Intraoral Herpes

[Unsettledinla]

I have been diagnosed with HSV-1 with outbreaks on my facial lips having outbreaks starting as far back as 2006 that I can recall. I have always had them only around my lips but would appear on any given spot ( right side, left side, top lip, bottom lip.) Never in the same spot. In 2013 I think I had my first outbreak in my nose and had at least one other outbreak in my nose since then. I am fearful that I am possibly now starting to get them intra-orally on my roof palate. This past Sunday I felt pain around my canine tooth, didn’t think much of it, don’t remember feeling any kind of bumps so just brushed it off as brushing my teeth too hard. Monday decided to look into my mouth and found white ulcers extremely similar ( pretty much exact) to herpes pictures I found online. So these are my questions:

1. Is it possible that this will be a “new” sight of outbreaks? Everything I read says intra- oral herpes is extremely rare. And this would not be a primary infection but rather secondary.
2. I did have sexual relations Sunday (including oral), I am now extremely worried that I could have transmitted this to the man I performed the oral on. How easy is it for the virus to penetrate the penile skin?
3. I do have a slight post nasal drip, can the ulcers be sinus related and not herpes?

I can’t get any doctor appt. or dentist appt. until next week. Which by then I’m sure the area will be cleared up. Any insight is greatly appreciated.

[Terri Warren]

I wouldn’t agree that intraoral herpes is rare. It might be rare to present with lesions in the mouth, but we know that people shed virus from inside the mouth, so whether it is a lesion or just shedding virus, the mouth is involved in the process. The virus you have lives in the trigeminal ganglia (or nerve group). This nerve group supplies activity to the entire facial area – lips, mouth, chin, nose, and even eye. How the virus decides which nerve to travel on to get to the surface of the skin is a mystery – some people always have an outbreak in the same location and some people are like you with outbreaks occurring all over the place. If you do have an outbreak in your mouth, and only swabbing would tell you whether this is a herpes outbreak or not, this is not a new infection in any way, it is a recurrence in a little different spot.

HSV 1 can be transmitted via oral sex, yes. And it does not appear to be a problem to penetrate the penis skin. Do you know if this person has ever had a cold sore? Because if they have, it is extremely unlikely that they would now get infected genitally as well.

I don’t know what the ulcers are without a swab test, preferably using PCR, to see if they are herpetic. YOu can’t go to urgent care for a swab test? If you do, try to get PCR vs. culture.

Terri

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