Can you get genital herpes if you have oral herpes

Oral herpes is an infection typically caused by herpes simplex virus type 1 (HSV-1). Commonly referred to as “cold sores” and “fever blisters,” symptoms of oral herpes most commonly appear on or around the lips. Oral herpes is not always limited to this area, though. For some, symptoms may appear between the upper lip, on or inside the nose, or on the chin or cheek. In these instances, herpes is referred to as oral-facial herpes. You have most likely seen someone experiencing an oral herpes outbreak before.

How does someone get oral herpes?

Oral herpes is transmitted through direct contact between the contagious area and broken skin (a cut or break) and mucous membrane tissue (such as the mouth or genitals). In other words, HSV can be passed on through kissing or oral sex.

Herpes can also be transmitted when there are no symptoms present. There are several days throughout the year when the virus reactivates yet causes no symptoms (called asymptomatic shedding, viral shedding, or asymptomatic reactivation).

If a person is experiencing symptoms orally, we recommend abstaining from performing oral sex and kissing others directly on the mouth until signs have healed and the skin looks normal again. Because most adults have oral herpes, we don’t suggest that a person should stop giving or receiving affection altogether between outbreaks (when there are no signs or symptoms) simply because they have oral herpes. However, using a barrier (such as a dental dam) or condom when performing oral sex (even though there are no symptoms present around the mouth) can reduce the risk of contracting genital herpes.

By performing oral sex on someone who has genital herpes, it would be possible to contract oral herpes – but this is rare. Most cases of genital herpes are caused by HSV-2, which rarely affects the mouth or face. Also, and even more importantly, most adults already have oral HSV-1, contracted as a child through kissing relatives or friends.

The First episode

A primary infection with oral herpes can be similar to a first episode of genital herpes in that symptoms can be more severe. During the first episode, classic lesions tend to form as small fluid-filled blisters that can appear as a single blister or in a cluster. Sores may also appear inside the mouth or on the back of the throat, and the lymph nodes in the neck may swell.

Like genital herpes, though, symptoms of oral herpes can be very mild and go unnoticed. Subtle symptoms can be easily mistaken for another infection or condition such as a small crack or cut in the skin, chapped lips, bug bite, or a pimple, to name a few examples.

Recurrences

At least a quarter of people with oral herpes experience recurrences. Again, as with the first episode, symptoms vary from person to person. Lesions may appear as either a blister or a cluster of blisters or sores. It is possible that a recurrence will involve only the subtle symptoms described above.

Signs and symptoms of a recurrent episode (when they occur) tend to last about 8 – 10 days on average. Blister- or sore-like lesions will usually crust over during the healing phase.

If a person had fairly mild symptoms in their first episode, then recurrences will likely also tend to be mild. The number of recurrences varies from person to person and tends to decrease over time. Exposure to sunlight’s ultraviolet rays may trigger a recurrence.

Many people will experience a “prodrome” or warning symptom prior to developing an outbreak. As you may recall from the section on genital herpes, a “prodrome” is an itching, tingling, or painful sensation in the area where their recurrent lesions will develop. The prodrome often precedes lesions by a day or two. During this time, it is best to assume virus is active (and, therefore, can be spread through close contact).

The virus that causes cold sores—herpes simplex virus type 1 (HSV-1)—also causes a third a 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.

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.

Recap

Cold sores and genital herpes are highly contagious infections caused by one of two herpes simplex viruses: HSV-1 and HSV-2. HSV-1 primarily causes cold sores; HSV-2 primarily causes genital herpes. However, both types of viruses can infect the genitals or lips and can be transmitted via oral sex.

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 STIs
• Have had sex with someone who has herpes
• Have lesions that look like herpes on any part of your body
• Have 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.

Frequently Asked Questions

• Can a cold sore be passed to the genital area?

  Yes, oral herpes can cause genital herpes. In fact, roughly one-third of genital herpes cases are caused by the virus that causes cold sores.
  

• Can I get genital herpes from my own cold sore?

  Yes, in theory. If you touched your cold sore and then your genitals, you can develop herpes sores in your private parts. If you have a cold sore, be sure to wash your hands frequently—especially before touching your genitals.

• Can I get oral herpes from giving oral sex?

  Yes, if you perform oral sex on someone who has an active herpes outbreak, you can develop cold sores (herpes lesions) in and around your mouth.

• What are the chances of getting herpes from infected partner?

  The chances of catching herpes from an infected partner vary. An uninfected woman is more likely to become infected by their partner than an uninfected man.

  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.