I've had four partners in my life, all used condoms for penetrative sex but not for oral sex, which didn't happen that often. 3 tested negative for HSV1 and 2, one was not tested. I have had dozens of IGG type specifics tests and one negative swab on an area of concern (which the doctor said looked like yeast as it was just red and irritated). Every once in a while I get an irritated patch on the right outer labia, it feels raw but never really looks like anything is there and I look very closely, often pulling the skin tight to make sure I'm not missing anything. Sometimes it looks like there could be a sort of stretch-mark like striation there, or some discoloration but whenever I go in and get it looked at, doctors don't seem to think anything is there. 

This irritation cropped up again and I went in yesterday to have it looked at. The doctor swabbed after I asked, she said she could maybe see something that could look open, like I hit the skin with a nail while wiping and swabbed in 'an abundance of caution' but did ask me if I wanted her to prescribe antivirals. I'm just not really sure what to think at this point. I know the IGG tests aren't totally accurate but I've had a bunch of doctors dismiss the area before and a negative swab. The timing seems odd too. It occurs probably twice a year, which seems too frequent for GHSV1 from what I've read (which would seem more likely than HSV2 given condom use). I figure I would have contracted it about 2 years ago if this is what it is. There have never been any obvious lesions or large paper-cut like lesions either. I'll have the swab results back in a day or two, but do you have any thoughts given the presentation?

Thank you so much for your time, I really appreciate it. 

Sorry to be a day late answering this.  We've been camping without internet access.

With the negative IgG tests AND condoms with all penetrative sex (good for you, BTW), I would tend to be very reassured that this is not HSV.  The IgG is not perfect, you are correct, it misses 8% of HSV 2 and 30% of HSV 1.  The more definitive antibody test is the western blot.  However, if it is positive for HSV 1 only, you will not be able to know if this is oral or genital.  have you ever in your life had a cold sore on your lip?  If yes, then I doubt that this would be genital HSV 1.  Let me know the results of the swab test (and let me know if it is culture or PCR)

Terri

I've never had a cold sore before, but my sister gets them. I do occasionally get a cut right inside the tip of my nose, especially if I'm rubbing my nose frequently; I'm not sure if that indicates HSV1 at all. It just seems very odd that this irritated area keeps cropping up. I've never seen anything that looks like a blister or like an obvious cut or deep ulceration, and I check relatively frequently and especially when the discomfort crops up. Would a GHSV1 ulceration be very shallow? It mostly just appears slightly more red than usual. Results aren't in yet but I did speak to the doctor again and she said she wasn't particularly concerned about the spot because it didn't look at all typical and she was swabbing because I brought it up and better to be cautious. Is there anything else that could cause some sort of re-occurring spot like this? It's always in the same exact place too.

Thanks again!

The thing inside your nose could be an HSV 1.  It does occur in the nares as well as on the vermillion border of the lip.

I'm not sure what could be causing your symptom.  It's difficult to know from your description if there is actually an ulcer  present or it's just red.  Herpes could certainly cause an ulceration and it could be shallow.  Did you go in to see your doctor when the symptom was full on in it's presentation?  That's the best time to get a swab test.  There are two things you could do here: 1) if the swab test is negative, move on and let it go or 2) if the swab test is negative and you are still concerned, you could obtain a herpes western blot, the most definitive antibody test.  I'm at a loss about what else might cause a continuing symptom in the same location

Terri

The PCR swab came back negative. I had it done within 48 hours of the onset of the symptoms (same with the previous swab). Given two negative swabs, negative IGGs and all lack of concern of all the doctors who have looked at the spot, do you think I should assume it isn't herpes? I just want to be as cautious as possible because I would really hate to accidentally pass anything. I could also continue to get it swabbed whenever it happens.

I think with a negative PCR and negative IgG results, it is extremely likely that you are not infected with HSV.  If you still have worries, I would advise the herpes western blot as the final word on this worry.

Terri