[Question #7296] Oral to Genital HSV1 Risk Assessment

7 months ago

Hello,


First of all, thank you for your website and services, I've been reading your forum as well as MedHelp every time I've had panic attacks regarding a "risky" sexual encounter and your advices were always appreciated. About 16 days ago I've received oral from someone who has HSV-1.(I'm HSV1/2 Negative) She did not have an outbreak or sores while the oral was received. I did have some symptoms afterwards which I'll list below to make the timeline easier to understand.


Day 1(Sep21): Received Oral (2-4 minutes)

Day 5(Sep26): A single small pimple appears on the left side of my glans, I take a picture and send it to an online dermatologist. Derm says it's a papule with no specific trigger, says it doesn't need treatment and I can resume sex.

Day 9(Sep 30): The pimple is almost gone. Brief unprotected vaginal (5 minutes)

Day 10(Oct 1): Pimple gone.

Day 11: (Oct 2): 2 pimples of the same kind reappear on top of glans, I take a picture and send it to the same dermatologist, Derm says it's still papules and not to worry, they will be gone soon

Day 15: (Oct 6): The 2 pimples seems to fade but another 3 little papules appear to a site close to the 2 other. Send picture to same dermatologist, says not to worry and to apply Eucerin tid

Day 16(Oct7): 3 pimples still there. Wondering if I should take some sort of anti fungal?


From the moment I've seen them, they never "broke" and became open sores, they always stayed reddish and never itched or burned. I've read most of the questions asked on your website and I'm still not sure the symptoms fit with HSV but the timeline is what's making me wonder. I've been very anxious about the oral episode and I also developed some acne on my forehead (usually happens when I'm really stressed), I've also had genital oriented anxiety for the last 2 weeks, I'm wondering if the papules could be HSV and if not, fungal or simply like my forehead, pimples/papules appear when I'm under a lot of stress?


Thanks a million for your time

7 months ago
Forgot to add, the papules/pimples seem to be located under the skin. Never had liquid in them and are smaller than 1-2mm in diameter each.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
7 months ago
The lesions that you describe do not sound like herpes to me.  Normally, as I think you know, a herpes lesion will open, form an ulcer, and scab when it is on tissue like the shaft or head of the penis.  These don't even sound like they are on top of the skin but rather beneath it.  And they are very small indeed.   Without a swab test of the lesions, it isn't possible to tell for sure but from your description, these do not sound herpetic to me.

Terri
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7 months ago
Thanks for the feedback Terri.

So to be sure, if I don't see any ulcers, blisters, sores or anything remotely looking like that after 1-2 days once the pimple/papule appear, or if the pimples/papules don't burn or are painful it wouldn't suggest and initial HSV1 outbreak on the genitals? I assume an initial HSV outbreak would be quite noticeable in terms of pain/burning sensation?

It might also be worth mentioning that those pimples/papules seems to fade away rather quickly and that if I stretch the skin on my penis head, I can see many many of them underneath the skin.

Could it perhaps be me clogging the pores of the skin by over-manipulating my penis every day for the last 2 weeks? (I've been looking at my penis almost every 2 hours trying to find something) Would you suggest a single-dose of fluconazole 150mg taken orally for good measure?

Thank you again for your time.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
7 months ago
I would not suggest any treatment at all - what would you be treating?  These could be hair follicles that are irritated for some reason (even if no hair is sticking out of them).  I would expect something that would be tender, would open up and usually scab over. 

Terri
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7 months ago
Thanks for the quick answer Terri, so all in all I should be out of the woods considering it's been almost 3 weeks since the oral and I didn't get any blisters / sores? How long does it usually takes for lesions to transform into blisters from the moment they appear on an initial HSV1 outbreak?

Like I said, as time keeps passing, I'm starting to be fairly confident I didn't catch HSV1 from the oral I received.

Thanks again! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
6 months ago
I cannot say if you acquired HSV 1 or not for sure.  I can say your symptoms don't sound like herpes to me.  The average time from infection to the appearance of lesions is 5 days with the range beng 2-10 days, sometimes 14 days at the most I've ever seen.  Based on no symptoms at all in a person who is negative for HSV 1 and 2 prior to the encounter, I also think it is unlikely that you have become infected with HSV 1 at your encounter.

Terri
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