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Is it safe to indulge in vaginal sen when suffering from sores?

DOCTOR OF THE MONTH - Dec 2013
Dec 2013
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Dermatologist
Practicing since : 2002
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Hi Dr. Kanodia, I chatted with you a few days ago re: the possibility of spreading HSV1 to my boyfriend via oral sex. Based on our discussion, my understanding was that the chance was pretty low. I am writing to you at this time because I had a couple of follow-up questions I thought of that I would like to ask you. 1. While researching HSV1 online recently, I saw on a site that someone wrote that HSV1 is most likely to be transmitted while the sore is forming and bumps are present. This was contradictory to what we discussed (that I was at lower risk of transmitting the virus to him as I had "bumps" but no open sore), and I just wanted to clarify with you that I was in face at lower risk, not higher risk. I was concerned when I saw someone right that the early days, while bumps are forming, is the highest time of transmission. 2. If he were to be infected (hopefully not!) how long would it generally take for him to experience an outbreak? 3. While I have the sore (which I still do), is it safe to engage in vaginal sex as long as there is no kissing involved (as kissing could transmit to him orally)? Again, I do not have any sores on my genitals. 4. Do you have any recommendations for me re: getting rid of the sore faster? It's taking quite some time and I am feeling frustrated by it. 5. Some sites I read online say the likelihood of me transmitting the virus to myself on another part of my body (such as genitals or eyes) is low or impossible because my body is already exposed to HSV1, while other sites say it is very possible to spread it to another part of my body. I was wondering if you could clarify? Sorry for all the questions, and thanks again for your help!
Posted Sat, 8 Feb 2014 in Skin Hair and Nails
 
 
Answered by Dr. Sanjay Kumar Kanodia 3 hours later
Brief Answer: The stage was of bumps & not turned into open sore Detailed Answer: Hello young lady, Warm welcome to the forum again. You are most welcome to ask as many concerns you have in your mind. Let me answer your queries one by one: 1. While researching HSV1 online recently, I saw on a site that someone wrote that HSV1 is most likely to be transmitted while the sore is forming and bumps are present. This was contradictory to what we discussed (that I was at lower risk of transmitting the virus to him as I had "bumps" but no open sore), and I just wanted to clarify with you that I was in face at lower risk, not higher risk. I was concerned when I saw someone right that the early days, while bumps are forming, is the highest time of transmission.  Let you understand the phase of change of herpes lesion- there is initial itching or pain for few hours, then slight redness turns into bumps and after 12 -24 hours bumps start forming open sores (ulcers).  As I told earlier that virus inoculation occurs most frequently when there is breach in the continuity of the skin. It is general fact that trauma facilitates the entry of the virus because of the easy and direct entry onto the skin or mucosal surface. Getting this thing in mind and correlating to your stage of incidence- which occurred at the red bump stage. This red bump stage is present for initial 12 -24 hours. After a period of minimum 12 hours the skin from the surface of bump gets eroded and there is formation of ulceration in around 24-48 hours. There must be sores (ulcers) and not bumps alone to transmit the virus to another partner. The partner must also have breach in the skin so that the viruses get inoculated into his or her skin. SO you can get that the one important thing of not having ulceration at the time of incidence and the second thing is that the skin was totally intact. I visualized the pictures which made everything clear and showed intact skin. In your stage the red bumps were intact and there was no sage of ulceration (sores). So I am still standing firm on my statement that you are at lower risk transmitting the virus to your partner as you had "bumps" but no open sore. I think you learned the difference and transition between red bumps to sore stage anything more than a medical student!!! 2. If he were to be infected (hopefully not!) how long would it generally take for him to experience an outbreak?  If your partner were to be infected then there are around 50 % chances in first 5 days and around 90 % in 2 weeks. SO you can get that in 2 weeks of period you can know whether he got the clinical manifestation (outbreak) or not. 3. While I have the sore (which I still do), is it safe to engage in vaginal sex as long as there is no kissing involved (as kissing could transmit to him orally)? Again, I do not have any sores on my genitals.  Preferably we guide patients to not to engage in any type of sexual activity during active stage. It is always better to abstain from every type of activity during active stage as the virus is shed from all body fluids. Even if you want then can use condoms and avoid kissing to any part. 4. Do you have any recommendations for me re: getting rid of the sore faster? It's taking quite some time and I am feeling frustrated by it.  If I were your treating dermatologist then would have suggested you to take Valacyclovir 1g by mouth once daily for 5 days for this recurrent infection stage. After that I would have recommend to take a suppressive dose of 500 mg daily for 6 months as suppressive therapy. 5. Some sites I read online say the likelihood of me transmitting the virus to myself on another part of my body (such as genitals or eyes) is low or impossible because my body is already exposed to HSV1, while other sites say it is very possible to spread it to another part of my body. I was wondering if you could clarify?  Oh dear lady, first of all relax…do not worry!!! Let me clarify this point also. As you have oral herpes, so there are antibodies prevent in yourself. These antibodies are of protective nature to every individual. Whenever the level of these protective antibodies declines below its protection level then there is an episode of herpes. The level of protective antibodies may decline because of stress, strain work pressure, illness, fever, exposure to cold or sun light and more of these related factors. But still the antibodies are present. It may vary from individual to individual (who are already infected with herpes) to have full or partial protection according the antibody level. That is why some sites say possibility and some says less possibility, but I add the note of level of antibody in an individual.  I also add that accordingly it is also an important fact that we very often observe that if a person is infected with HSV-1 then there are less chances of getting HSV-2 (genital herpes) again depending on the level of antibodies. We also observe sero-dicordant couples where despite of unprotected contact, the other partner do not get herpes lesions because of good immunity. So I hope you must be pretty relaxed after knowing all important facts. Lastly again I tell you that herpes is one of the simplest of viral infection and it is the anxiety and related depression which makes its impact on higher side. So do not worry about yourself as well as your partner. I hope you got your answers and if you have any further queries I will be glad to help. With regards, Dr Sanjay Kumar Kanodia
Above answer was peer-reviewed by
 
Follow-up: Is it safe to indulge in vaginal sen when suffering from sores? 2 days later
Hi Dr. Thanks for all of the great info. I always feel better after understanding how all of this works! You've been an amazing help Thankfully today is 8 days after my "incident" and not only is my partner still symptom free (hoping it stays that way!) but also my sore is finally almost gone. I have attached a photo- sorry the quality may not be too great- for you to see. I mostly have just redness in the area where the bumps were. I still feel a slight difference in the texture of the skin when I touch with my tongue, but the blisters themselves seen to be all gone. My next question is as follows: once the redness is gone and my skin appears normal to the eye, is it safe to engage in kissing or sexual activity, or at what point is it safe to do so? Thanks again!!
 
 
Answered by Dr. Sanjay Kumar Kanodia 5 hours later
Brief Answer: Have safer sex for 2 weeks; take valacyclovir Detailed Answer: Hi young lady, I am really a happy to know that you feel relaxed now. It is also good news from your side that till now your partner is symptom free, making all of us more relaxed and happy. I am pretty confident that he might not show any sign in the rest of the period also!!! Now for the further part of your query- I have analyzed the picture and is quite helpful in deciding the further course of action. As presently the scab is fallen off so directly speaking the most crucial period has passed. At this stage there is very less of shedding of virus is present. But even then it is best to abstain for 2 weeks ( till complete healing). In your kind of situation I suggest to the couples to have safer sex as much as possible. Many a times there is viral shedding during asymptomatic phase also. So a better way is to take a prophylactic treatment which reduces the viral shedding to less than 50%. As I suggested before you can take Valacyclovir 500mg once daily for 6 months. It will not only reduce the chances of recurrence but also help you better in your relationship. Have a happy and prosperous relationship!! With regards, Dr Sanjay Kumar Kanodia
Above answer was peer-reviewed by
 
Follow-up: Is it safe to indulge in vaginal sen when suffering from sores? 42 hours later
Hi Dr. Thanks for your help! I continue to have a red "patch" where the bumps were. I have attached another picture for you to see where I am at in healing at this time. I will certainly be sure to use condoms for the next two weeks, but at this stage, is kissing OK? I plan to go to Dr. Tomorrow and see if I can obtain Valtrex prescription. Also, any advice on getting rid of this red patch? Thank you!! Best
 
 
Answered by Dr. Sanjay Kumar Kanodia 15 hours later
Brief Answer: Wait for complete 2 weeks Detailed Answer: Hi young lady, I have gone through the picture sent by yourself and can see that redness is present. It is a usual sign to get delayed redness and it is not abnormal. You can apply Acyclovir 5% cream for 3-4 times in a very thin layer. For kissing let complete 2 weeks get passed and if you can start valtrex at the earliest which takes care of its effect in 5 days. So have bit patience dear lady!!! "All the best for your healthy relationship" With regards, Dr Sanjay Kumar Kanodia
Above answer was peer-reviewed by
 
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