Brief background: male here, 30s, who was recently diagnosed with genital warts/HPV. I received cryotherapy for the afflicted areas two weeks ago and was instructed to use a moisturizer (Aquaphor) to prevent scabbing and aid in healing the area.

My concern: I also have oral HSV-1 and have for years. There have been a few times in the past week or so where I fear as though I might have touched one of the oral sores (I was having an outbreak) and then touched my genitals to apply the lotion to the cryotherapy site. I did and do wash my hands prior to application, but because the area was in the process of healing, I'm afraid it might be more susceptible to self-infection regardless. Of course, the area has a little bit of a burning sensation and is still swollen/blistering from the nitrogen treatment, so it's really impossible to tell visually at this point.

My questions: Since I've had HSV-1 for years, what are the chances I could self-infect in another area? Do the odds go up if I touch an area still growing new skin from the cryo even though I've washed my hands prior? I know statistically it's unlikely, but as a provider, have you seen patients self-infect if they had any kind of damaged skin at the recipient site? I'm really worried I somehow had the HSV virus on my finger and basically created an HSV ointment that I applied to the genital area.

As whoever reading this might surmise, I have health anxiety, but after a positive HPV diagnosis, I'm currently in the "now anything is possible" mindset. Thanks in advance.

I, in 33 years of practice, have never seen a person with a well established HSV 1 history, touch a lesion and infect themselves at a new location.  There has been one person in our practice who reported having cold sores in the past and then had an HSV 1 lesion genitally.  That's in 33 years.  I think you should completely take the worry of infecting yourself genitally with HSV 1 off your worry list - really.

Terri
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Thank you, Doctor Warren. One additional question: for the past few days, I've been experiencing redness and a burning/tingling feeling in my scrotum. There are no lesions or any other visual symptoms beyond some generalized redness. It's a bit mystifying. I'm curious if an irritated scrotum could be in any way attributable to a herpes infection by damaging or affecting nerves in the genital area. Thanks.

I think without lesions, that is unlikely.  Especially in the summer, we see many itchy and red scrotums, mostly due to fungus that multiplies more easily in the summertime. 

Terri
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