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Suggest treatment for herpes

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Posted on Thu, 17 Dec 2015
Question: I was looking for some help and understanding today when it comes to oral herpes and autoinnoculation. I've read both online and heard from speaking to doctors face to face so many different thoughts on this subject that I'm not sure what's true and what's not. I've heard that autoinnoculation is very common and I've also heard that it is extremely rare due to the bodies supply of antibodies after the first primary outbreak. I'm having a hard time here sorting fact from fiction and truth from myth. I have seen two general practitioners and one ophthalmologist in person and even they seemed unsure about how common or rare autoinnoculation is. I've done extensive Google searches on this and all those sources seem to claim that autoinnoculation is extremely rare however I know Google sources are not always accurate. I just want so good highly supportive proven facts about autoinnoculation and how rare or common it truly is. I've even had a doctor on here tell me before that autoinnoculation is so rare and that I now have a supply of antibodies that I could touch an infective sore and touch my eye and chances of the virus spreading to my eyes in the form of ocular herpes would be minuscule at best, then I had another doctor on here tell me that autoinnoculation is very very common. I'm so lost on this subject. If it makes a difference I'm a 29 year old XXXXXXX male, I've been getting outbreaks on my lips for 5 years now and thus far have never had a blister anywhere else on my face or body, and in a typical year I get anywhere from 2-6 actual blister outbreaks, and I have never taken any antiviral medications for them as both my general practitioners feel that since I heal in about 7 days and I don't get outbreaks monthly then I have no need for antiviral medication.
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Answered by Dr. Kakkar S. (4 hours later)
Brief Answer:
Autoinoculation is rare

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have understood your concern

Autoinnoculation, though can happen, is not very common. In my presonal clinical experience i rarely if ever see a case of autoinnoculation.
Common sites of infection with herpes virus are either Orolabial mucosa Or Genital mucosa. This virus usually is transmited by direct oral or genital contact.
Simply touching the cold sore or genital sore is not going to autoinnoculate herpes virus on to fingers because intact skin is hardy/ keratinised and the virus cannot establish itself easily as it does in a mucosa unless the skin is compromised e.g a torn cuticle is a common site for herpetic whitlow.
Only a few well known scenarios where autoinoculation is thought to occur are worth mentioning i.e autoinnoculating one's own eye through fingers, immediately (without washing) after touching an oral herpes sore or genital herpes sore and herpetic whitlow due to thumb sucking in a child who has oro-labial herpes (constantly moistened skin of thumb is less resistent to infection as compared to dry keratinised skin). Apart from these 2 scenarios, autoinnoculation is extremely rare.
Mind you, circulating antibodies due to previous infection with herpes virus e.g cold sore or genital herpes infection, is not protective against a new infection at a different site.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kakkar S. (6 minutes later)
So is there no risk of autoinnoculation when i dont have a blister or should i still be cautious when touching my lips and then my eyes?
doctor
Answered by Dr. Kakkar S. (5 minutes later)
Brief Answer:
Avoid touching a cold sore

Detailed Answer:
Hi.

Yes, you should be cautious about touching your eyes when you have a cold sore. As I said this is one of the two common scenario where autoinnoculation can happen. The best precaution would be to avoid touching cold sore as much as possible and wash your hands frequently. Another, good measure would be to treat with an antiviral as it would cut short an episode and reduce the risk of spread.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kakkar S. (1 minute later)
What about when i have no visible cold sore? Should i still be very careful when touching my lips and eyes?
doctor
Answered by Dr. Kakkar S. (2 minutes later)
Brief Answer:
During an episode

Detailed Answer:
Hi.

Be careful only till an epsiode heals.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kakkar S. (0 minute later)
Once the cold sore is 100% healed i dont have to be careful?
doctor
Answered by Dr. Kakkar S. (5 minutes later)
Brief Answer:
be careful during an episode

Detailed Answer:
Hi.

I don't think so. Just need to be careful during an epsiode because thats when there would be virus laden secretions/ fluid.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 9532 Questions

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Suggest treatment for herpes

Brief Answer: Autoinoculation is rare Detailed Answer: Hello. Thank you for writing to us I have gone through your query and I have understood your concern Autoinnoculation, though can happen, is not very common. In my presonal clinical experience i rarely if ever see a case of autoinnoculation. Common sites of infection with herpes virus are either Orolabial mucosa Or Genital mucosa. This virus usually is transmited by direct oral or genital contact. Simply touching the cold sore or genital sore is not going to autoinnoculate herpes virus on to fingers because intact skin is hardy/ keratinised and the virus cannot establish itself easily as it does in a mucosa unless the skin is compromised e.g a torn cuticle is a common site for herpetic whitlow. Only a few well known scenarios where autoinoculation is thought to occur are worth mentioning i.e autoinnoculating one's own eye through fingers, immediately (without washing) after touching an oral herpes sore or genital herpes sore and herpetic whitlow due to thumb sucking in a child who has oro-labial herpes (constantly moistened skin of thumb is less resistent to infection as compared to dry keratinised skin). Apart from these 2 scenarios, autoinnoculation is extremely rare. Mind you, circulating antibodies due to previous infection with herpes virus e.g cold sore or genital herpes infection, is not protective against a new infection at a different site. Regards