Aa
herpetic whitlow??
Doctor:
I've been dating a woman now for a month now who is HSV2 positive. She takes 1g of Valtrex daily. In the past month, we've had sex about 6 times (not including fingering and oral) and have used a condom every time except one time, which was very brief and only lasted 10-20 seconds).
About 2 weeks ago, I had a small cut on my right index finger, just below the fingernail. At some point, that part of the finger became red and swollen. It was moderately painful to the touch, though there was no tingling or anything and it would only be painful when touched. After about 3 days, it went away completely. It never blistered, ulcerated, oozed fluid, or anything of the sort. It was just red for about 3 days and that was it. I never saw any vesicles. There was no lymphadenopathy. It never looked like any pictures of herpes whitlow that I've seen on the internet. The following are my questions:
1. Does this sound like herpes whitlow? Does all/most herpes whitlow necessarily blister and ulcerate?
2. How reliable is a Biokit test 4 weeks post-exposure?
3. After every sexual act with her, I've also taken a Valtrex. Is there any reason to think that taking Valtrex may prevent me from even becoming infected to begin with?
4. What are some of the features of "atypical" herpes that indicate that the infection is nonetheless herpes. Does atypical herpes last just as long as "classic" herpes, even though it looks different? Or can atypical herpes go away within 2-4 days?
Thanks so much!
I've been dating a woman now for a month now who is HSV2 positive. She takes 1g of Valtrex daily. In the past month, we've had sex about 6 times (not including fingering and oral) and have used a condom every time except one time, which was very brief and only lasted 10-20 seconds).
About 2 weeks ago, I had a small cut on my right index finger, just below the fingernail. At some point, that part of the finger became red and swollen. It was moderately painful to the touch, though there was no tingling or anything and it would only be painful when touched. After about 3 days, it went away completely. It never blistered, ulcerated, oozed fluid, or anything of the sort. It was just red for about 3 days and that was it. I never saw any vesicles. There was no lymphadenopathy. It never looked like any pictures of herpes whitlow that I've seen on the internet. The following are my questions:
1. Does this sound like herpes whitlow? Does all/most herpes whitlow necessarily blister and ulcerate?
2. How reliable is a Biokit test 4 weeks post-exposure?
3. After every sexual act with her, I've also taken a Valtrex. Is there any reason to think that taking Valtrex may prevent me from even becoming infected to begin with?
4. What are some of the features of "atypical" herpes that indicate that the infection is nonetheless herpes. Does atypical herpes last just as long as "classic" herpes, even though it looks different? Or can atypical herpes go away within 2-4 days?
Thanks so much!
A related discussion, Herpes Whitlow/HSV2 was started.
A related discussion, Herpatic Whitlow was started.
Doc,
Thanks for the advice. I forgot to mention that I am HSV1 positive, and I was wondering if that fact made it more likely for me to have "aytpical" or mild outbreaks. I was also wondering how common fluid-filled blisters are in an attack of herpes. Are those blisters almost always there when one has symptomatic herpes, atypical/mild or not? The information on the internet is conflicting, and that is so frustrating. It seems that herpes can manifest in one of a million ways, including "cracks" or "fissures" on the skin.
Last question, I promise. How frequently would someone, who takes daily Valtrex, be *asymptomatically* shedding the virus? How many days out of the year, roughly? Again, the info on the internet is quite conflicting.
Thanks again for all your help.
Thanks for the advice. I forgot to mention that I am HSV1 positive, and I was wondering if that fact made it more likely for me to have "aytpical" or mild outbreaks. I was also wondering how common fluid-filled blisters are in an attack of herpes. Are those blisters almost always there when one has symptomatic herpes, atypical/mild or not? The information on the internet is conflicting, and that is so frustrating. It seems that herpes can manifest in one of a million ways, including "cracks" or "fissures" on the skin.
Last question, I promise. How frequently would someone, who takes daily Valtrex, be *asymptomatically* shedding the virus? How many days out of the year, roughly? Again, the info on the internet is quite conflicting.
Thanks again for all your help.
You are worrying yourself too much about this!
valtrex on average reduces shedding by 70% when taken suppressively. I suck at math but if on average folks with hsv2 shed about 45 days a year and you reduce that by 70% - it's not much. The chances of her actively shedding the virus on that day were minimal.
Bacterial infections are far more common than herpes is - especially on the hand area.
I'm totally with HHH - you have to stop allowing yourself to think that everything on your body might be herpes. You are far, far, FAR more likely NOT to contract your gf's hsv2 than you are to become infected with it. Work on convincing yourself of that or think about moving on. You'll drive yourself crazy worrying that everything on your body is herpes otherwise. I know it's easier said than done but you really are at low risk for contracting hsv2 on any body part.
grace
valtrex on average reduces shedding by 70% when taken suppressively. I suck at math but if on average folks with hsv2 shed about 45 days a year and you reduce that by 70% - it's not much. The chances of her actively shedding the virus on that day were minimal.
Bacterial infections are far more common than herpes is - especially on the hand area.
I'm totally with HHH - you have to stop allowing yourself to think that everything on your body might be herpes. You are far, far, FAR more likely NOT to contract your gf's hsv2 than you are to become infected with it. Work on convincing yourself of that or think about moving on. You'll drive yourself crazy worrying that everything on your body is herpes otherwise. I know it's easier said than done but you really are at low risk for contracting hsv2 on any body part.
grace
MEDICAL PROFESSIONAL
Someone else asked almost the same question just a couple of days ago. There is a theoretical risk of transmission of HSV-2 by fingering, especially if there is a prior skin lesion like a cut, inflammation around the fingernail, etc. But in 30+ years in this business I have never seen a case, and I am not aware of any reports of it in the medical literature--so common sense says the risk is extremely low, maybe zero, given the frequency of fingering, of genital herpes, and of cuts or lesions on finger. So statistically, it is an unlikely explanation for your symptoms.
Second and equally important, herpes whitlow lasts a couple of weeks, even 3 weeks or more, defintely not 3-4 days.
So although I cannot make a specific diagnosis, my replies are: 1) No. 2) Biokit USA takes up to 3 months to become positive. My guess is about half the time it would be positive by 4 weeks. 3) Most likely Valtrex would have protected you against infection, although such use has not been studied. 4) Too complex a question. Most people with genital herpes have typical, not atypical symptom. (They are atypical only in that they are mild.) No initial infection with HSV-2 causes symptoms that clear up in only 3-4 days.
The overall tone suggests you are unreasonably nervous about catching y-2 in this relationship. My advice is that if this is a committed, or potentially committed permanent relationship, you just stick to the precautions you and she already are taking and accept the small risk that transmission may occur despite those precautions. If you're not certain about the future of the relationship, consider openly discussing your fears with your partner right away and get out of the relationship. Better sooner than later, if that's where this is going--which seems likely, given your obvious anxieties. But if the relationship has promise for the long term, herpes is definitely a trivial issue in comparison--and in that case, just suck it up and move forward with what is important.
Good luck-- HHH, MD
Second and equally important, herpes whitlow lasts a couple of weeks, even 3 weeks or more, defintely not 3-4 days.
So although I cannot make a specific diagnosis, my replies are: 1) No. 2) Biokit USA takes up to 3 months to become positive. My guess is about half the time it would be positive by 4 weeks. 3) Most likely Valtrex would have protected you against infection, although such use has not been studied. 4) Too complex a question. Most people with genital herpes have typical, not atypical symptom. (They are atypical only in that they are mild.) No initial infection with HSV-2 causes symptoms that clear up in only 3-4 days.
The overall tone suggests you are unreasonably nervous about catching y-2 in this relationship. My advice is that if this is a committed, or potentially committed permanent relationship, you just stick to the precautions you and she already are taking and accept the small risk that transmission may occur despite those precautions. If you're not certain about the future of the relationship, consider openly discussing your fears with your partner right away and get out of the relationship. Better sooner than later, if that's where this is going--which seems likely, given your obvious anxieties. But if the relationship has promise for the long term, herpes is definitely a trivial issue in comparison--and in that case, just suck it up and move forward with what is important.
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.
