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HSV 1 questions
Hi Drs,
Thanks for a great forum. I've tried to do my homework on HSV 1 and have a few questions. I'm a 25yo female in an exclusive heterosexual relationship. My partner tested positive (blood test) for HSV1 but has never had symptoms. About 2 months ago, I developed what looked like cold sores on my lip- swollen, tiny blisters that hurt for a few days and then healed. I've had a few more that were tiny and healed within a day. I believe they are cold sores and assume I contracted them from my boyfriend. Then this week I experienced vaginal itching and noticed a raw spot of skin near my clitoris that is slightly painful. I assume that this is also HSV1 on my genital area and that I'm an unlucky one who contracted it in both places from one exposure period.
My questions are:
1. do my descriptions sound consistent with having hsv1 in both places. I know I'll see a dr. to confirm
2. Is my genital infection now "new" since this is the first noticeable outbreak- should I worry about autoinnoculation (wiping after using the restroom, underwear, etc)
3. If I have HSV1 orally and genitally, will the outbreaks coincide? Will I have more genital outbreaks since I also have it orally or should I expect a few genital outbreaks and then none at all after a few years?
4.I read that if you have HPV and HSV2 you have increased risk for cervical cancer. What about HPV and HSV1 on the genitals? Is there increased risk then?
Thank you so much!
Thanks for a great forum. I've tried to do my homework on HSV 1 and have a few questions. I'm a 25yo female in an exclusive heterosexual relationship. My partner tested positive (blood test) for HSV1 but has never had symptoms. About 2 months ago, I developed what looked like cold sores on my lip- swollen, tiny blisters that hurt for a few days and then healed. I've had a few more that were tiny and healed within a day. I believe they are cold sores and assume I contracted them from my boyfriend. Then this week I experienced vaginal itching and noticed a raw spot of skin near my clitoris that is slightly painful. I assume that this is also HSV1 on my genital area and that I'm an unlucky one who contracted it in both places from one exposure period.
My questions are:
1. do my descriptions sound consistent with having hsv1 in both places. I know I'll see a dr. to confirm
2. Is my genital infection now "new" since this is the first noticeable outbreak- should I worry about autoinnoculation (wiping after using the restroom, underwear, etc)
3. If I have HSV1 orally and genitally, will the outbreaks coincide? Will I have more genital outbreaks since I also have it orally or should I expect a few genital outbreaks and then none at all after a few years?
4.I read that if you have HPV and HSV2 you have increased risk for cervical cancer. What about HPV and HSV1 on the genitals? Is there increased risk then?
Thank you so much!
MEDICAL PROFESSIONAL
1) That description doesn't sound like herpes, both from the description and location on the inside of the lip. Of course I haven't seen the lesions and I'm not making any definite decision about it.
2) I have never heard of HSV being autoinocuated to more than one spot. You do not need to be careful with anything, especially if you don't have herpes.
3) True, except that the recurrent outbreaks usually are not severe. About 40% of people with a first episode of genital HSV-1 have no recurrent outbreaks at all; another 40-50% have just 1-2 outbreaks in the next couple of years. Only a few have 3 or more outbreaks, and even those are uncommon -- versus HSV-2, which on average reactivates with symptoms 4-5 times a year for several years.
Please read my original reply again and concentrate on it. From this additional description, I am even more certain you have not caught your partner's herpes. If you remain concerned about it, however, stop trying to confirm it by online searching or this (or any other forum). You can never get firm answers that way, only by in-person exam and testing by a health profossional. If your symptoms are due to herpes, your HSV-1 blood test will now be positive. I'll be happy to comment further if and when you report the result of professional evaluation and HSV testing -- but not until then.
2) I have never heard of HSV being autoinocuated to more than one spot. You do not need to be careful with anything, especially if you don't have herpes.
3) True, except that the recurrent outbreaks usually are not severe. About 40% of people with a first episode of genital HSV-1 have no recurrent outbreaks at all; another 40-50% have just 1-2 outbreaks in the next couple of years. Only a few have 3 or more outbreaks, and even those are uncommon -- versus HSV-2, which on average reactivates with symptoms 4-5 times a year for several years.
Please read my original reply again and concentrate on it. From this additional description, I am even more certain you have not caught your partner's herpes. If you remain concerned about it, however, stop trying to confirm it by online searching or this (or any other forum). You can never get firm answers that way, only by in-person exam and testing by a health profossional. If your symptoms are due to herpes, your HSV-1 blood test will now be positive. I'll be happy to comment further if and when you report the result of professional evaluation and HSV testing -- but not until then.
Thank you for your answers, Dr. Handsfield. I forgot to mention that I tested negative for HSV1 and HSV2 via blood test prior to meeting my current boyfriend.
I have just a few follow up questions, please.
1. My suspected cold sores emerged as red bumps and then tiny (pin head size) blisters that popped though they never scabbed. They were on the inside of my lip. I've only ever seen people have cold sores on the outside of their lips, is this true?
2. The inoculation I'm curious about is transmitting it to myself in multiple places if I do have a new outbreak. Do I need to be careful with underwear, bathroom hygiene, etc if this is a new and contagious genital outbreak?
3. I have heard that if you have genital HSV1, most people get 1 to 2 severe outbreaks and then none after a few years. Can you confirm this in your experience? I have only seen one 'suspicious' leison that is already starting to shrink after one day.
Thanks
I have just a few follow up questions, please.
1. My suspected cold sores emerged as red bumps and then tiny (pin head size) blisters that popped though they never scabbed. They were on the inside of my lip. I've only ever seen people have cold sores on the outside of their lips, is this true?
2. The inoculation I'm curious about is transmitting it to myself in multiple places if I do have a new outbreak. Do I need to be careful with underwear, bathroom hygiene, etc if this is a new and contagious genital outbreak?
3. I have heard that if you have genital HSV1, most people get 1 to 2 severe outbreaks and then none after a few years. Can you confirm this in your experience? I have only seen one 'suspicious' leison that is already starting to shrink after one day.
Thanks
MEDICAL PROFESSIONAL
Welcome to the STD forum.
Neither your oral nor genital symptoms sound like herpes. Cold sores or genital symptoms cannot clear up within a couple of days; every outbreak takes at least 5 days and usually 7-10 days, to progress from red bump to blister/pimple-like, to open sore, to scab, to healing. And although it is possible to have an HSV infection in both sites (genital and oral), it is uncommon. Most are only at one site or the other. Once infected at one location, people are immune -- or at least highly resistant -- to a new infecttion with the same virus type, anywhere on the body.
Also, the first HSV infection, if it causes symptoms at all, is generally much more severe than you describe for either your oral or genital symptoms. And half of all adults in the US are infected with HSV-1, as your partner is. But you don't say whether or not you have been tested. If not, you should be. If you are also already HSV-1-positive, you aren't going to catch it again from your partner. To your questions:
1) Most likely your symptoms are not herpes; see above.
2) Autoinoculation is almost entirely limited to the initial herpes infection, rare in longstanding herpes. And both mouth to genital or genital to mouth autoinculation seem to be rare. Almost all autoinoculation is to a finger (herpes whitlow) or eye (severe conjunctivititis).
3) I am unaware of data on whether dually infected people have simultaneous outbreaks at both sites. Probably not. But it's unlikely you're infected at both sites.
4) There are some data to suggest a higher risk of HPV progression to pre-cancer or cancer when HSV-2 is also present. But those data are by no means certain; this is not a proved relationship. If there is such an effect, it is small. There are no data on HSV-1, but my guess is that it has little effect on HPV.
Your first step here should be to confirm whether or not you have HSV-1. If not done, have a blood test. Or see a provider immediately (within 1-2 days) of the next apparent outbreak, either oral or genital, so lesions can be tested for the virus. Or both. In the meantime, don't worry much about all this. Among couples in which one partner has HSV-1 and the other doesn't, in the majority transmission never occurs.
I hope this helps. Best wishes-- HHH, MD
Neither your oral nor genital symptoms sound like herpes. Cold sores or genital symptoms cannot clear up within a couple of days; every outbreak takes at least 5 days and usually 7-10 days, to progress from red bump to blister/pimple-like, to open sore, to scab, to healing. And although it is possible to have an HSV infection in both sites (genital and oral), it is uncommon. Most are only at one site or the other. Once infected at one location, people are immune -- or at least highly resistant -- to a new infecttion with the same virus type, anywhere on the body.
Also, the first HSV infection, if it causes symptoms at all, is generally much more severe than you describe for either your oral or genital symptoms. And half of all adults in the US are infected with HSV-1, as your partner is. But you don't say whether or not you have been tested. If not, you should be. If you are also already HSV-1-positive, you aren't going to catch it again from your partner. To your questions:
1) Most likely your symptoms are not herpes; see above.
2) Autoinoculation is almost entirely limited to the initial herpes infection, rare in longstanding herpes. And both mouth to genital or genital to mouth autoinculation seem to be rare. Almost all autoinoculation is to a finger (herpes whitlow) or eye (severe conjunctivititis).
3) I am unaware of data on whether dually infected people have simultaneous outbreaks at both sites. Probably not. But it's unlikely you're infected at both sites.
4) There are some data to suggest a higher risk of HPV progression to pre-cancer or cancer when HSV-2 is also present. But those data are by no means certain; this is not a proved relationship. If there is such an effect, it is small. There are no data on HSV-1, but my guess is that it has little effect on HPV.
Your first step here should be to confirm whether or not you have HSV-1. If not done, have a blood test. Or see a provider immediately (within 1-2 days) of the next apparent outbreak, either oral or genital, so lesions can be tested for the virus. Or both. In the meantime, don't worry much about all this. Among couples in which one partner has HSV-1 and the other doesn't, in the majority transmission never occurs.
I hope this helps. Best wishes-- 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.
