Time Frame

[whatislikelytohappen]

I understand that someone who is hsv positive always has a slight risk of transmitting the virus even when no symptoms are present. However, I understand that the risk is significantly increased during an outbreak. I’m confused about when the outbreak is understood to be safely over.

If cold sores are treated and do not form scabs during the healing process, how long are they contagious?

Does a red area of skin after having a cold sore indicate that the virus is still present?

It is necessary to wait until all visible redness is gone to prevent transmission, or is a week to two weeks after the skin has flattened mean that a long enough time frame has passed?

If there is slight redness where the sore was present, does that mean that the virus is still present in saliva?

[Terri Warren]

You know that is a good question. Viral shedding can happen before, after and during an outbreak so you can’t be absolutely certain when shedding is occurring. But my advice is to consider the lesion healed when new skin has replaced the previously broken skin. The same is true with both oral and genital herpes. It is not possible to know if virus is still present when the skin is still red. Virus is not usually present in saliva.

Asymptomatic viral shedding, by definition, occurs without symptoms so your desire to nail down exactly when it is safe and no virus is present, is not possible to know.

Terri

[whatislikelytohappen]

Could you help me understand what you mean by new skin?

When my boyfriend gets cold sores above his lip, the skin can remain pinkish red for several weeks after the blister is gone. I’m not sure if the reddened area of the skin would be considered new skin or not.

I understand that there is never a time to be completely sure that no virus is present, but I’ve read that viral shedding is much more likely in the week before and the week after the outbreak, so I just wasn’t sure how to conceptualize that time frame. I’ve heard it described as seven days after the scab falls off naturally, but there was no scab this time.

I did not realize that the virus isn’t typically present in saliva.

[Terri Warren]

New skin, for me, would be skin that is not broken. Pinkish red skin with no breaks I would consider new skin. about 50% of viral shedding happens before and after an outbreak and about 50% happens randomly.

Is the situation that he is positive for HSV 1 and you are not? Have you actually been tested? The HSV 1 screening test picks up about 73% of infections, far from perfect. The herpes western blot is far better.

Terri

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