Eczema and Newly Infected

[onegoodguy]

Hi Terri

First off, thank you for this service.

I am a male and have been recently infected (6/23) with HSV2 (genital area) from my girlfriend (also genital area) who did not have an outbreak for 10 years (infected 18 years ago)
As a data point for you, we always had sex with a condom but likely got infected because there was a lapse in taking her valtrex when we had sex and contracted the infection from asymptomatic shedding. Assuming this is all true then we are a seroconcordant couple.

I also have eczema on my hands and am a little obsessive-compulsive which brings me to my questions.

1) Are there any special concerns and prevention methods regarding spreading the infection to my hands due to my eczema?
2) Before the HSV2 infection my eczema would sometimes manifest itself with very small blisters. Now that I am HSV2 infected would I be able to differentiate these benign blisters against those caused by HSV (to serve as an indication that I have spread the infection to my hands).
3) If I ever do get the infection on my hands asymptomatic shedding would normally be nil due to the thicker skin (I believe this is what I read in your forum). But the eczema can cause cracks in the skin, so is asymptomatic shedding possible in this scenario? As it is now I hesitate when people offer to shake my hands and am worried about diaper changing a baby in the future (would probably use gloves anyways 🙂 ).
4) How effective is a hand sanitizer (like Purell, ethyl alcohol based) at killing the virus, in lieu of soap and water?
5) I understand (thanks to your info) that my antibody defense won’t be fully developed until after 4 months. As I mentioned I am a little obsessive-compulsive, so I feel like I won’t be able to relax due to fear of spreading the infection to other parts of my body until that time has passed. Are my fears warranted?
6) As a seroconcordant couple, if we practiced oral sex (yay), what is the risk of infection to the oral region if genital lesions are not present (asymptomatic shedding) after or before the initial 4 month post-infection (to allow antibody development). If the lesions are present?

Thanks in advance for all your help and information

[Terri Warren]

1) Are there any special concerns and prevention methods regarding spreading the infection to my hands due to my eczema?
Not really, just wash your hands after touching the genital area. In four months or so, autoinoculation will not be an issue, by the way.
2) Before the HSV2 infection my eczema would sometimes manifest itself with very small blisters. Now that I am HSV2 infected would I be able to differentiate these benign blisters against those caused by HSV (to serve as an indication that I have spread the infection to my hands).
My experience with herpetic whitlow (herpes of the hand) is that the blisters are NOT small but really significant.

3) If I ever do get the infection on my hands asymptomatic shedding would normally be nil due to the thicker skin (I believe this is what I read in your forum). But the eczema can cause cracks in the skin, so is asymptomatic shedding possible in this scenario? As it is now I hesitate when people offer to shake my hands and am worried about diaper changing a baby in the future (would probably use gloves anyways 🙂 ).

Are you treating the eczema with something effective? I seriously doubt that you would be shedding through eczema.

4) How effective is a hand sanitizer (like Purell, ethyl alcohol based) at killing the virus, in lieu of soap and water?

Very effective. We use hand sanitizer between patient at the clinic

5) I understand (thanks to your info) that my antibody defense won’t be fully developed until after 4 months. As I mentioned I am a little obsessive-compulsive, so I feel like I won’t be able to relax due to fear of spreading the infection to other parts of my body until that time has passed. Are my fears warranted?

Maybe just a little. But it is simple just to do handwashing.

6) As a seroconcordant couple, if we practiced oral sex (yay), what is the risk of infection to the oral region if genital lesions are not present (asymptomatic shedding) after or before the initial 4 month post-infection (to allow antibody development). If the lesions are present?

After the 4 months have passed, no real risk at all. Before, minimal but present risk

Terri

[onegoodguy]

Hi Terri

Below are some followup responses/questions.
Thanks again in advance for your help and advice. It is really appreciated.

3) If I ever do get the infection on my hands asymptomatic shedding would normally be nil due to the thicker skin (I believe this is what I read in your forum). But the eczema can cause cracks in the skin, so is asymptomatic shedding possible in this scenario? As it is now I hesitate when people offer to shake my hands and am worried about diaper changing a baby in the future (would probably use gloves anyways 🙂 ).

“Are you treating the eczema with something effective? I seriously doubt that you would be shedding through eczema.”

I use an over-the-counter eczema relief specific moisturizer that keeps it generally under control. Winter time is more challenging. However I will still have small cuts/cracks in my hands frequently and therefore was concerned about the aforementioned auto-inoculation in the hands and subsequent transmission.

6) As a seroconcordant couple, if we practiced oral sex (yay), what is the risk of infection to the oral region if genital lesions are not present (asymptomatic shedding) after or before the initial 4 month post-infection (to allow antibody development). If the lesions are present?

“After the 4 months have passed, no real risk at all. Before, minimal but present risk”

For clarity … as the newly infected male is it “safe” for her to give fellatio but “not as safe” for me to give cunnilingus before the 4 months? Or is this “reversed” as I am currently shedding more virus?

NEW QUESTIONS
After an outbreak and lesions have healed, should there be a wait time before having intercourse again? If so, would it be different before or after the initial 4 month period?

I seemed to have had another outbreak after my initial one within 2 weeks from each other. Although much more minor, one set of lesions have appeared in a different spot in the boxer shorts region. Is this typical? In future out breaks should I expect lesions to appear in new boxer short region spots or same ones. During this time I also had what appeared to be a mosquito bite 2 inches above the waistline on my abdomen, it did not develop into smaller vesicles, so can I safely assume that it was just a bite?

I play basketball and there is a lot of physical hip-to-hip contact especially when wrestling to obtain court position. I have heard of herpes gladitorum and wondered if transmission was possible in this scenario? As far as I understand, transmission should be skin to skin contact but the dermatologist that initially diagnosed me with the condition gave me some instructions to prevent transmission to others which sparked me to ask this question.

[Terri Warren]

I think asymptomatic shedding from eczema troubled skin is very unlikely and not shaking hands is an over the top response to that concern.
If you are infected only genitally, then there is no risk of you giving her oral sex and it is past 4 months, if I am reading your question correctly. After four months from new infection, assuming no every day suppression, whatever you do sexually is likely to be no problem at all.
There is no specific time to avoid intercourse that is 100% reliable, but I always tell people to wait to have sex until the lesions are healed.
It is common to have a couple of outbreaks with new infection, close together, while the immune system gets good at handling herpes.
Herpes gladitorium is HSV 1, not HSV 2. I would not worry about transmission via sport

Terri

[onegoodguy]

Hi Terri
Sorry I am repeating the scenario but this thread was getting a little lengthy so I just restated the conditions so you do not have to re-read the above posts to gather the info. I know you are busy reading and answering everyone else’s questions too. 🙂

In regards to the eczema on my hands, the initial concern I have is spreading it on to my hands due to the open cuts there. Should I assume anywhere I have open cuts I need to be concerned about auto-inoculation (before the 4 months)? Maybe wear bandages over the cuts, gloves when touching the infected area, etc.?

For clarity on this previous question … both of us are genitally infected. I am male and newly infected, she has been infected for 10+ years. Before the 4 months time (of my new infection), can she safely give me fellatio without risking her getting an oral infection (I assume she is immune now) and can I give her cunnilingus without risking me getting an oral infection (I assume I can still get an oral infection from her since I do not have antibodies yet)? Or, because I am newly infected, and shedding more virus, is she still at risk of getting an oral infection if performing fellatio on me?

I truly do appreciate the service and your advice as it helps dispel many fears. For example, knowing there is a 4 month auto-inoculation window, as opposed to an unlimited auto-inoculation window is more comforting. I hope you can continue to help the many people that are out there, physically and emotionally.
Thanks you

[Terri Warren]

If you just wash your hands after touching the genital area, you will not autoinoculate.
Yes, she can give you oral sex before the four months are up because she already has the infection you have.
Hope this is helpful!

Terri

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