[Question #6892] ORAL HSV2

9 months ago
I have a confusing question. I am waiting to be accurately diagnosed with HSV2. My boyfriend recently tested positive for HSV2 with a high IGG, I have experienced some symptoms but they are ambiguous. I have been diagnosed with HSV1. I have never had living memory of having a cold sore or any genital symptoms. However, I have been on suppression for HSV1 due to be afraid to pass it along to my other partners. I haven't thought much about it until now. After having some genital issues I saw multiple doctors thinking I may have contracted HSV2. All doctors said no it did not appear to HSV2 and blood tests were negative due to probably the prolonged anti virals. Now, During the time all this was happening I had two oral outbreaks a month apart. This one that popped up lately was pretty bad. Typical Redness Blister and open sore. healing. Could I have OHSV2 and GHSV2? I presumed that the genital outbreaks were mild due to anti viral usage. but this one of my mustache area on my face was pretty bad. Does all this make sense? I couldn't get it swabbed in time. I am very confused on this whole situation 
1. would antivirals change appearance of my genital outbreaks and not my facial ones? 
2. Why wouldnt the antivirals be working for my face? 
3. This is super strange. what should i think? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
Antivirals would change the appearance of outbreaks anywhere, facial and genital.  How much antiviral medicine are you taking daily and which one?  It's possible that you have oral HSV 2, yes but uncommon.  And the antivirals could definitely impact your HSV 2 antibody test, yes.  The only way to know for sure if you are infected with HSV 2 would be to stop antiviral medicine for 8-12 weeks and retest.  And if you get another outbreak, have it swab tested and typed.  In either location.  Just because your partner is infected, doesn't mean that you are, for sure.  Let me know about your dosing and drug taken

Terri
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9 months ago
Well, I take 500 g two times a day of generic valtrex. 

Does HSV 2 reoccur often? I read that is sheds very little... 
You said it would change the appearance. Does that mean just present as a rash or just heal the sores quickly?

 I have never had what I had one my genitals like i did on my face. It was the size of a dime. and once i popped it.. It because an ulcer looking abrasion. that healed within 3 days. I also have similar abrasions in my eye brow area too. but have been spreading. Very Very strange. 

MY genital presented as rash and it seemed to appear every two weeks coming and going. 
Would herpes reoccur every two weeks. and have spots coming and going without blister or ulceration?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
That is an appropriate dose. 
The appearance might be like a cold sore but milder.
I seriously doubt that herpes would be appearing as a rash and coming every couple of weeks. 
If you have concerns that you could have herpes, I would strongly suggest that you have a clinician take a peek and a swab if necessary to be more clarity.

Terri
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9 months ago
Thank you. I did have a cold sore on my lip and eye brow area... I am not sure if it was correlated.
1.Would HSV2 oral cause frequent outbreaks on valtrex?
2. is a herpes lesion on the genitals the size of a pin head. Tiny pimple that had clear fluid and next day dark scab that healed within 4 days?
3. Would genital herpes while on valtrex occur every few weeks. for example 2 weeks then 3 weeks. 
4. Would one have a genital outbreak and then a few days later have an oral outbreak?
5. I went to the doctor for my lip abrasion and she said it was scabbed over and could not swab. and didn't appear to be a cold sore because it wasn't on my lip..
6. Would Genital herpes cause leg tingling that came and went throughout the month?

I am sorry for the questions I am just confused and trying to get answers. Doctors do not seem to help too much. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
The nerves that supply the face include the lip and the eyebrow area, but I couldn't say for sure if what you had on your eyebrow was a herpes outbreak
1.  No.
2.  A lesion that tiny would be extremely unusual and it doesn't sound like herpes to me.
3.  No
4.  It is possible that someone with both oral and genital herpes could have outbreaks close in time to each other, yes
5.  Cold sores normally come on the edge of the lip, where it meets the face, or in the nares.  The most sensitive test, PCR or NAAT testing could recover virus even from a scab
6.  That is also highly unlikely to be herpes.

I know you are trying to sort out if you have acquired HSV 2 from your partner.  But while you are on daily herpes medicine, this is going to be very difficult if not impossible to sort out, I'm afraid.  If you develop an actual lesion, go to be seen right away, before scabbing happens, for the best possible diagnosis

Terri
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