[Question #1314] can herpes recur at the nose where I accidentally infected a cut

49 months ago
At age 56, I had my first ever herpes symptoms beginning 2 weeks ago on genitals and lips. It's my initial outbreak. I don't know if it's 1 or 2 because it is too soon to test, post infection, (which was 5 weeks ago). Today, I noticed symptoms on a very small spot at the bottom of my nostril where I did have a cut from basal cell surgery. I think I spread it there (before I knew better). My question is: when I get later recurrences, will they also involve this spot on the nose or just the lips and genitals? Also, will this spot on the nose start the clock all over in terms of clearing up on the nose, even though the rest might have already healed, or would it dissipate sooner? Thanks!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
49 months ago
It's unfortunate that swab testing was not done of the oral and genital lesions - is that correct, that none was done?   If you have a new spot, you should request PCR swab testing of that area. 
If it is herpes, yes, you could recur anywhere in the boxer short area or the head area.  Nasal outbreaks are common, for the record, for oral herpes.  Have you recently had a new sex partner, is that why you think it is too soon to test with an antibody test?  The timing should be from contact with a person, not from development of symptoms

Terri
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49 months ago
Yes, I had a new partner 5 weeks ago. That was first and only contact. Symptoms began just a week to 10 days later.  I had the proper blood test done at 4 weeks from initial contact and was negative for 1 and 2, but it is early for that test. No swab test was done. I have a new spot, the one on the nose. However, that spot just appeared, which is a full 3 weeks since my lip and genital symptoms began.  I am quite sure I spread it with my fingers to the open cut from the basal surgery at the base of the nostril (it is precisely where there was a not-yet-completely healed area where they patched me up after the Mohs surgery).
So...I'm hoping that it would not recur there since it did not originate there. That was my question. If it began at the nose, like the lip and genital areas, I understand that these areas will recur, but I was wondering about an area for which I was the secondary cause, and hoping it was less likely. Thanks so much...
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
49 months ago
I don't believe if this IS herpes that you spread it to yourself - it can travel along a slightly different nerve in the trigeminal ganglia all by itself, with no help from you, and show up in a new spot.  it very often recurs not in the place it first went in.  And it may well recur at the base of the nostril, you'll just have to wait and see unfortunately.  And if you did spread it yourself, it really doesn't matter how it got there about whether it will recur there or not.

Were you the giver of oral sex and had intercourse with the same person. Or was the person the giver of oral sex to and kissed this person?  The reason I ask is that you will want to know if you have HSV 1 or HSV 2 to know something about your future with outbreaks and your transmissibility to others.  For example, if you have HSV 1 orally and genitally, and you are giving oral sex to a person with a known history of cold sores, you are not going to be infectious to them genitally because they already have the same type.  Well, you say, I can determine what type I have from a blood test.  Except that with HSV 1, the IgG test misses 30% of HSV 1 infections.  If you end up being HSV 2 positive, that's far more likely to be picked up by the antibody test.  That's why, when there is a lesion, it should always be swab tested.  The swabbing tells you both the type and the location.  In the end, it may be very clear, but in case you are negative for both types down the road when enough time has passed to do a test, that suggests HSV 1, not HSV 2. 

Terri
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49 months ago
Thanks for the great explanation. I gave oral sex and had intercourse with the same person. She did the same with me, along with kissing, so really it is a chocolate mess without the data you describe! 
I will try to see if I can find a place for a swab test. I wanted to do it as privately as possible. I'm not sure my GP would have such a test, so I'm not sure where to go. I have every classic sign of Herpes, even the leg aches that came a day before symptoms, and the prodrome, so I'm quite sure it is one or the other or both types. Unfortunately, I'm outside in the sun and sweating a lot every day, so healing is something that I'm not helping along.
Thanks again for all your help.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
49 months ago
OK, now I am tying together to two posts, this one and the one where you describe the groin rash.  You absolutely need swab testing to confirm what is going on here.  You might be able to get one done at Planned Parenthood or a county clinic or an urgent care clinic. 
Are you able to ask this partner to be tested?
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49 months ago
I told her of my symptoms and she said she would get tested. I later called to tell her my 4 week test was negative but I had symptoms. She claimed to have been tested and that she was negative, but it was only 4 weeks post my symptoms and frankly, I have no way of knowing if she did get tested (she did not at all sound surprised or even the SLIGHTEST bit upset when I reported my symptoms to her and she would not show me a test result). I suspect she knew she was positive, and further discussions revealed she had multiple partners unprotected, so she could have been carrying and not know as well. This was literally my first ever unprotected event in my life (was married to my first partner for over 20 years). Regardless, it is my own stupidity, and I take full responsibility for my situation. 
I will go to planned P today for a swab test.