[Question #4689] Superficial Cuts (ones that are not deep) and HIV

26 months ago

Hello Doctors,

I genuinely appreciate all the work you have been doing!

I have HIV phobia and unfortunately I came across an article that says superficial cuts can transmit HIV.  link: https://www.ncbi.nlm.nih.gov/m/pubmed/25354026/?fbclid=IwAR2f7Hy7M7h8zuQtEWGMeXnnC_cUvmtSqxh_nu3zcWA19_JuzDp52i9Z6g8

I contacted my primary care doctor and he said that only deep cuts that are actively bleeding can be route for HIV transmission, because they have direct access to the bloodstream, unlike superficial cuts. And he also said the majority of these cuts would need immediate medical attention and possibly stitches-- correct me If he is wrong please.

Now I have previously done manicure care and now I am afraid I got HIV from that or from my superficial cuts touching others’ blood.

  1. Can I get HIV from manicure care?

  2. Do superficial cuts (not deep ones) serve as a route for HIV transmission?

  3. Can I safely have sex with my husband?

4. Is the link I attached a proved case or is it just speculation based on nothing? 

Thanks a lot doctors!

26 months ago
And what I mean by a superficial cut is one that results from a paper cut and similar forms. One that stops bleeding in a matter of seconds. 
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
Welcome to the Forum.  I'll be glad to comment.  One of the best pieces of advice I can give to you in dealing with your phobia is to stay off of the internet.  The stories and statements there are often wrong and taken out of context.  The create undue fears and concerns for persons who tend to be impacted by such stories and one-time events.  

This single report, which I was unaware of, is such a case.  The risk of HIV infection from superficial cuts and cuts which are no longer bleeding do not represent a meaningful risk for acquisition of HIV.  The case report you found has a number of very strange features which make the situation unusual.  While the two persons viruses were somewhat related, the fact that the infection may have occurred over a decade before the infection was discovered and that the possible exchanges of fluids (including the sharing of manicure tools) make the report questionable.  Thank you for shoring it.  Based on this I will now indicate that there is a single case in which sharing manicure tools MAY have led to HIV transmission but it will not temper my counsel that for there to be a meaningful risk of infection, blood needs to injected DEEP into tissues and that superficial scrapes, cuts and healing wounds do not represent a meaningful risk for infection.  

In answer to your specific questions:
  1. Can I get HIV from manicure care? This is the only such case I have ever heard of. I suppose there is a tiny risk but I would put the risk at about the same magnitude as your risk of being struck by lightening. It is not something I would worry about of not get manicures because of (I would add that professional manicurists typically take precautions to clean their tools carefully- that may not have happened in the case you shared.

  2. Do superficial cuts (not deep ones) serve as a route for HIV transmission? NO

  3. Can I safely have sex with my husband? Certainly

4. Is the link I attached a proved case or is it just speculation based on nothing?  As I mentioned above, much about this case is so unusual that it will not change my assessment that superficial cuts, scrapes (including paper cuts) and sores to not represent a meaningful risk for HIV

I hope this comment is helpful.  EWH
26 months ago
Thanks for the responses Doc.

1.does that mean if the case proved accurate--that the lady got infected with HIV as a result of manicure care--then it happened because there was the tools was deeply inserted into the lady's body part? 

2. what types of cuts in the hand (fingers) result in HIV infection? could you please describe what kinds? I was told they have to be deep and bleeding, to the point where medical and professional care is demanded (eg. stitches)? is that correct? and does it mean if the bleeding stops in less than 10 seconds then it means it is a superficial cut? 

3.I noticed that I have a superficial cut in my hand, one that did not bleed for more than 5-10 seconds, and is not deep because I did not even notice any blood or feel any pain. would that pose ANY risk because it was cut by something (I don't know what resulted in this minor injury).
Thanks a lot for the reply! 
26 months ago
So my main concern is that does the article i attached here mean that there must have been a deep wound in the manicure care? 
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
I really can't say more than I said in my original response.  On one hand, there is a theoretical possibility that somehow the subject of the report was infected through sharing of manicure equipment....or some other means  If so, it is the only such case among the millions and millions of such exposures and is realistically not something to worry about.  .  Either way, whatever happened, happened more than 10 years earlier- far too long an interval to really know.  As I said above, realistically, there is no reason to worry about contamination of superficial cuts to lead to HIV infection.  Thus, in answer to your questions"
1.  There is no way to tell  what really happened.
2.    Cuts themselves would NOT be a risk. There would have to be a DEEP cut in which blood or other infectious material was then injected DEEP into the cut.  Superficial cuts would not be a concern.
3.  The cut you describe would not put you at risk for HIV.
26 months ago
Last two questions: 
I would be forever grateful of you could answer the two questions in depth, as I am panicking right now (sorry but the phobia is taking its toll on me)
1. Would you please elaborate on what is considered a deep or a superficial cut? how can i know if my cut was "deep" enough to provide a route for HIV transmission? Do you mean by deep one where it would bleed profusely, and would need medical attention (eg. stitches). 
2. are DEEP wounds or cuts the only way to transmit HIV, meaning superficial cuts won't be a route for hiv? 
2. I did not notice my cut until i looked at my hand by coincidence, does that mean it was not deep enough? I am really worried doctor. Am I in no risk AT ALL?  
26 months ago
All I want to know what is a deep cut. And if the cut is not deep, does that mean there would be absolutely no risk for HIV transmission? 
26 months ago
and lastly, according to the article, how sure are they that she got infected from her cousin? you said the hiv is similar in both. are they certain or is it a mere speculation? 

Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
Sigh. Please realize that this is your phobia acting up, not reality.  You do not mention the circumstance of your manicure(s) but the chance  that your manicurist had/has HIV is very, very low.  You questions are a bit repetitive and that is not going to change my answers:

1.  "Deep" cuts go through the entire epidermis (skin layer) into muscle, creating sustained bleed.  The cuts you describe in no way sounded deep. there would be profuse bleeding and stitches would be needed. Even in this circumstance the chance of infection is vanishingly low since the blood would be coming out not inward as would be needed to transmit infection.  
2.   HIV is not transmitted with superficial wounds.  Even with DEEP wounds, transmission is unlikely.
3.  This is a shallow, non worrisome wound.  Please relax

As I said above (twice), the single nearly five year old paper you mention is suspect and while it raises a theoretical concern, it certainly should not be a worry.

This will end this thread. Please don't worry. If you continue to worry, I suggest you seek counseling as the scientific assessment of risk will not change.  If you are truly worried, get tested, it will PROVE that  you do not have HIV and have nothing to worry about.

Should you post further repetitive, anxiety-driven question the thread may be closed without a response and without return of your posting fee.  Please don't worry.  EWH