Dr. Dhepe Snehal Madhav
Venereology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have a sexual relationship with a girl. She had a cold sore under her bottom lip (I could see, and she said her outbreak was a few days before), so we did not have intercourse at that time. After 17 days, there appeared to be no cold sore at all. However, she was wearing making up at the time. After intercourse, her makeup came off. I saw a red mark or spot under her bottom lip in the same place her cold sore was, and I panicked and asked her what it was. She told me not to worry and that her outbreak was over and it had already scabbed over, and the scab had disappeared, and what remained was a red mark or scar. I am really worried that maybe I have been exposed because there was full intimacy, and I am not sure if I was at risk at that point even though it had been all that time. Kindly give your opinion.
Hi,
Welcome to icliniq.com.
There is less risk if no active lesions are present. Are there any symptoms like tingling sensation, burning, painful blisters, or fever? Please answer the questions so that I can guide you accordingly.
Patient's Query
Hi doctor,
Thank you. She had a red mark or spot in that area (not sure, just something red). She stated that it had already scabbed over and healed, but that mark or spot remained. But then again, she is not an expert. Also, please note our encounter 17 days after I first saw her active cold sore. I do not blister and no fever. I do not think I am having any tingling or burning sensations, but there was one time a few hours ago I thought maybe I had a slight sensation, but I am not sure if that was me being paranoid. Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
Good to know you do not have symptoms at present. At present, if you have not developed any symptoms, then no need to worry. Worry only if evident symptoms develop like a tingling sensation, burning, painful blisters, erosion, ulcer, or crust appears. You can get a lab test done for the herpes simplex virus (HSV-1 or HSV-2, IgG (immunoglobulin), and IgM) in case you want to be sure. IgM positivity will suggest a recent infection. Rest is important. Avoid triggers like tension, stress, etc. Kindly follow up if any symptoms develop or IgM turns positive. Is there any systemic illness or on any particular medication? Do you have a neurological illness? Are there any environmental triggers? Do you smoke? Please answer the questions for further help. I hope this was helpful.
Patient's Query
Hi doctor,
Thank you. I do feel a bit better. When you say watch out for symptoms, will a cold sore always follow after burning or tingling sensation (just thinking that if I think if my mind I have those sensations and no cold sore appears, then I know it was just my mind)? If after I wait two weeks. Is it safe to say there is a good chance I did not contract it from that encounter? Also, based on what I told you about the stage she was at with her virus, assuming that to be true. Is it safe to say there is a good chance she was not contagious? I do not have any medical history or neurological diseases, not under any medication. I do not smoke. Kindly give your opinion.
Hi,
Welcome back to icliniq.com.
The symptoms start with itching or burning, painful blisters or erosions or ulcers or crust. There is a very low risk of contracting the infection as you do not present with symptoms after ten days of exposure as the incubation period for herpes1 (labialis) is three to ten days. After ten days post-exposure, if active infection is present, it starts with itching, burning at the vermilion border of lips. It progresses to erythematous papules then studded with grouped blisters. Primary infection if HSV-1 (herpes labialis) (IgM positive) takes one to three weeks to heal. HSV-1 is less common (20 to 30 percent) as compared to genital herpes (HSV-2). And incubation period of genital herpes is two weeks (14 days), presents with small grouped blisters post-exposure over four to six days which soon become ulcers. Is there any pain in urination? Cloudy or pus cells in urine? Painful and tender lymphadenopathy? Please follow up with reports. I hope this was helpful.
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Venereology
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