If not lesion by then, he did not get infection.  (Remember, there is a better than 50/50 chance he already has HSV-1 and does not know it.  If this is the case, he would not be likely to get genital HSV-1 from you performing oral sex on him with a cold sore).

As for you, there is no reason to worry about your BF transferring your own HSV-1 from your lip to his and then on to your genitals.  This does not happen.

Hope this helps.  EWH

[worrywart1983]

So does the lesion always show up in about 3-10 post infection?  

Can you also explain a bit on how how him kissing me and and performing oral sex on me when i had a cold sore wouldn't transfer the virus to my genitals?

[Edward W Hook, MD]

There is no such thing as "always" in medicine or with human beings.  I suspect you know that and if I were to answer you that it was the case, you should not believe me.  As I said, there are no absolutes. Nonetheless the data make this useful for you to guide your own risk assessment.

As for the explanation of why it doesn't work, the effect has to do with dilution effect.  With each passage from one surface to another, the amount of virus gets smaller and that, combined with the fact that HSV does not leive well outside of the body make the situation you have suggested a "never" ever.

Your questions suggest that you are really worrying about this more than is appropriate.  There is nothing you can do to change what is done and if you did happen to pass herpes to him or yourself (I would be a LOT of money you didn't and I am not a betting person) it is not the end of the world. Time for you to move on.  EWH

[worrywart1983]

I am a bit worried about this sorry.  However if i had a cold sore above nose and he did kiss me and then perform oral that is still low risk?  this concept of autoinculation, how does it pertain to the situation I have described.  please explain.  Thanks so much for all your help!

[worrywart1983]

One more thing when you said in your previous posting...."the fact that HSV does not leive well outside of the body make the situation you have suggested a "never" ever."  what did you mean by never ever?  Thanks again

[Edward W Hook, MD]

My aptientce has worn thin.  Your anxiety about this is not helping you and you are asking questions that do not have a simple answer. This will be the last answer and then further questions will be deleted without response in efforts to not further fuel your inappropriate worries.

First question.  I really meant it when I said low risk.  Repeating the question will not change the answer.

Autoinoculation pertains to the idea that you suggested that one could, directly or indirectly spread your own infection to other spots on your body, either with your own hands or on his lips.   This simply does not happen.

Sorry, typing too fast.  I meant to write "never event" which is another way of saying it does not happen.  

End of discussion.  EWH

[worrywart1983]

Sorry but your input has been very helpful!   Thanks!