I have had HSV1 cold sores on my lips all my life

Dear Dr. Rob:

I have a couple of questions, I`ve had HSV1 cold sores on
my lips all my life, so I`ve been a little paranoid about
contracting genital herpes now that I am older. About two
years ago, I had some redness after sexual intercourse and I
went to see my doctor. The redness had no lumps or lesions,
which I characteristically would see with my HSV1 infections
along with no pain or real itching. My question is would a
herpes genital infection look and feel much like an infection
I am used on my lips? I went back to the doctor just because
I wanted piece of mind…at my earlier visit he dismissed the
redness as irritation and said it was not typical of a Herpes
infection. I had a HSV1/HSVII type specific blood test
done for piece of mind, but the only issue is obviously the
HSV1 would come back positive for antibodies because I
have had HSV1 cold sores on my lips all my life; HSVII
was negative. How can I distinguish between HSV1 on
my lips and genitals?

Fast forward two years to current…I recently had sexual
contact with a condom and during sex I began to get irritated
in my genital area due to the rough contact. The next day I
had some redness and irritation that lasted for 2 days and
went away…no blisters, no swelling, and a little itching.
I guess my main question is would a Herpes genital infection
be very similar to the infections I have on my lips and should
I be concerned about this latest irritation two years later?
What testing can I do to make sure that I do not have genital
herpes once and for all and how would I be able to separate
between HSV1 on my lips (which I would be positive for on
a blood test due to my oral cold sores) and HSV1 on my
genitals? Sorry for the novel, I appreciate your expert

Dr Rob’s Response:

Dear MJ:

A quite long question, but a simple answer: you can`t.
Oral Herpes or HSV1 is, in fact, the cause of lesions in
20% of genital herpes so that the lesions can occur either
place. The difference is that Type 1 typically occurs in the
oral area and Type 2 typically occurs in the genital area, but
there is at least a 20% over lap. I would repeat the Herpes
Select Test that you had, as that will answer your question.


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