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Friday, March 7, 2014
HERPES and Auto-Inoculation by Saliva
Since childhood, I have had Type I recurrent oral herpes (approximately 4 outbreaks a year on the mouth or lower cheek region until college; now I have only about 1 outbreak a year). I take Valtrex when I feel an outbreak coming on, which works very well. When in the shower, I often spit on my penis for lubrication before masturbating. Most of the time, some of the saliva goes into the urethra, which is always partially open when I have an erection. I may have spit on my penis and masturbated while I had a cold sore, but honestly I cannot remember. I am worried that I may have spread my Type I oral herpes to the genital area. Recently, I have had hard red bumps on my penis shaft (where hair is present) and yellow pustules near where my underwear rubs (which have itched). I had these conditions examined by my family doctor and two dermatologists. All three doctors concurred on a diagnosis of folliculitis after viewing the bumps. After prescribing an antibacterial pill, the symptoms went away and did not return. However, I have had similar bumps in other area: chest, back, butt, etc. (My dermatologist says it`s acne). My concern is that Herpes takes many forms, and while a visual examination is good evidence, it is never conclusive. Also, from researching the issue, I understand that the Oral Herpes Type I virus IS often present in saliva. I hope to eventually have unprotected sex with my future wife, but I would never want to unknowingly put her at risk of genital herpes. I am a virgin, both in terms of vaginal, anal, and oral sex. 1) Is it possible to spread oral herpes to the genital area via saliva alone (given the way I masturbate)?
It is unlikely that oral herpes type I will be passed from your saliva to your genital area but it is not impossible. About 30% of genital herpes is due to Herpes type I. This typically occurs during oral sex where a partner puts their mouth on your penis while they have a herpes outbreak or are "shedding" herpes in their mouth. It is safest for you to use lubrication other than spit (hand cream or soap) to protect yourself. Folliculitis and acne are common. Oral herpes is very, very common affecting 1/3-1/2 of all persons. Chances are that your wife or partner may have it already (once you meet them in the future). Your best bet is to discuss this further with your doctor.
Carl Fichtenbaum, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati