[Question #2433] Question on HSV-1 Self-Infection/Autoinoculation

43 months ago
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.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
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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43 months ago
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.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
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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