Hsv 2 - shedding

[worrier123]

Dr,
I am pretty well versed in hsv 2 but have yet to find a definitive answer to allay any fears. I know that the hsv 2 virus can shed asymptomatically from the anogenital region,  which is the penis and anus. I've also read that thicker, non mucousal skin such as the thighs and buttocks is too thick to shed the virus without an overt outbreak. My question then is, what if I scratched raw these thicker areas of skin or had eczema in the thighs. Would it then be possible to asymptomatically shed from these compromised areas of skin?  I know this question may seem a bit irrational but I'd like the peace of mind. Any advice would be greatly appreciated.  

[Edward W Hook, MD]

Welcome to our Forum. In preparing to address your question I note that you have over 20 other posts on MedHelp Community sites regarding unlikely sources of HSV acquisition/transmission yet in looking them over, I cannot tell if you have HSV or you are worried about getting it.  If it is the latter, your fears are clearly far out of proportion to the risk of infection through the activities you describe.  If you have the infection, and are worried about spreading it, your fears are also disproportionate to the risk.  Perhaps you could clarify the basis of your questions?

As for your question, there are no studies which evaluate asymptomatic shedding of HSV from non-genital skin such as the thigh or buttocks but there are studies which demonstrate that the virus can be present at such sites and that recurrences can occur at these sites.  Thus I would assume that asymptomatic shedding could occur from such sites.  On the other hand, transmission to others from sites is unheard of.  EWH

[sadgirl789]

Wow, this is interesting.  Never heard of this before......re: asymptomatic shedding from thick skinned areas.  You say that shedding could occur...but transmission to others from these sites is unheard of...what do you mean?  does this mean that someone could shed from the buttock and pass on the disease in the absence of lesions?

[worrier123]

Dr. Hook,

Thank you for your prompt response. I have hsv 2 and am worried about transmitting it to my new partner or to my family and friends. The reason I'm worried is that I have dry skin that I often itch. What I am concerned with is being able to spread the disease through shedding firm these open patches of skin. For example, if I were to scratch my legs and then while cuddling, our legs touched and she had a fresh open cut, could the virus be transmitted?  Or if our thighs were grinding together during "dry humping" and i had an open wound, could she get the disease. I know im probably being over critical and over thinking this, but your advice is invaluable. Thanks again.

[Edward W Hook, MD]

You are being overcritical.  Herpes is spread from areas where the infection is, not from all over the body or sites of other dermatological processes.  EWH

[sadgirl789]

So, if someone has herpes recurrences on the buttocks, and is not having an outbreak, they could potentially shed the virus from this area?  or is it just from the ano-genital area?

[worrier123]

Thanks dr.  So basically is it safe to assume that any contact wih these non-mucousal (areas other than the penis/anus) sites won't transmit the virus unless there is an outbreak occurring on the thicker skin?

[Edward W Hook, MD]

Please re-read my comments.  HSV is not spread from areas where herpes infection is not present.  EWH

[worrier123]

Ome last question and I thank you for your patience. Would your opinion change if i was having a genital outbreak at the time?  Could the virus be shed from non mucousal skin?

[Edward W Hook, MD]

No, my opinion would not change. EWH