I have been dating my boyfriend for 3.5+ years and we have been having unprotected oral sex for that entire time. Neither of us has ever had a classic cold sore, and I have never been concerned about having oral HSV1 up until the last year (no signs or symptoms). I have, in the last year, had one or two possible outbreaks of oral HSV1, as I had a small irritated dot on my lip after a cavity filling, but that could have been due to drying or stretching of lips during the filling.

This past weekend I performed unprotected oral sex on him when we were in the shower. We had protected intercourse after. After this, while looking in a mirror I found a small, painless cut just above my lip perpendicular to the border of my lip, barely a quarter centimeter long. I can only see it when I stretch my lip out like I'm smiling. Otherwise it disappears into the skin. It did not bleed, ooze, hurt, itch, tingle, or scab, and it was in a different spot than the only other suspicious irritation I've had. I could barely feel it with my tongue the day I found it and can't feel it today with my finger or tongue--it's that small. Had I seen it beforehand, I never would have given my boyfriend oral sex, just in case. However, I've never had this happen before and I am wondering if I'm overreacting. I do have an anxiety disorder that focuses on disease as a result of a sexual assault I experienced in college. I have been reading about "papercut lesions" and am unable to figure out if this sounds like mine.

Should I be worried about oral HSV1? I didn't say anything to my boyfriend as my needless worrying has caused tension in the past and I feel like I've cried wolf too much to bring it up without being sure. Should we get tested, even without lesions, due to how common HSV1 is? If a person is infected during an outbreak instead of from viral shedding, will lesions show up faster? I don't even care if I have it, I would just feel so guilty if I passed it on to my boyfriend.

I guess in this case, I would not recommend testing.  You've been having oral sex for 3.5 years, nothing you've written here sounds like HSV 1 to me, and more than half the population has HSV 1.  Also, most transmission of herpes happens in the first three months of a relationship and you are waaaaaay beyond that.  In addition, the IgG test misses 30% of HSV 1 infections so if it's negative, you could be falsely reassured.  Just so many reasons not to test.  Having said all of that, if you do decide to test, you both should test and you should use the western blot instead of the IgG test - it's expensive, but far more accurate. 

I'm more likely to recommend herpes testing than my colleagues here, but in this case, I just think not, for the reasons described above.
Let me know what you think

Terri
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Thank you for your answer. I thought that might be the case, that since we've been together for so long it's probably a moot point. I just can't find any conclusive info about papercut lesions. The cut on my face was a little red line like when you get a papercut, and the skin around it wasn't red or inflamed, and it didn't hurt or anything. I wondered if I had scratched myself while messing with a zit that was right next to the cut, because I was looking at my face all day while I looked at the zit and didn't notice it until the day after I spent all afternoon scratching the zit. Are papercut lesions common with oral HSV1? Do they usually sting or burn like normal lesions? I also wondered whether he could even get HSV1 genitally through an incident like this if he already had HSV1 orally and just didn't show symptoms. I will be nervous for the next couple weeks just in case he shows symptoms but your answer made me feel a bit better.

No, papercut type lesions are NOT common with oral HSV 1.  Those most often are found genitally.  Orally, the usual is the classic cold sore that is a blister or group of blisters that opens up, forms an ulcer and then scabs over.  This sounds nothing like that.  Has he ever had a cold sore?  if yes, then it is very unlikely that he would subsequently acquire HSV 1 genitally

Terri
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Hi Terri, 

You can obtain the western blot with the help of your own provider, yes. You need to contact the University of Washington to send you the kit - 206-685-6066.  Then your provider needs to be the person who fills out the lab requisition  and do the ordering once you have the kit.  It cost about $230 plus whatever you provider would charge for the visit to see you, draw your blood and shipment costs.  If they won't do this for you, I can, would need to make an appointment with me for a video conference.  We will order the blot and would use your data, IgG vs. western blot results, without your name of course, in our research study.
Let me know if I can help

Terri
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