Are Cold Sores Contagious? 7 Oral Herpes Questions, Answered

LONDON, ENGLAND - SEPTEMBER 14: (EDITORS NOTE: Image has been retouched) A model backstage during the Xiao Li show during London Fashion Week Spring Summer 2015 at on September 14, 2014 in London, England. (Photo by Miles Willis/Getty Images)
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We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. This week’s topic: just how contagious oral herpes or cold sores are.

Q: I just started seeing this guy a few weeks ago, and last time I saw him he had what seemed very much like what I can only assume is a cold sore on his lip. It’s weird that he didn’t tell me he had it, maybe it’s because he doesn’t think it’s a big deal? But if he kisses me, I can get it too, right? What about sharing drinks? And what if he goes down on me? If I already caught oral herpes from him does that mean I can get herpes on my vagina? If I get it, what will it be like for me?

A: There are many myths and misunderstandings about cold sores. And once you learn that they are technically oral herpes, a ton of stigma usually rears its head as well (because the word “herpes”). However, this virus is so prevalent that nearly everyone has the herpes simplex virus by the end of their lives. So it’s good to know what life is like with it, because chances are you already have it — and if you don’t yet, you’re likely to get it. Spoiler alert: It’s really not a big deal for most people.

1. What Is Oral Herpes?

Herpes is the symptoms caused by the herpes simplex virus, or HSV. This incurable virus affects your nerves and is in the same family as the chicken pox, shingles, and mononucleosis (mono). Luckily, it’s mostly dormant, only showing itself every once and a while.

There are two types of HSV infections: HSV-2 is most likely to be found around your special parts, causing genital herpes blisters; and HSV-1 is most likely found around your mouth, and is most often called cold sores or fever blisters. However, each can be found in the other location. (More on that in a minute.)

2. How Do You Get It?

HSV-1 is transmitted through contact with the skin or saliva of someone who has it. While it’s most contagious when there are actually cold sores present, it can be transmitted between blisterings, or even if the person doesn’t know they have it. You can get infected with HSV-1 through kissing or giving oral sex, but also through things like sharing drinks, toothbrushes, utensils, or towels. So basically, it’s really easy to get.  

3. What's It Like To Have It?

Most people who are infected with HSV-1 don’t know it, because they never experience symptoms. However, if you’re someone who is symptomatic, every once and a while you’ll get small fluid-filled blisters on your lips, tongue, and gums. These usually take around two to four weeks to go away. Outbreaks are often preceded by tingling, burning, itching, or painful feelings in the affected areas for about a day. The first time you have an outbreak is by far the worst and can also include a fever.

4. What Triggers Them?

Herpes sores can be triggered by changes in your health, such as an infection, fever, or any shifts in your immune system. They also are more likely to crop up at certain times in your menstrual cycle — this is due both to the changes in your hormones and stress, which is one of the overall most common triggers. Being overly tired is also a culprit, as is sun exposure (good to know for these summer months!).

5. How Can I Prevent Them?

Unfortunately, once you have the herpes virus in your system, it’s with you for life. The good news is that most of the time you won’t have any symptoms (if you have any ever). The better news is that there are a number of things you can do to manage the sores when they arise, and even to minimize them.

Over-the-Counter Medication

There are a number of ointments available over the counter that can shorten the length of an outbreak, and you can also get creams to minimize any pain you may be feeling when you get a blister.

Alternative Medicine

There’s less research on these, but many people swear by some alternative medicine options. These include the amino acid lysine, propolis (a synthetic beeswax), and a cream of rhubarb and sage (which sounds kind of like a great savory dish, am I right?). Vitamin C, bioflavonoids, and zinc can shorten the healing process, and Vitamin E can minimize nerve pain (remember that cold sores are actually a nerve infection).

SPF Chapstick

One of the triggers for recurrence is sun exposure, so rock that chapstick — and make sure it has sunscreen in it.

Stress Reduction

Another of the major triggers for recurrence is stress. This can be daily life stress, a particular stressy incident, or (in a cruel feedback loop) the stress of worrying about having herpes. This means that it’s important to zen the f**k out — it’s for your health! Do whatever you do to chill out, whether it be meditation, exercise, Netflix ... you know you best. Also, some research shows that B vitamins can counteract stress.

Diet

When you’re actually experiencing an oral herpes outbreak, it’s a good idea to eat foods with high nutrition value (basically treat yourself well, like you would with any other illness). But there are some foods you can eat regularly to stave off an outbreak. Some research shows that it’s good to eat foods rich in the amino acid lysine (these include fish, chicken, beef, lamb, milk, cheese, and basically all fruits and vegetables except for peas) and avoid those rich in arginine (chocolate, coconut, flour, whole wheat, and nuts). In particular, clinical studies have found that indole-3-carbinol can interfere with the way HSV-1 replicatesThis can be found in broccoli, cabbage, brussels sprouts, collards, cauliflower, kale, mustard greens, and turnips — so eat your greens!

Prescription Medication

If none of these lower-impact methods are working for you, there are some more intense prescription medications like Valtrex you can take to hustle along the healing process when you do end up with a sore. These can come in the form of creams or pills, and in intense cases, injections. If you’re experiencing an extreme bout of sores, talk to your doctor about getting one of these solutions.

6. How Can I Make Sure I Don’t Spread It?

Not spreading your HSV-1 to other people is pretty hard, unless you’re bubble boy. However, if you’re someone who gets cold sores (as in, you’re symptomatic), you can avoid touching other people with your lips when you have a blister, or when you feel one coming on. You can also avoid sharing drinks or other things that go in or on your mouth during this time. Finally, it’s a good idea to clean your hands more frequently when you have a sore, because if you touch your mouth and then touch someone else, you can spread the infection.

7. Can I Get Genital Herpes From Oral Herpes?

Unfortunately, having HSV-1 doesn’t protect you from getting HSV-2, and vice versa. While HSV-1 likes mouths better and HSV-2 prefers your sexy bits, these viruses are equal opportunists and can set up shop in either area. Similarly, having one of these outbreaks in one part of your body doesn’t stop you from getting infected in another part of your body. If you’re going down on someone who has HSV-1 or HSV-2, your mouth area can become infected with the virus. If the mouth licking you has oral herpes, that can transfer to your genital region. You can also infect yourself, if you touch your mouth and then your genitals or vice versa.

However, it’s not all that common to be infected with both versions of the virus — it’s estimated that only 10 percent of adults in the United States have both. Researchers think that’s because being infected with HSV-1 can offer partial immunity to catching HSV-2. The good news is that if you have HSV-1 and you become infected with HSV-2, you’re less likely to have an intense outbreak.

The Bottom Line

Both types of herpes are extremely stigmatized in our society (genital herpes way more so, because of it likes to hang out) but at their core, they’re annoying skin disorders that only show up every once and a while if you experience symptoms at all. I would say that from a public health perspective, it’s always a good idea to try to not spread disease, but from a mental health perspective, please don’t freak out about this! Chances are you’re going to end up with HSV-1 in your system at some point in your life, and even if you’re someone who gets bad symptoms, it will mess up your life only every once and a while at the absolute worst. So seriously, don’t stress about this (because remember — stress triggers outbreaks!).

Images: Getty, Giphy

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