I recently submitted a question (#5151) where I was concerned about contracting genital HSV-2 from a sex worker. I was specifically concerned about genital HSV-2 because I already have HSV-1 from childhood and because I was experiencing some tingling / itching / burning sensations on my butt, anus, and scrotum. I never actually saw a lesion anywhere and thanks to your responses am not quite as worried about that as I was (although I'll still get tested later).

Now, I'm worried because for the last two days I've been feeling tingling / burning on my lips of increasing intensity. I don't recall kissing the sex worker and definitely didn't perform oral sex on her, so I'm not so much concerned about a new infection but a recurrence of oral HSV-1. I haven't had an outbreak for at least 20 years, I don't remember the last time I had a cold sore.

What I'm wondering is the following:

1) If I came into contact with HSV-1 on another part of my body, could it trigger a recurrence outbreak of cold sores even though the contact was somewhere else?

2) If I came into contact with HSV-1 on my lips, could it trigger a recurrence outbreak?

3) Maybe what I'm feeling isn't an oncoming outbreak, or maybe it's one caused by stress, but if it is, what if anything can I do to lessen the severity and length of the outbreak? I have to make several public appearances next week and would like to be able to manage this to the extent possible.

Hopefully this burning / tingling will go away without incident, but if it doesn't I want to be prepared. 

Many thanks in advance!

1.  No

2.  No

3.  You can take oral antivirals like Valtrex - the dose for a suspected cold sore is 2 grams, then 12 hours later 2 grams again.  It is very effective - I do it when I have to give a speech and it works like a charm if I think I'm getting a cold sore.

The sensations that you feel are either not a cold sore coming OR a cold sore coming, maybe from the extended stress of worrying about this, but it doesn't have to do directly with your contact with the sex worker.

Terri

I greatly appreciate the information! This did not turn into a cold sore, thankfully, but it does make me wonder the following:

1) Is it possible for oral herpes to cause just the tingling/burning sensation without leading to cold sores?

2) As I mentioned,  I was (and still am a bit) concerned about a genital HSV-2 infection due to the symptoms described (tingling/burning/itching in buttocks, anus, and genital area) that lasted about 10 days. Also, all of my skin down there, including on my penis, has been more sensitive lately, for example feeling agitated after masturbation or sex when it normally wouldn't. Apologies if this is repetitive but have you ever seen herpes cause those kinds of symptoms without any lesions?

3) Could the symptoms from question 2 be caused by anxiety or something else, like dehydration or another contagious skin condition?

Thank you so much.

Does the over the counter stuff like Abreva work? I might not be able to get a prescription for antiviral meds very quickly, especially if an outbreak occurs on a weekend.

Thanks

1.  Oral herpes can cause symptoms like burning without evolving into an actual cold sore - this is called an aborted outbreak.

2.  I have seen people who have odd skin symptoms who test positive by antibody test, yes, but whether these symptoms are actually due to herpes cannot be known without a swab test, even if the skin looks completely normal.

3.  I think the symptoms could be caused by any number of minor skin issues but it could also be that you are observing so very very very closely when you normally do not and you are noticing things that in any other setting, would have not meaning and therefore no worry for you.

You should have a prescription filled and ready and home so you can treat a cold sore right away.  yes, you can try Abreva - I'm not a huge fan

Terri