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Cold Sores And Oral Sex: What You Need To Know

by MARIA DEL RUSSO

If you’re someone who deals with cold sores on a regular basis, you don’t need us to tell you how pesky they can be. But if you’re in a relationship — be it long-term, short-term, or just for one night — cold sores can do more than just make you want to reach for extra concealer. They can also impede your sex life, especially when it comes to oral sex. 

But can receiving oral sex from a partner with a cold sore cause you to contract herpes? Let’s take a look at the risk factors. 

HSV-1 vs. HSV-2

According to Dr. Michael Reitano, MD, physician in residence at Ro, there isn’t all that much of a difference between cold sores and genital herpes. Both can be caused by both Herpes Simplex Virus 1 (HSV-1) or Herpes Simplex Virus 2 (HSV-2). “HSV-1 tends to be a little bit more accustomed to infecting and thriving in the oral region, while HSV-2 is a little more accustomed to infecting the genital area,” Dr. Reitano says. 

In other words, more people are first contracting genital herpes via the HSV-1 virus. But those who have HSV-1 don’t tend to see the virus recur on their genitals. 

The Oral Sex Connection

The reason for this is pretty simple, according to Dr. Reitano. “Most young people acquire HSV-1 on their genitals when they’re engaging in intimate contact with other young adults,” he says. In fact, the CDC found that some teens use oral sex to put off or delay penetrative sex. (1) So if a teen or young adult is already a cold sore sufferer, they can transmit the HSV-1 virus to their partner without even realizing it. 

And, according to Dr. Reitano, they can transmit that infection even when they don’t have an active breakout. Studies have shown that the virus reactivates more frequently than previously understood, and that it can shed and transmit even when you don’t have symptoms. (2) That’s right — you can transmit both HSV-1 and HSV-2 even when you aren’t having an active outbreak.

Interestingly, while it’s more common to get genital herpes from a cold sore when receiving oral sex, it’s difficult to contract oral herpes from genital herpes when performing oral sex. That’s because the majority of recurring cases of genital herpes are caused by HSV-2, which rarely affects the mouth or the face. (3) 

Preventing Transmission

Firstly, it’s important to remember that most adults already have oral HSV-1 and have been exposed to the virus as a child through kissing relatives or friends. They might just not have symptoms. 

If you are having an outbreak, it’s a good idea to abstain from oral sex, as well as kissing or other types of touching. HSV-1 and HSV-2 are highly contagious, so even the slightest touch during an outbreak can cause the virus to spread. “Between outbreaks, barriers like dental dams and condoms can be useful in preventing transmission,” Dr. Reitano says. He also suggests talking to your doctor about prescription medication to treat both oral and genital herpes and blunt the frequency of transmission.

Regardless of how you choose to prevent HSV-1 and HSV-2, remember that it’s more common than you think. “About 80 percent of adults suffer from one of these viruses,” Dr. Reitano says. It may feel alienating, but you’re absolutely not alone — and there are ways to manage both oral and genital herpes. 

REFERENCES

  1. When Do US Youths Start Oral Sex, Intercouse? WebMD. Accessed September 20, 2019. View resource
  2. Current Concepts for Genital Herpes Simple Diagnostics and Pathogenesis of Genital Tract Shedding. American Society of Microbiology. Accessed September 20, 2019. View resource
  3. Oral Herpes. American Sexual Health Association. Accessed September 20, 2019. View resource