HSV 1 risk

[JMilkman]

Last year I went through a herpes scare that became such an issue I had to seek help from a psychiatrist.  I eventually received the correct diagnosis of a rather mild case of molluscum and I had 3 herpes select tests that were all negative, which I'm now certain were correct.

I'm now dating someone who at my request was tested and showed a positive result for HSV1 with the IGG number at 5, but she has no recollection of ever having any kind of outbreak in her entire life.  I still have problems where I freak out sometimes about skin irregularities and I'm curious to know what the risk of contrcating HSV1 is when there are no signs of an outbreak.  I've been under the impression that a number as high as 5 would indicate a recent outbreak or recent shedding.  

Is it likely that if my girlfriend never has an outbreak, that my risk of contracting HSV 1 is so low that it is not worth worrying about?

[Edward W Hook, MD]

This is not HSV eye infection.  What you describe in no way suggests it and HSV of the eye is quite uncomfortable.  EWH

[JMilkman]

Last question, I swear.  My girlfriend never had any obvious signs of an HSV 1 outbreak, but she did get a small red rash on her cheek a few weeks ago and she said that it happens from time to time.  I never thought anything of it as it was hardly noticeable.  

A couple of days ago I started getting an ache in my right eye, possibly caffeine withdrawal related, but almost exclusively around my right eye.  A few days later a group of small tiny spots appeared near the outside corner of the eye and though the eye itself is not red at all, it is irritated.  This is only day two with the red spots and they are starting to look like dry skin that is turning a little white and flaky looking.  The pain around my eye comes and goes, but is never extremely painful, just annoying.  

I wish I could unlearn everything I ever read about herpes, but what I have read suggests that occular herpes actually affects the eye itself and it doesn't seem that my eye is affected.  My vision seems normal except that I can't help, but to rub my eye, which causes a little blur.  Does this suggest a possible HSV 1 infection of the eye?

Thanks  

[Edward W Hook, MD]

What you describe does not suggest a cold sore.  EWH

[JMilkman]

I now have what looked like a pimple under my nose.  I couldn't resist the urge to pop it and it bled more than anything I ever popped before.  It re-formed the next day and I've left it alone.  It is not painful or itchy but I've had some pain around my right eye (the bump is on the left side of my face.) Could this be a cold sore?

[Edward W Hook, MD]

I hope I can help.  Your GF has HSV-1.  Her test results prove this.  The fact that her test result gave a result of 5 does not mean the her infection is more or less serious than someone else with a lower number, nor does it in any way indicate how long she has been infected.  That she has never had a cold sore that she is aware of is not at all unusual, that in fact is the case for most of the over 60% of the population who have HSV-1 (note the converse as well, that you do not have HSv-1 effectively makes you in the minority).  Statistically it is far more likely that she has oro-labial infection than genital infection.  

Could her infection be transmitted to you.  Possibly but not likely. There is asymptomatic shedding of HSV in persons who are infected, whether or not they know they have the infection.  My advice would be not to worry about this.  Even if you were to get her infection all that would do is make you like most people.  Given your prior experiences with anxiety however I realize this may be difficult.  Much good information about herpes can be obtained by accessing excellent informational web sites such as the one run by the American Social Health Association (disclosure, Dr. Handsfield and I are both on the Board of Directors of ASHA).  In addition, you may wish to work through your concerns with your mental health professional.

Hope this helps and I wish you a happy New Year.  EWH