Table of ContentsView AllTable of ContentsAbout Cold SoresAbout Genital HerpesHSV-1 or HSV-2?SymptomsTreatmentComplicationsDiagnosisPrevention
Table of ContentsView All
View All
Table of Contents
About Cold Sores
About Genital Herpes
HSV-1 or HSV-2?
Symptoms
Treatment
Complications
Diagnosis
Prevention
The virus that causes cold sores—herpes simplex virus type 1 (HSV-1)—also can cause genital herpes cases. HSV-1 is contagious and can be passed orally and genitally, either from mouth to mouth, genitals to genitals, mouth to genitals, or genitals to mouth.
That means that you can get genital herpes if someone with a cold sore performs oral sex on you. And, that’s a concern given that nearly half of the U.S. population has HSV-1, according to the Centers for Disease Control and Prevention (CDC).
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.
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Key Facts
According to the CDC:
What Are Cold Sores?
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 asprodromalsymptoms.
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.
What Is Genital Herpes?
Overview of Herpes
Can HSV-1 Spread Genitally?
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. People assigned female at birth are more susceptible to contracting genital herpes and are twice as likely to have HSV-2 than people assigned male at birth.
Why You Should Tell Your Partner if You Have HSV-1
Although not nearly as common, it isalsopossible 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.
Who’s at Greater Risk for Herpes?
Symptoms of Oral and Genital Herpes
Both progress in similar ways:
Oral herpes tends to heal in four to six days.Genital herpes can take anywhere from one to three weeks to fully heal.
Can You Give Herpes to Yourself?In theory, if you touch your cold sore and then your genitals, you could possibly transmit the virus to your genitals (referred to as autoinoculation). Even so, this is considered uncommon.On the other hand, if you touch a herpes sore and then your eye, you can get an infection calledHSV keratitis. The infection usually heals without damaging the eye, but severe infections can lead to scarring and vision loss.
Can You Give Herpes to Yourself?
In theory, if you touch your cold sore and then your genitals, you could possibly transmit the virus to your genitals (referred to as autoinoculation). Even so, this is considered uncommon.On the other hand, if you touch a herpes sore and then your eye, you can get an infection calledHSV keratitis. The infection usually heals without damaging the eye, but severe infections can lead to scarring and vision loss.
In theory, if you touch your cold sore and then your genitals, you could possibly transmit the virus to your genitals (referred to as autoinoculation). Even so, this is considered uncommon.
On the other hand, if you touch a herpes sore and then your eye, you can get an infection calledHSV keratitis. The infection usually heals without damaging the eye, but severe infections can lead to scarring and vision loss.
How Is Genital Herpes Treated?
Genital herpes is treated withantiviral drugswhich don’t cure the disease but may reduce the severity or duration of the infection if started early (ideally within the first 24 hours of the appearance of symptoms).
There are three antivirals approved for the treatment of genital herpes:
If there are frequent recurrences, your healthcare provider may prescribe Zovirax, famciclovir, or Valtrex in a low dose to be taken once daily (a practice known as herpesprophylaxis). Doing so may significantly reduce the risk of repeated outbreaks while lowering your risk of passing the virus to others.
Possible Complications
For most people, genital herpes is a self-limiting infection that poses no long-term harm.
But for people withcompromised immune symptoms, such as those withadvanced untreated HIV, the virus can sometimes disseminate (spread) to other parts of the body, causing potentially life-threatening complications like:
Genital herpes also increases the risk of getting HIV. This is not only because the open ulcer allows HIV easier access into the body but also because the infection draws the very immune cells (calledCD4 T-cells) that HIV targets for infection.
How Herpes and HIV Are Linked
How Is Genital Herpes Diagnosed?
In most cases, genital herpes can be diagnosed based on the appearance of the characteristic lesions. If there is any doubt about the diagnosis, a swab of fluid from the sore can be sent to the lab for positive confirmation using a genetic test calledpolymerase chain reaction (PCR).
Where the tests may be useful is when there is a recurrence of genital herpes. Because HSV-1 is less likely to cause recur over the long term compared to HSV-2, the differentiation can help determine whether herpes prophylaxis is needed.
The blood test may also be useful in detecting if the person’s partner has herpes. If the partner is uninfected (or does not have the same type of herpes), the findings can support the case for starting herpes prophylaxis.
How to Prevent Genital Herpes
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.
What Is a Sexually Transmitted Infection?
Use a Condom
Anexternal condomthat goes on a penis will not completely eliminate the risk of spreading the herpes virus from a cold sore to another person’s genitals. Neither will aninternal condomplaced into an anus or vagina. But they will provide some protection when used correctly.
The Best Condoms for 2024, According to Experts
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 a 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:
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.
Progress in Developing a Herpes Vaccine
Summary
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Herpes simplex virus (HSV).Centers for Disease Control and Prevention.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.Centers for Disease Control and Prevention.Genital herpes.Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.Mount Sinai.Herpes simplex.MedlinePlus.Genital herpes.Gilbert M, Li X, Petric M, et al.Using centralized laboratory data to monitor trends in herpes simplex virus type 1 and 2 infection in British Columbia and the changing etiology of genital herpes.Can J Public Health. 2011;102(3):225-229. doi:10.1007/bf03404902Planned Parenthood.Oral & genital herpes.Tronstein E.Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.JAMA. 2011;305(14):1441. doi:10.1001/jama.2011.420MedlinePlus.Herpes - oral.Uysal M, Arslan M, Bolat A, Balamtekin N.An adolescent patient with perianal herpes as a finding of child abuse: case report.J Clin Images Med Case Rep. 2021;2:1044. doi:10.52768/2766-7820/1044Rosołowski M, Kierzkiewicz M.Etiology, diagnosis and treatment of infectious esophagitis.Prz Gastroenterol. 2013;8(6):333-7. doi:10.5114/pg.2013.39914Srinivasan D, Kaul CM, Buttar AB, Nottingham FI, Greene JB.Disseminated herpes simplex virus-2 (HSV-2) as a cause of viral hepatitis in an immunocompetent host.Am J Case Rep.2021;22:e932474-1–e932474-6. doi:10.12659/AJCR.932474Bougioukas L, Psoinos RBC, Jones DC, Morris EA, Hale AJ.Disseminated herpes simplex virus 2 as a complication of pregnancy.IDCases.2021;24:e01107. doi:10.1016/j.idcr.2021.e01107U.S. Food and Drug Administration.Is it really ‘FDA approved’?Mayo Clinic.Genital herpes.MedlinePlus.Herpes HSV test.Additional ReadingLafferty WE, Coombs RW, Benedetti J, Critchlow C, Corey L.Recurrences after oral and genital herpes simplex virus infection. Influence of site of infection and viral type.N Engl J Med. 1987;316(23):1444-1449. doi:10.1056/NEJM198706043162304.Ryder N, Jin F, McNulty AM, Grulich AE, Donovan B.Increasing role of herpes simplex virus type 1 in first-episode anogenital herpes in heterosexual women and younger men who have sex with men, 1992-2006.Sex Transm Infect. 2009;85(6):416-419. doi:10.1136/sti.2008.033902
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Herpes simplex virus (HSV).Centers for Disease Control and Prevention.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.Centers for Disease Control and Prevention.Genital herpes.Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.Mount Sinai.Herpes simplex.MedlinePlus.Genital herpes.Gilbert M, Li X, Petric M, et al.Using centralized laboratory data to monitor trends in herpes simplex virus type 1 and 2 infection in British Columbia and the changing etiology of genital herpes.Can J Public Health. 2011;102(3):225-229. doi:10.1007/bf03404902Planned Parenthood.Oral & genital herpes.Tronstein E.Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.JAMA. 2011;305(14):1441. doi:10.1001/jama.2011.420MedlinePlus.Herpes - oral.Uysal M, Arslan M, Bolat A, Balamtekin N.An adolescent patient with perianal herpes as a finding of child abuse: case report.J Clin Images Med Case Rep. 2021;2:1044. doi:10.52768/2766-7820/1044Rosołowski M, Kierzkiewicz M.Etiology, diagnosis and treatment of infectious esophagitis.Prz Gastroenterol. 2013;8(6):333-7. doi:10.5114/pg.2013.39914Srinivasan D, Kaul CM, Buttar AB, Nottingham FI, Greene JB.Disseminated herpes simplex virus-2 (HSV-2) as a cause of viral hepatitis in an immunocompetent host.Am J Case Rep.2021;22:e932474-1–e932474-6. doi:10.12659/AJCR.932474Bougioukas L, Psoinos RBC, Jones DC, Morris EA, Hale AJ.Disseminated herpes simplex virus 2 as a complication of pregnancy.IDCases.2021;24:e01107. doi:10.1016/j.idcr.2021.e01107U.S. Food and Drug Administration.Is it really ‘FDA approved’?Mayo Clinic.Genital herpes.MedlinePlus.Herpes HSV test.Additional ReadingLafferty WE, Coombs RW, Benedetti J, Critchlow C, Corey L.Recurrences after oral and genital herpes simplex virus infection. Influence of site of infection and viral type.N Engl J Med. 1987;316(23):1444-1449. doi:10.1056/NEJM198706043162304.Ryder N, Jin F, McNulty AM, Grulich AE, Donovan B.Increasing role of herpes simplex virus type 1 in first-episode anogenital herpes in heterosexual women and younger men who have sex with men, 1992-2006.Sex Transm Infect. 2009;85(6):416-419. doi:10.1136/sti.2008.033902
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic.Herpes simplex virus (HSV).Centers for Disease Control and Prevention.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.Centers for Disease Control and Prevention.Genital herpes.Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.Mount Sinai.Herpes simplex.MedlinePlus.Genital herpes.Gilbert M, Li X, Petric M, et al.Using centralized laboratory data to monitor trends in herpes simplex virus type 1 and 2 infection in British Columbia and the changing etiology of genital herpes.Can J Public Health. 2011;102(3):225-229. doi:10.1007/bf03404902Planned Parenthood.Oral & genital herpes.Tronstein E.Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.JAMA. 2011;305(14):1441. doi:10.1001/jama.2011.420MedlinePlus.Herpes - oral.Uysal M, Arslan M, Bolat A, Balamtekin N.An adolescent patient with perianal herpes as a finding of child abuse: case report.J Clin Images Med Case Rep. 2021;2:1044. doi:10.52768/2766-7820/1044Rosołowski M, Kierzkiewicz M.Etiology, diagnosis and treatment of infectious esophagitis.Prz Gastroenterol. 2013;8(6):333-7. doi:10.5114/pg.2013.39914Srinivasan D, Kaul CM, Buttar AB, Nottingham FI, Greene JB.Disseminated herpes simplex virus-2 (HSV-2) as a cause of viral hepatitis in an immunocompetent host.Am J Case Rep.2021;22:e932474-1–e932474-6. doi:10.12659/AJCR.932474Bougioukas L, Psoinos RBC, Jones DC, Morris EA, Hale AJ.Disseminated herpes simplex virus 2 as a complication of pregnancy.IDCases.2021;24:e01107. doi:10.1016/j.idcr.2021.e01107U.S. Food and Drug Administration.Is it really ‘FDA approved’?Mayo Clinic.Genital herpes.MedlinePlus.Herpes HSV test.
Cleveland Clinic.Herpes simplex virus (HSV).
Centers for Disease Control and Prevention.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.
Centers for Disease Control and Prevention.Genital herpes.
Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.
Mount Sinai.Herpes simplex.
MedlinePlus.Genital herpes.
Gilbert M, Li X, Petric M, et al.Using centralized laboratory data to monitor trends in herpes simplex virus type 1 and 2 infection in British Columbia and the changing etiology of genital herpes.Can J Public Health. 2011;102(3):225-229. doi:10.1007/bf03404902
Planned Parenthood.Oral & genital herpes.
Tronstein E.Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.JAMA. 2011;305(14):1441. doi:10.1001/jama.2011.420
MedlinePlus.Herpes - oral.
Uysal M, Arslan M, Bolat A, Balamtekin N.An adolescent patient with perianal herpes as a finding of child abuse: case report.J Clin Images Med Case Rep. 2021;2:1044. doi:10.52768/2766-7820/1044
Rosołowski M, Kierzkiewicz M.Etiology, diagnosis and treatment of infectious esophagitis.Prz Gastroenterol. 2013;8(6):333-7. doi:10.5114/pg.2013.39914
Srinivasan D, Kaul CM, Buttar AB, Nottingham FI, Greene JB.Disseminated herpes simplex virus-2 (HSV-2) as a cause of viral hepatitis in an immunocompetent host.Am J Case Rep.2021;22:e932474-1–e932474-6. doi:10.12659/AJCR.932474
Bougioukas L, Psoinos RBC, Jones DC, Morris EA, Hale AJ.Disseminated herpes simplex virus 2 as a complication of pregnancy.IDCases.2021;24:e01107. doi:10.1016/j.idcr.2021.e01107
U.S. Food and Drug Administration.Is it really ‘FDA approved’?
Mayo Clinic.Genital herpes.
MedlinePlus.Herpes HSV test.
Lafferty WE, Coombs RW, Benedetti J, Critchlow C, Corey L.Recurrences after oral and genital herpes simplex virus infection. Influence of site of infection and viral type.N Engl J Med. 1987;316(23):1444-1449. doi:10.1056/NEJM198706043162304.Ryder N, Jin F, McNulty AM, Grulich AE, Donovan B.Increasing role of herpes simplex virus type 1 in first-episode anogenital herpes in heterosexual women and younger men who have sex with men, 1992-2006.Sex Transm Infect. 2009;85(6):416-419. doi:10.1136/sti.2008.033902
Lafferty WE, Coombs RW, Benedetti J, Critchlow C, Corey L.Recurrences after oral and genital herpes simplex virus infection. Influence of site of infection and viral type.N Engl J Med. 1987;316(23):1444-1449. doi:10.1056/NEJM198706043162304.
Ryder N, Jin F, McNulty AM, Grulich AE, Donovan B.Increasing role of herpes simplex virus type 1 in first-episode anogenital herpes in heterosexual women and younger men who have sex with men, 1992-2006.Sex Transm Infect. 2009;85(6):416-419. doi:10.1136/sti.2008.033902
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