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Herpes Transmission and Saliva

Since childhood, I have had Type I recurrent oral herpes (approximately 4 outbreaks a year on the mouth or lower cheek region until college; now I have only about 1 outbreak a year).  I take Valtrex when I feel an outbreak coming on, which works very well.

When in the shower, I often spit on my penis for lubrication before masturbating.  Most of the time, some of the saliva goes into the urethra, which is always partially open when I have an erection.  I may have spit on my penis and masturbated while I had a cold sore, but honestly I cannot remember.

I am worried that I may have spread my Type I oral herpes to the genital area.  Recently, I have had hard red bumps on my penis shaft (where hair is present) and yellow pustules near where my underwear rubs (which have itched).  I had these conditions examined by my family doctor and two dermatologists.  All three doctors concurred on a diagnosis of folliculitis after viewing the bumps.  After prescribing an antibacterial pill, the symptoms went away and did not return.

My concern is that Herpes takes many forms, and while a visual examination is good evidence, it is never conclusive.  Also, from researching the issue, I understand that the Oral Herpes Type I virus IS often present in saliva.

I read the Frequently Asked Question No. 13, (Oral Herpes Transmission to Other Body Parts).  However, as a wrestler, I have seen several individuals with extremely bad cases of herpes gladitorium after already having a previous oral herpes infection.  It was not pretty!  

I hope to eventually have unprotected sex with my future wife, but I would never want to unknowingly put her at risk of genital herpes.

I am a virgin, both in terms of vaginal, anal, and oral sex.

1) Is it possible to spread oral herpes to the genital area via saliva alone (given the way I masturbate)?  

2)      Can genital herpes exist in a male's urethra without him ever knowing it?
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The medical term for self-infection from one part of the body to another is "auto-inoculation".  Auto-inoculation is often described as a problem with herpes, the most dangerous form being transmission of HSV from an oral or genital lesion to the eyes; herpes in the eye risks serious damange and even blindness.  Occasionally auto-inoculation occurs to other sites, such as the fingers (called herpetic whitlow).

However, you have no worries:  Auto-inoculation with HSV is only a problem during the initial infection.  People with chronic infection and recurrent outbreaks are immune to infecting another part of the body.  You cannot infect your genitals with your own HSV-1 strain, and you also are immune from catching genital HSV-1 from a partner who performs oral sex on you.  By the same token, any risk of transmitting HSV-1 to your future wife or other sex partners is going come from kissing and oral sex (if they are susceptible), not from genital intercourse.

As to question 2:  Asymptomatic genital herpes due to HSV-2 is common.  But asymptomatic or recurrent genital HSV-1 infection is rare.

Good luck--  HHH, MD
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