That means that you can get genital herpes if someone with a cold sore performs oral sex on you.
This article explains how you can get genital herpes from a cold sore and vice versa. It also details how herpes can spread through oral sex and offers tips to prevent herpes transmission.
Cold Sores and Genital Herpes
A cold sore (herpes labialis) is a cluster of tiny fluid-filled blisters that usually form on one side of the lips. Most people can tell when a cold sore is coming on: The area will feel tingly or itchy just before the lesion pops up. These sensations are known as prodromal symptoms.
Cold sores break open easily. When they do, the clear fluid inside oozes out and the blister forms a crust. Most blisters go away after a week or two.
Genital herpes (herpes genitalis) lesions are clusters of blisters that may be preceded by pain or tingling. Lesions can form on or inside the vagina of females, on the penis or scrotum of males, and around the anus, thighs, or buttocks of people of either sex.
The Herpes Virus
Cold sores and genital herpes are both caused by a herpes simplex virus. Most cold sores are caused by herpes simplex 1 (HSV-1), while genital herpes is most often caused by herpes simplex 2 (HSV-2).
It is well established that HSV-1 is far more prevalent than HSV-2 (47.8% versus 11.9% respectively), and it is not uncommon for children to have cold sores.
Genital herpes is diagnosed in adults, or adolescents, who are sexually active through direct contact with the genitals. Women are more susceptible to contracting genital herpes and are twice as likely to have HSV-2 than men.
However, sometimes genital herpes infections can be caused by HSV-1. This infection on the lips of one person can spread to the genitals of another person during oral sex, causing an HSV-1 infection.
In fact, some scientists estimate that more than half of new genital herpes infections are caused by HSV-1 rather than HSV-2.
Although not nearly as common, it is also possible for a genital HSV-2 infection to be transmitted to a person’s mouth—in other words, you could develop a cold sore if you perform oral sex on someone with genital herpes.
It’s important to be aware that both cold sores and genital herpes can be transmitted from one person to another even when there are no obvious lesions. This is known as asymptomatic shedding.
Prevention and Management
The same measures that help prevent a herpes infection during genital-to-genital contact can help prevent infection of the genitals from a cold sore, including the following:
Abstain
If your partner has a cold sore, the only way to guarantee you won’t get infected is to avoid oral sex until the lesion has cleared up completely.
Someone with a cold sore can pass herpes to you, which means you can pass it back to them. Prevention is key, so it’s best not to kiss or share a toothbrush, coffee cup, water bottle, or eating utensils.
Use a Condom
Neither a male condom nor a female condom will completely eliminate the risk of spreading the herpes virus from a cold sore to another person’s genitals. But it will provide some protection when used correctly.
Make sure the condom you use is approved by the Food and Drug Administration (FDA) for protection against sexually transmitted infections (STIs).
Medication
Antiviral drugs such as Valtrex (valacyclovir) and Zovirax (acyclovir) help prevent the virus from reproducing and shedding. This lowers the risk that your partner can pass herpes on to you.
These medications also help reduce the frequency of outbreaks.
Get Tested
Herpes testing isn’t a standard part of sexual health care. However, if you believe you’ve been exposed to herpes and want to know what your status is, ask your healthcare provider for a test.
You may also want to be tested if you’re at risk for a herpes infection. You could be if you:
Do not use a condom (or use it improperly)Have a partner with human immunodeficiency virus (HIV) and/or another STI since having HSV-2 increases your risk of becoming infected with other STIsHave had sex with someone who has herpesHave lesions that look like herpes on any part of your bodyHave multiple sex partners
Testing may involve swabbing fluid and cells from a lesion or taking a sample of blood from a vein. Both types of samples are then tested for the virus in a lab.
Some blood tests are designed to identify specific types of herpes virus, but they are not 100% accurate.
Summary
Cold sores and genital herpes are both caused by herpes viruses. Cold sores most often are associated with HSV-1 while genital herpes is associated with HSV-2. However, HSV-1 can be transmitted from one person’s mouth to another person’s genitals during oral sex. Prevention steps include abstaining from oral sex, using condoms, and taking medication to suppress the herpes virus.
One study tracked couples where only one partner had herpes and found that 10% of non-infected partners became infected in a year. Of those, 70% of cases occurred when there was no obvious outbreak.
