Sexually Transmitted Diseases/Appropriate Soap For HSV II & HPV

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QUESTION: Dear Mark,

Sorry to bother you again.  I thought of another question to make sure I am safe with HSV II and HPV.  Is a non antibacterial soap good enough?  I am a massage therapist, so it is important I do the best thing here.  

There are two soaps I use that are not antibacterial.  One has Organic Calendula and Organic Comfrey Infused Saponofied Oils of Organic Coconut, Organic Sunflower and Organic Castor, and Citric Acid. That's it.

And the other only has Organic Traditional Saponified Cold Pressed Virgin Coconut Oil.

Would both of these be enough or do I need to be using a stronger soap?  One is only coconut oil, I am surprised that is a cleanser.  I knew it was a moisturizer.

Thank you again for all you do.  I deeply value your time.
Star
35 years old
Oklahoma City, OK/United States

ANSWER: Hello Again, Star,
Antibacterial soaps are all thought to be no more effective than nonbacterial soaps. The physical act of physically washing  with any soap and water without damaging the skin or causing excessive dryness, is thought to be the recommended practice, and alcohol based hand sanitizing lotion/gels are also effective.  Although I am unaware of specific tests designed to determine if soaps can inactivate viruses, the idea is to remove superficial germs.  As HSV involves a peripheral nerve infection with virus being shed from the nerve and superficial skin, washing by itself with or without soap will be essentially ineffective. Similarly, HPV is an infection not of the surface of the skin, but involves deeper cellular infection by virus and therefore soap isn't enough to get rid of the virus. Placing a bandaid over the suspected lesions should be sufficient to prevent those particular viruses being spread to you.

Good luck!
--mark


---------- FOLLOW-UP ----------

QUESTION: Dear Mark,

Thank you for your thorough explanations.  I am asymptomatic and not sure when I am shedding or where I shed from.  I guess my biggest concern is after going to the bathroom and making sure my hands are not passing either of these viruses (HPV & HSV II) to my clients.

You state, “Although I am unaware of specific tests designed to determine if soaps can inactivate viruses, the idea is to remove superficial germs.  As HSV involves a peripheral nerve infection with virus being shed from the nerve and superficial skin, washing by itself with or without soap will be essentially ineffective.”

I guess I am concerned about the ineffective part.  If washing my hands is ineffective after I wipe after going to the bathroom, aren’t I a threat to my massage clients for both HPV and HSV II?  They shave all the time and are likely to have cuts I can’t even see or maybe I don’t notice it until it’s too late.
Thank you again for all of your efforts.  My deepest gratitude,
Star
35 years old
Oklahoma City, OK/United States

ANSWER: Hello Again, Star,
Any soap that is not irritating to the skin is effective, as long as moisture in retained (so as to not dry it out).  Soap, like other things, may be specific to your particular skin, and some may be fine for some people but not others. Mild soaps are usually white or beige in color (like Dove, Jergins, Camay, Tone, etc.); strong soaps have blue or green dyes or strong fragrances (Lever 2000, Dial, Zest, Shield, Irish Spring, etc.).  Super mild soaps may be needed for very sensitive skins (e.g., Basis).

Good luck!
--mark


---------- FOLLOW-UP ----------

QUESTION: Dear Mark,

As always, thank you so much for your helpful replies.  I think I understand where you are coming from, but I do not want to assume.  It sounds to me like what you are saying is something like this:  That soap technically does not inactivate certain virus/bacteria.  But, it is still effective enough for things like HSV II and HPV?  By washing my hands for the time indicated on the product, I will not then be spreading HSV II or HPV?  I feel bad continuing to reach out to you for guidance, but I guess I am still feeling a little uncertain.  

I guess I just want to make sure that I am being ethical by not putting anyone at risk for contracting HSV II and HPV.  That washing my hands for 20 seconds after using the bathroom is enough to prevent me from spreading HSV II and HPV during a professional massage?  I am asymptomatic with HSV II, so I do not know when I am contagious.  Currently, the HPV is under control, but I want to know in case it silently reactivates?

I do apologize, but thank you so very much for helping me come to terms with this.

Star
35 years old
Oklahoma City, OK/United States

Answer
Hello Again, Starr,
No, soaps of any kind (except perhaps surgical scrubs used prior to the operating room) are mostly INEFFECTIVE in inactivating germs of any kind. They wash most of them away. If herpes or HPV are on your skin, they may be washed way with any soap. However if you have an active herpes or HPV lesion, they may remove the superficial germs, but if virus is being actively shed, washing will not be 100% effective. If the site of your active lesion is covered with clothing, there is no way it can be spread regardless of how much or little you wash.

You may benefit from reading the literature on microbiology and the transmission of disease, or take a class on this at a local community college or university.  

Good luck!
--mark  

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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