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When to call a scab a scab ???
Nov 9, 2000

I have been going through some of your answers on HIV transmission through cuts where you have said 'Once a scab is formed, there is no longer an access to the blood stream'. I'd like to know how to identify if a cut has a scab on it or not. As far as I know, when there is a cut, it bleeds for a while, then clots. The clot on hardening forms a scab. So, scab formation is a continuous process. At what point can we say that there is no longer an access to the blood stream? Is it something like the scab has to be dark red/brown or black (also does it depend on the skin colour of the individual?) to be considered 'no longer an access to the blood stream'? Knowing this would greatly help in assessing risks due to cuts. One more question: Do dry lips (with skin peeling, but no bleeding) constitute an access to the bloodstream? Is it true that cuts on the lips heal faster than those on other parts of the skin? Thanks you for your time and knowledgeable responses.

Response from Mr. Kull

I'm sorry, but I don't recall writing that response (maybe it was Rick's?). I did say that it is highly unlikely that HIV would be transmitted through a scab, and I base that on epidemiological information combined with some general HIV transmission information. The level of detail in your question goes beyond my realm of knowledge. Maybe the details of your question would be more appropriate for a medical doctor.

The general thinking is that HIV is unlikely to be transmitted when coming into contact with a cut that isn't fresh. What that means EXACTLY in terms of time frame will be hard to determine because studies that examine this have not been funded, nor would they be given a priority. My understanding is that many, many people have sexual contact with some sort of hangnail, paper cut, or scratch of some sort and no cases have been reported to the CDC reflecting this mode of transmission.

If you have any doubts about the integrity of your skin during sexual contact, you could always avoid getting fluids on questionable areas of your skin or use some sort of barrier (latex) to protect that area (a condom for a finger, a latex glove, a dental dam, etc.). Assessing what stage a scab is in in order to determine what you are going to do sexually might be a fruitless endeavor.

Sorry I can't be more specific, but I hope this helps.

RMK



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