[Question #1131] Chance of contracting herpes on thigh

48 months ago
Hi doctor. Just like to start by saying you all do a great community service by having this forum. To the question. A few days ago I visited a masseuse. While giving me a massage, she got completely naked a sat on my thigh right above the left knee as she massaged me. Her vagina had direct contact with my leg. As far as I know there was no thrusting or humping, just sitting as she massaged me. I turned over, and I believe she did the same thing on the other side. 1. Is there a realistic possibility that I could contract herpes from such contact? 2. I have chronic atopic dermatitis, but not in the area of contact. Could this make me more vulnerable to contracting herpes? One more kinda off topic question: if in theory someone were to contract one type of herpes in a banine location such as in the web of your toe, would that make the person immune to catching the same strain (1 or 2) somewhere else on the body like on the genitals? Thank you for your time
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
I don't believe that you have the risk of acquiring herpes in the situation that you describe, if she did happen to be infected.  The thigh skin, when intact, is too thick for virus to enter.  Good that the dermatitis was not in that area so you don't worry about that factor in the situation. 
To your second question:  the toe is a bad example because the innervation of the genital area also includes the foot (though not really the toe).  Anyway, let's pick a different location for the example.  Let's say you acquired HSV 2 in your mouth.  That would make it extremely unlikely that you would then acquire HSV 2 genitally, correct.  Not impossible, but extremely unlikely, a vaccination against genital infection, sort of.

Terri
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48 months ago
Hi Terri! Thank you for your prompt and candid reply. Can you expand on intact skin? At what point would contact be concerning? I am not worried I am just trying to educate myself. I have had exzema (dermatitis) on my penis before and get it every year or so when I'm stressed or in poor hygiene. Does this significantly increase my risk for aquiring it in the case I were to have sex with someone who does indeed have it. It's my understanding that exzema can become infected with herpes to a point of medical emergency, am I at significant risk for this? The last question was more theoretical: though it is rare, could atypical location such as herpetic whitlow caused by  hsv2 act as protection in more common places such as genitals?  Thank you for your time
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
Intact skin would be skin that isn't broken by cuts or breaks in the skin of other kinds. 
How long does the episode of eczema on the penis last?  If you have that at the time you have sex with a person who has HSV 2, then yes, that would increase your risk of acquiring HSV as then there i a break in the skin in a place that also has very thin skin.  I see no reason why contracting herpes while having eczema would constitute a medical emergency. 
And yes, if you had whitlow that was HSV 2, it would likely protect against genital HSV 2, though 95% of people who have HSV 2 at all shed virus genitally so having it on your finger alone would be unusual

Terri
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48 months ago
Thanks Terri! Thank you again for your response. Sometimes I hav a few little  painless raised red bumps at the site of hairs on my thighs, though not broken unless I agitate them, like squeezing a pimple. That would still constitute as intact skin? As for the exzema, it really depends on my stress level, hygiene, diet, and how much I itch it. When I get it down there (which is rare but almost always have it somewhere on my body) I really pamper it cuz it freaks me out having exzema break outs on my penis shaft, so usually just a few days to a week. I have had a doctor tell me that if the exzema itself gets infected with hsv than it could turn into a condition called exzema herpeticum, which according to him is a medical emergency. So even if u acquire hsv2 in a location other than genitals, it will still shed from the genitals? Thank you for your time.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
Yes, I think that would still be intact skin. 
This is not really my area of expertise but it is my understanding that eczema herpeticum is only a big worry if it becomes superinfected with bacteria and causes sepsis and I believe it is more of a sever problem in children, but again, not really my area of expertise.  There are certainly lots of people who have herpes and have eczema, for sure! 
If you acquire herpes in an area NOT innervated by the sacral ganglia (that innervate the genitals) then you would not have genital herpes nor shed from the genital area, no. 

Terri
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