[Question #204] Herpes Transmission

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100 months ago
I have rare outbreaks. When I do it is like 2-3 pimples on my front thigh about 7 inches down from my groin area. No pus or scabs just a little pimple with little to know fluid.  I have never had any sores on my genitals or any other location. My concern is transmission to my wife. If I cover the infected area when I have an out break or when inactive with a large band aid each time we have sex will that stop transmission. Asked another way, does shedding only occur in the usual out break area so that covering will prevent transmission. Thanks 
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Terri Warren, RN, Nurse Practitioner
100 months ago
Good morning Tim,
Thanks for your question.  I'd like to back up a little bit and ask you - if you've never had any sores on your genitals, how were you diagnosed with herpes?  But then you said you have rare outbreaks, so I'm a little confused.  Blood antibody test?  If yes, can you tell me the number associated with the positive result?
I'm going to assume you actually have herpes.  The pimples on your thigh sound like pimples to me, but there is no way for me to know for certain based on your description.  Usually, in my experience, herpes lesions on the thigh present with a group of little water blisters on a red base.  People often think they are poison ivy or poison oak.  I would say 90% of the men that I see in my practice have little bumps on their thighs or buttocks so these are exceedingly common.  I don't think from your description that they are herpes, but if you really would like to know you can ask you clinician do to a PCR swab test (not a culture) from one of these to see. 
Let me ask a few more questions:  has your wife had a herpes antibody test to determine if she is infected as well?  If you do know for certain that you have herpes, do you know if you have HSV 1 or HSV 2? 
Viral shedding occurs from very thin skin like genitals and anus and mouth (if oral herpes) and nose (if oral herpes).  The virus, without a a lesion, cannot get out of the body through thick skin like thighs and buttocks and belly. 
The best ways to prevent transmission are daily antiviral therapy for you (not her) and regular condom use.  But without knowing through a test if she is infected or not, it is difficult to recommend transmission reduction strategies. 
So if you would be so kind as to answer those questions, I think I can help you more accurately.  Thanks, Tim