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Is cold sore on my lower lip since childhood a sign of HSV?

DOCTOR OF THE MONTH - Dec 2013
Dec 2013
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Dermatologist
Practicing since : 2002
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Hello Doctor, I apologize for the very long question here, but I am incredibly nervous and really looking for someone to answer my question and relive my worry (hopefully!). I have gotten cold sores since I am a young child. Usually 1-2 a year, always in the same spot on my lower lip. Thankfully my outbreaks have never been too severe (only one sore at a time). Last night, I felt that my lower lip was chapped, but did not feel any other signs associated with an oncoming cold sore (no bumps, tingling/burning/itching, at least not enough for me to take notice of). This morning, my lip still felt chapped, but again, I did not feel any bumps. Without looking in the mirror first, I performed oral sex on my boyfriend. Following this, I looked in the mirror and saw reddening/bumps where I normally have a cold sore. I still wasn't sure it was one, but now, hours later, a cold sore has clearly popped up. I know that it is possible to transmit my HSV1 to him genitally, and I am INCREDIBLY nervous about this. I know there is not a definitive answer, but I am wondering if you could tell me the likelihood of this happening. He is 34 yrs. old, reports he has never had a cold sore, but I suppose he could be asymptomatic. I am typically very cautious when I think I am getting a sore and won't kiss or share cups, let alone anything else, so I am incredibly worried I may have passed this on to him genitally. Please help!
Posted Thu, 30 Jan 2014 in Sexually Transmitted Diseases
 
 
Answered by Dr. Sanjay Kumar Kanodia 39 minutes later
Brief Answer: Kindly send details Detailed Answer: Hi, Welcome to the forum and thanks for posting your query. I have gone through your complete query with diligence and can make out the level of stress you are experiencing. I can understand your part of concern for herpes and its possibility in your boyfriend. Though you have provided with best details which you can, but I require some more informations from your side so that I would be able to answer your query best. Kindly let me know few important points: 1. Are you under any therapy for herpes prophylaxis (any antiviral medicines if you are taking). 2. Do you have any similar problem at genitals. 3. Have you ever gone for any antibody testing for Herpes IgM or IgG 4. Is your boy friend have any minor cuts or abrasions over his penis. 5. How many episodes of herpes you have in one year period. Kindly send these details so that I can help you better. With regards, Dr Sanjay Kumar Kanodia MD ( Dermatology & Sexually Transmitted Diseases)
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Follow-up: Is cold sore on my lower lip since childhood a sign of HSV? 9 minutes later
Hi Dr. Thank you for taking the time to answer me. You are correct, I am incredibly stressed about this. I hope to answer your questions the best I can. 1. I am not currently on any anti-viral medications. I have taken Valtrex in the past (most recently Oct or Nov 2013), when I feel a sore coming. I do not take daily medications for HSV. 2. I have never had any sores in the genital region. 3. I have never had any antibody testing. I have had a blood test, which confirmed I have HSV, but not any other testing. As I mentioned before, I have gotten cold sores since I was a young child; never had any genital sores. 4. I did not notice any cuts, sores or abrasions on my boyfriend's penis. 5. I have not had a cold sore actually "pop up" in the past year. I have been prescribed Valtrex and as I am very paranoid about getting sores, normally take it any time I experience the slightest bump/tingling. I do not take it daily. As a result, the last time I actually had a sore emerge was over a year ago. I had them more as a child, but noticed as I have entered by 20s, they have decreased in frequency. The most I typically got was, I think at most, 3 a year, and normally when I was already sick. But now that I have discovered Valtrex and take it at the first signs of a sore, I haven't had one emerge in some time. Part of the reason I feel so frustrated is that I did not experience (at least enough for me to take notice of) any signs of the oncoming sore last night. My lips felt chapped, but I didn't feel any bumps or burning or tingling. I didn't realize one was coming until I looked in the mirror this morning, after performing the oral sex, and saw the bumps/redness there. They were not there last night. As today has gone on, the sore has gotten worse (most certainly a cold sore) as it is slightly itchy/burning, red and bumpy. But even this morning it was not as pronounced as it is now- I knew something was off, but the symptoms were not this pronounced. Thank you for your help. I am truly hoping the likelihood of transmitting this to him genitally is low!
 
 
Answered by Dr. Sanjay Kumar Kanodia 4 hours later
Brief Answer: Less chances of transmission by HSV-1 Detailed Answer: Hello young lady, Welcome to the forum again and thanks for posting the important details so that now I can guide you best. After getting all the information from your side and analyzing these with diligence let me tell you that the chance of giving infection to your boyfriend is present but in a very low possibility. To tell you more about the low possibility of the same let me tell you certain important points: 1. At the time of oral sex with your boy friend you had only red bumps and no sores. There is highest possibility when the open sores are present. Open sores sheds out virus directly through the oozing fluid so in comparison to the red bumps, oozing ulcers or sores are more potentially able to transmit the infection. 2. In your boyfriend there are no open cuts or any sores are present so again making least possibility of transmission of virus from the intact skin. 3. Additionally you have a history of maximum of 3 episodes in a year making yourself a low shedder. Getting all these points in consideration you can get that, though there is possibility but on the least of the side because of the facts that neither you and nor your boyfriend had open sores or cuts at the time of oral sex. It is much more commonly transmissible when both the partners have open sores, and at least one of the partners has open sores. It is also more common in those person who have nearly or more than 6 episodes per year as have viral shedding due to frequent episodes. One very important information to share with you is that though both viruses can cause genital herpes, HSV-1 has been associated with fewer recurrences and less viral shedding than HSV-2. So you can get form this point that you have oral herpes which is caused by HSV-1 and therefore the chances of viral shedding is low. There had not been any episode of genital ulceration or genital sores so the possibility of HSV-2 is nil. It is with HSV-2 mainly that there is high viral shedding and therefore more chances of transmission in genital herpes as compared to oral herpes. Additionally you should know that herpes is one of the simplest viral infections. The major impact of genital herpes is generally emotional. It never poses in serious problem in relationship and is very well treatable though if not curable. So do not get so much anxious, it happens some times when things are not in our control. I am really happy to know that you care so much about your boyfriend and accordingly for your relationship. In future aspect always use a dental dam or condoms to have safer sex and hence protection form all STDs in one another. I hope these information will relax you. If you have any further queries I will be glad to help or if not then can close the query and rate the answer. All my best wishes to you. With regards, Dr Sanjay Kumar Kanodia MD ( Dermatology & Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
Follow-up: Is cold sore on my lower lip since childhood a sign of HSV? 45 minutes later
Hi Dr. Thank you so much for your help. I feel much better after reading this. Just to make sure you agree that I didn't have an open sore at the time, I have attached two photos. I took the first a few hours (2-3 hrs later) after the incident, so if any my symptoms are more pronounced. The slickness on my face in the photo is from an ointment. The second photo was taken several hours (4-5 hrs later) after the incident so again, a little more progressed than at the time of oral sex. As I said, I did not feel any bumps at the time (unlike now, sore is very painful and itchy), but just want to double check with you that I am right about having "bumps" as opposed to an "open sore", since that makes such a difference in the possibility. Again, thank you so much for your help!!
 
 
Answered by Dr. Sanjay Kumar Kanodia 45 minutes later
Brief Answer: No open sores; just red bumps Detailed Answer: Hello young lady, Welcome to the forum again and thanks for posting the pictures. I must say you are really very caring lady. Hats off!!! for your commitment. Now let me reciprocate the good news for you that the picture does not show any evidence of open sores. It is just the redness and mild bumpy appearance on the right side of the lower lip. There are no open sores at present in both the pictures. To tell you more importantly, medically we observe that the sores are formed after 12-24 hours of appearance of bumps. In yourself you noticed bumps right after the incidence so the kind of open sore appearance will be forming in next 12-24 hours. It makes us bit relaxed about the possibility of transmission at present. I further guide you t abstain form sex for next couple of days till the scab fall off. I hope these information will relax you. If you have any further queries I will be glad to help or if not then can close the query and rate the answer. "With best wishes" Dr Sanjay Kumar Kanodia MD ( Dermatology & Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
Follow-up: Is cold sore on my lower lip since childhood a sign of HSV? 16 hours later
Hi Dr. Thank you so much! I can't tell you how much better I feel after reading all of this. I truly hope it goes well and he doesn't contract anything. One last quick question for you: the cold sore appeared yesterday and today when I woke up, i have a bump on my neck, just under the jawline and not too far from my right ear lobe (the side where the cold sore is). It is a bit painful to the touch and is hard. Is this likely related to the sore? i dont recall having one before with a cold sore, but it has been awhile. Again, thank you for all of your help it is very greatly appreciated!!!
 
 
Answered by Dr. Sanjay Kumar Kanodia 1 hour later
Brief Answer: simple lymph node enlargement due to herpes Detailed Answer: Hi, I am really happy to know that you are out of the great anxeity. For the part of bump on the right side is simple lymph node enlargement due to herpes. To tell you simply- due to herpes infection there is drainage of the infected body fluid to the concerning side of lymph node. These lymph nodes filter the infective material ( viruses and related components) so that it does not pass to general circulation. That is why it gets inflammed due to its activity on that particular side. This is a good sign of immunity and remains for 4-5 days till the infection by herpes is active. You can take a pain killer tablet such as paracetamol for 1-2 times for couple of days and it will be alright accordingly. I hope these information will relax you completely. If you have any further queries I will be glad to help or if not then can close the query and rate the answer. "With best wishes" Dr Sanjay Kumar Kanodia MD ( Dermatology & Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
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