Autoinnoculation and face

[Lost321]

I was recently diagnosed two weeks ago, and I've been reading things here and there about autoinnoculation. In some of the threads I've read that Oral HSV 1 is in the entire lower face area not just in the mouth or on the lips? Is this right? If this is, is it possible with viral shedding that if I scratched an itch on my cheek or chin or near my mouth but not touching it and then scratched an itch on my eye brow that I could have spread it? This is really concerning to me... Also...if I use chapstick should I be worried about using it if I don't have any symptoms? I haven't had any OB on my lips yet even though they've been a little tingly lately (not sure if they're just chapped or if its symptoms)... Also, if I could be affected anywhere on my face, should I be concerned if I hug anyone cheek to cheek or touch them with any part of my face to their face or hands (of course with regard to viral shedding)? Any insight would be helpful even though I'm prepared for the worst...

[RealisticGal]

Hi there,

It can all be awfully confusing, can't it? And of course, that is scary and worrisome.

I'm going to try to help with your question. Forgive me if I get a bit technical.

First of all, it is always a good idea not to touch your face (especially your mouth, nose and eye areas) without washing your hands. That is true whether you have herpes or not!

A lot of folks report that their sores always occur in the same place. And the most typical place for oral/facial herpes sores to occur is the border of the lips. But that is not the case for some.

Basically, oral/facial herpes lesions can potentially pop up anywhere on the skin surface which is served by the trigeminal nerve pathways, which come from the trigeminal nerve ganglion (the place oral/facial HSV goes to when it is dormant). You can see the trigeminal nerve paths in this diagram:

(Trigeminal nerve, shown in yellow)

See how that nerve has branches going all over the place?

The skin surface supplied by nerve pathways from the trigeminal ganglion are defined by something called a dermatome. Dermatome is the term for an area of skin that is mainly supplied by a single spinal nerve. Here is a diagram of the trigeminal dermatomes.

(Dermatome distribution of the trigeminal nerve -- green, pink and yellow sections)

Here's another:

So you see, what I'm saying is that if you have oral/facial herpes, you could get a lesion in any of the areas of skin shown in this chart, which is a lot more area than just the lower face.

It doesn't have to do with "spreading" it through auto-inoculation, either. It has to do with the fact that the nerve pathways come to the skin surface anywhere in these areas, and so a lesion can pop up anywhere in that zone.

Please let me know if this is a clear enough explanation, or if it is still confusing?

I'm not sure what your question is about chapstick.

[Lost321]

RealisticGal,

Thank you for the explanation; it makes sense, but it seems so bleak...so basically if I understand this correctly, I couldn't possibly spread OHSV to areas on my face because it is already there? I could spread it to my eyes though still, right? What about people who get sores on their noses? It's not possible to spread it there because it's already there? Just paranoid when I wash my face so I try to go through this routine of washing my forehead and every where else on my face before I go anywhere near my mouth... but it doesn't really matter?

My question about chapstick was about whether or not HSV can exist on my chapstick... I know it's spread through skin to skin, but if I use chapstick is there a concern about shedding the virus on it? Only I use my chapstick so I'm not worried about others using it, but just wondering.... Also, lately I have not been licking my lips because I was paranoid about my tongue having sores and licking my lips. My lips seem to feel a little burning for the past week, but I have not had any sores and the skin on my lips is a little more sensitive than usual (After I shower or get my lips really wet in some way, all the skin seems to peel). Is this perhaps a sign of an OB that has not shown sores yet? As I mentioned...I've quite paranoid about things (every bump, bruise and ache makes me wonder if it is an OB)...

[RealisticGal]

RealisticGal,

Thank you for the explanation; it makes sense, but it seems so bleak...so basically if I understand this correctly, I couldn't possibly spread OHSV to areas on my face because it is already there? I could spread it to my eyes though still, right? What about people who get sores on their noses? It's not possible to spread it there because it's already there? Just paranoid when I wash my face so I try to go through this routine of washing my forehead and every where else on my face before I go anywhere near my mouth... but it doesn't really matter?

Not sure what you mean by "bleak." If that is your way of saying my explanation was cold, clinical and technical, well, I warned you.

You have oral/facial herpes. So you can get a sore anywhere in that area (the dermatome, like on the charts). Yes, you should be careful and not touch your eyes after touching other areas of your face. That's always true. Our hands tend to have all sorts of stuff on them that shouldn't be in our eyes.

Soap and water deactivate the herpes virus. So I'm not sure how washing your face in any order could make a difference, although I know at least one member here who would disagree with me on that.

My question about chapstick was about whether or not HSV can exist on my chapstick... I know it's spread through skin to skin, but if I use chapstick is there a concern about shedding the virus on it? Only I use my chapstick so I'm not worried about others using it, but just wondering.... Also, lately I have not been licking my lips because I was paranoid about my tongue having sores and licking my lips. My lips seem to feel a little burning for the past week, but I have not had any sores and the skin on my lips is a little more sensitive than usual (After I shower or get my lips really wet in some way, all the skin seems to peel). Is this perhaps a sign of an OB that has not shown sores yet? As I mentioned...I've quite paranoid about things (every bump, bruise and ache makes me wonder if it is an OB)...

This is no different from the question about spreading it around your face with your hands or a washcloth. You already have oral/facial herpes. You can't get it "more."

If you use your chapstick on an area that is shedding virus, it should not survive there for long. The virus is deactivated by exposure to oxygen fairly quickly.

As far as your paranoia, let me assure you that's a normal way to feel at this point. More than likely, it will ease up as you get more used to the situation.

[lilkoka]

Thanks Realisticgal - those diagrams helped me understand a few things!!

Lost 321 - I have Ohsv - I used to only show sores around my lips, but in recent years have had the occassional breakout under my nose and on my chin. Personally, I take extra care when washing and showing sysmptoms - will wash with cleansing pads instead of lots of water all over the face, and i try not to rub over the sores to rest of my face as I worry this could spread it. Can't be sure, but theres no harm in being extra cautious if it worries you. It certainly has spread for me in the past, if i have used a lip balm and had a sore, it has spread all accross my lips rather than just in one corner of the lip.

I dont quite agree with Realistic gal about chap stick (sorry). If ever I know that near the time of using a chapstick i have come up with an outbreak, i no longer use it, it goes straight to the bin. I never use chapstick during an outbreak (this coul spread it) Whichever cream (acyclovir) or balm, i apply it with a cotton bud to the specific area only. I avoid using fingers ever as, yes apparently it can spread to your fingers. Always wash hands after even if you don't directly use your fingers.

I have never had an outbreak around the eye; but I understand that this could be more dangerous and I can imagine would hurt like hell. I think its pretty rare people getting it in their eyes but I think you do need to be careful.... not paranoid just sensible!!

[Lost321]

Realisticgal-thank you for all of the information; you seem so well-knowledgeable about "H" =). Also, thank you for the reassurance; I can't wait until the day when I won't be so paranoid about it .

Lilkoka-thank you for sharing your experience with me. I am definitely trying to be cautious about everything. I haven't had any OBs on my lips yet; I had a couple of small blisters in my mouth, but nothing major. So as far as chapstick, you use it until you have an OB then you toss it? I've been using the same chapstick and haven't had an OB on my lips yet... just concerned about viral shedding because there is no way to know when... I am trying to be super cautious when I touch my face or touch anywhere in the "lower" region (I have antibodies for HSV 1 and 2); I use latex medical gloves anytime I wash any of those areas because I am worried about Herpetic Whitlow. I also constantly wash my hands. At this point I think I am definitely "sensitive" to every little itch, bump, pain, etc...thinking that maybe it's "H" like my pointer finger had a hangnail on one side and then on the opposite side of the hangnail I've got a tiny little cut looking thing. I don't remember getting hurt there, but it doesn't look like a blister or any of the pictures I saw online with Herpetic whitlow. I know everyone's symptoms are different, but if it isn't painful and just looks like a little cut under the skin mustn't it be?

Anyway, thank you for the response; I realize I may type little "second guessing" type of thoughts in my posts and I appreciate the support from everyone during this "sensitive" and "getting used to it" time for me.

[RealisticGal]

I use latex medical gloves anytime I wash any of those areas because I am worried about Herpetic Whitlow. I also constantly wash my hands. At this point I think I am definitely "sensitive" to every little itch, bump, pain, etc...thinking that maybe it's "H" like my pointer finger had a hangnail on one side and then on the opposite side of the hangnail I've got a tiny little cut looking thing. I don't remember getting hurt there, but it doesn't look like a blister or any of the pictures I saw online with Herpetic whitlow. I know everyone's symptoms are different, but if it isn't painful and just looks like a little cut under the skin mustn't it be?

I just want to caution you about the constant hand washing, as well as the glove wearing. I used to work in healthcare, so I did both. It caused the skin of my hands to be quite chapped if I wasn't careful.

That would not be a good thing when you are trying to avoid Herpetic Whitlow. The skin of the hands is pretty thick, so it is hard to acquire Whitlow unless you have a break in the integrity of the skin. So I would say, just be sure to keep your hands well moisturized and only wash as necessary.