Herpes. When most of us hear the word “herpes” used, we think of the ones “down there”—AKA genital herpes (not to be confused with genital warts.)
Herpes simplex 1 (HSV-1) and herpes simplex 2 (HSV-2), can cause a genital herpes infection. These viruses are closely related but not identical.
First off, you should know that genital herpes is not the only kind of herpes people don’t want to get. There are multiple different viruses linked to herpes. For instance, both chicken pox and shingles are caused by a type of herpes strain (herpes zoster, to be exact.) Other strains cause conditions like Kaposi’s sarcoma, Epstein-Barr virus, etc.
All of that to say, if you have a strain of herpes in your body, it does not necessarily mean that you only have one “bad” or “less bad” type of infection. You don’t want any of them, but they’re all different or flare up in different ways.
Repeat after me, “Not all herpes viruses are created equal.” Having chicken pox does not mean you’re going to get genital herpes, or vice versa.
Both HSV-1 and HSV-2 can cause genital herpes.
However, it is possible to contract a genital HSV-1 infection through oral sex but is not the same as an HSV-2 infection. You just have HSV-1 down there.
In contrast, HSV-2 is almost always transmitted through vaginal or anal sex. It’s very rare for HSV-2 to spread to the mouth and lips.
There’s been a lot of debate over the years about what causes herpetic lesions to flare up. Some of the ones that most of us in the medical and dental fields agree on are:
Any time someone has an active sore that is shedding the virus, it can spread herpes. You want zero contact with those sores, regardless of whether they’re on your mouth or the nether regions. Zero. Because if you come into contact with them, you’re basically exposing yourself to a live virus on mucosal tissue, which means your body can quickly absorb it and cause a flare-up of your own.
Unlike the occasional oral cold sores, HSV-2 or genital herpes can also be spread through skin to skin or sexual contact even if there isn’t an open sore. That’s why things like safe sex practices, fewer partners, and abstinence can help you avoid getting sexually transmitted diseases (STDs.)
If you’ve never had a cold sore and you kiss someone with one, you’re probably going to get a cold sore at some point in the future. Which is why you also don’t want to, ahem, be intimate with someone who has a flare-up of the other strain of herpes either.
Keep in mind that one of the other exposed areas on your body with mucosal tissues are your eyes, and a herpes eye infection could wind up costing you your eyesight. In the days before dentistry, we even saw a form of herpes called a “herpetic whitlow” which would form on dental practitioners’ hands. There’s also a strain that can infect newborn babies during childbirth, so you should always talk to your doctor if you think you could be a carrier for HSV-2 or frequently experience outbreaks.
All of that to say, regardless of the type of active herpes blister you may or may not have, it’s a virus that will spread. HSV-1 vs. HSV-2 is really not important at this point. Your body will contract herpes from cold sore lesions—assuming you don’t already have it—when you come into contact with one through something like kissing or being intimate.
According to the CDC, yes, you can potentially get genital herpes if you were exposed to a cold sore through something like oral sex. It’s also thought that it can spread through saliva and other bodily secretions. The CDC advises complete avoidance of any “down there” intimacy if you or your partner is experiencing symptoms of a herpes outbreak. Using protection does not necessarily rule out the risk of contracting the virus; you can still infect one another.
The good news is that herpes like HSV-1 vs HSV-2 isn’t so contagious that it’s going to spread by touching surfaces, sitting on a public toilet, or swimming in a pool with a bunch of random strangers.
I know. Nobody wants to ask their doctor or dentist about something like genital herpes. Or especially a cold sore if you think it’s from genital herpes.
Cold sores are not usually looked at as an STD, so you don’t have to worry about your dentist or hygienist “judging you.” However, they do not want you to come in for an appointment if you have a cold sore. At all. If your cold sore is flaring up, rescheduling your appointment ASAP. In fact it’s one of the only times when your dental office wants you to call and cancel. Tell them you have a cold sore, and you’re instantly off the hook.
If you tend to get cold sores often, definitely talk to your dentist. They can prescribe you an antiviral medication to help with flare ups. Some dentists even offer laser therapy where they can treat the area of your lip once you feel the tingling-sensation that a fever blister is coming on (before it actually flares up.)
Of course, your dentist can’t help you with those other blisters or sores, so talk to your primary care physician, gynecologist, or visit a local health clinic that offers sexual health services. You will not be the first one to tell them you need to get tested or need medication. I promise. Approximately 1-in-6 adults have genital herpes from HSV-2, while almost half have HSV-1, the one that causes cold sores.
If you have an outbreak of genital herpes or a cold sore on your mouth, you’re contagious. The same goes for your partner. While the two conditions are usually caused by different strains of herpesviruses (HSV-1 vs. HSV-2) that does not necessarily mean you can or cannot get genital herpes from a cold sore. It’s safer just to assume that you can, and take a break for any of that hanky-panky stuff until everybody is in the all-clear.
Make your inbox smile!