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Dr. Andrew Rynne

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What causes cold sore on lip post oral sex?

Answered by
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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8028 Questions

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Posted on Wed, 27 Aug 2014 in Sexually Transmitted Diseases
Question: Hi about one year and a half ago I had a cold sore on my lip that I've been getting for years now ever since I was very young. I was 22 then. I was with my girlfriend at the time who has had no history of cold sores or any exposure to hsv-1 prior. I performed oral sex on her while I had this cold sore on my lip and had intercourse with her a few times over the next few days after theoretical infection day. Later on after those few days of having sex she started to suffer feverish symptoms which over the next few days to weeks turned into outbreaks of painful blisters and excessive itchiness. She later got a pap smear which was proved to be HSV-1. My question is...under the notion that I had intercourse with her before the blisters fully formed and opened and that fact that I've already had the hsv-1 oral infection since childhood. Does this mean I dont have the infection genitally?? I also want to note that I dont think ive experienced any symptoms at all. I dont recall seeing clusterlike blisters that formed on my genitals or anus that either hurt or itched that eventually popped and oozed. The closest I've ever gotten to having any sort of discomfort or itchiness was letting my pubic hair grow a little after shaving it. I figured it was the newly grown hair that irritated my scrotum skin and it did get really itchy to the point I scratched til the skin flaked on my scrotum but I do not remember seeing any oozing lesions or anything of that sort. The picture is attached. Im asking this question as a second opinion so If possible I would like another STD specialist to answer the question other than Dr. S XXXXXXX although I believe him to be highly competent. Thank You
doctor
Answered by Dr. Kakkar S. 45 minutes later
Brief Answer:
Genital herpes is a possibility

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your query and I have understood it. I have also looked at the picture. The picture does'nt seem to suggest HSV.

It is a possibility. You may have got the infection genitally with the same virus, however, it is not a necessity.

Herpes is a localised infection and even though you already have oro-labial herpes that does'nt confer immunity to genital infection. Having said that, it would only be known once you develop genital symptoms.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Kakkar S. 9 hours later
Thank you doctor for responding so promptly. Ive read from numerous sources on the internet that people who have had oral cold sores since birth have some sort of resistance against reinfection genitally. Image aside and talking from a theoretical standpointIs this true? I know it doesnt mean 100% immunity but does it really increase an individuals chance of being protected against reinfection versus a person who never has had the infection at all?
doctor
Answered by Dr. Kakkar S. 11 minutes later
Brief Answer:
Herpes genitalis

Detailed Answer:
Hi

Immunity is not absolute. Though it protects you but not completely, that is exactly the reason why you have recurrences in herpes. If it was absolute, there would have been no recurrences.

Genital infection with the same HSV which is causing cold sores is possible. The immunity plays a part only in reducing the frequency of recurrences and the severity of episode. e.g a person who has immunity would have less frequent episodes and milder in severity as compared to a newly acquired infection

Regards
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Kakkar S. 43 minutes later
So although ive experienced no symptoms or any of that sort since the day i came into contact with it. Can i assume that i definitely have it genitally?
doctor
Answered by Dr. Kakkar S. 23 minutes later
Brief Answer:
herpes genitalis

Detailed Answer:
Hi

You may have acquired it or may be not. This can only be resolved if you develop a clinical episode of Genital herpes. The blood work won't add anything more to what you already know i e hsv type 1. It won't distinguish between a cold sore or genital herpes as the same virus type is implicated.

Regards
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Kakkar S. 35 hours later
So if i do indeed have it what are the chances of passing it on ?
doctor
Answered by Dr. Kakkar S. 42 minutes later
Brief Answer:
Herpes Genitalis

Detailed Answer:
Hi

In a monogamous relationship, a female partner carries a substantially higher risk of contracting herpes from an infected male partner than vice-versa. The annual risk of passing herpes onto a woman, without the use of anti-viral medicines and condoms, is approximately 10%.

Taking acyclovir will help suppress herpes multiplication and will also reduce your chance of passing on the virus to a partner by 50%. However, acyclovir alone still leaves a female partner with a 5% annual chance of catching the disease.

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