Ever worry about catching a cold sore by kissing someone? You’re not alone. Chances are, you’ve likely heard about a friend who’s gotten one this way. And while it is possible to get the viral infection from kissing someone who already has it, here’s the truth: there are a number of ways you can actually get a cold sore. Here, discover what you need to know about how cold sores can be spread.
- What Causes Cold Sores?
- Herpes From Kissing: & Other Weird Middle School Myths
- Can You Get Herpes From Kissing?
- Common Oral Herpes Symptoms
- The Short Answer: again, yes.
- Secure and ConfidentialSTD testing services
- So Why Care?
- Can You Get Herpes From Sharing Drinks?
- Can You Get Herpes From The Toilet Seat?
- Common Genital Herpes Symptoms
- How Common are Genital Herpes Anyways?
- Congratulations, You Passed Middle School Sex Ed!
- What Should You Do?
- How Contagious Are Cold Sores?
- How to Avoid Spreading Cold Sores
- Herpes Simplex Virus Infection
- What is herpes?
- Herpes is a common infection.
- What’s the difference between genital herpes and oral herpes?
- How do you get herpes?
- Cold Sores
- Mayo Clinic Q and A: Direct Contact With Cold Sore Could Spread Virus
- Cold Sores (HSV-1)
- What Are Cold Sores?
- What Are the Signs & Symptoms of Cold Sores?
- How Do People Get Cold Sores?
- How Are Cold Sores Treated?
- When Should I Call the Doctor?
- Can Cold Sores Be Prevented?
- What you need to know about canker sores
- Treating canker sores: Use salt water
- How are cold sores different?
- How to soothe a cold sore
- Related posts:
What Causes Cold Sores?
Truth: You can get a cold sore by kissing.
The rumor is true: Kissing someone with a cold sore can transfer the virus that causes it (called herpes simplex virus or HSV-1) from them to you. “One of the most common ways the virus is spread is through kissing, because the virus frequently occurs around the mouth and the lips,” said Joshua Zeichner, MD, a New York City-based dermatologist. Even if you don’t see the sores, the virus can still be contagious. But you should be especially cautious about kissing someone who has active blisters, because that’s when the virus spreads most easily.
If you’re currently dealing with a cold sore, you’ll want to get rid of it — fast. When you have a cold sore, it may be all you can think about, and it might even stop you from hanging out with people. Thankfully, with medicine like Abreva Cream, you can get rid of your cold sore in two-and-half days1. And Abreva Cream starts to work immediately, based on laboratory studies (use as directed at the first sign of a cold sore).
Truth: You can get a cold sore by sharing utensils.
Sharing isn’t always caring, especially when it comes to silverware. Make it a general rule to always use your own fork, spoon, and knife. Why? “In some cases, cold sores may be spread through fomites, which are inanimate objects, like utensils, that directly touch the infected skin and may carry the virus,” said Dr. Zeichner. So if you have a friend over and can’t remember whether a fork is yours or theirs, it doesn’t hurt to grab a new one.
RELATED: Here’s How to Avoid Cold Sores
Truth: You can get a cold sore by borrowing beauty products.
Think twice before you ask to borrow your friend’s lipstick or a buddy’s lip balm — or before you lend out your own. According to the World Health Organization, the virus can be transferred via saliva, which may be present on something like lip balm. So make your lip balm off limits; it’s completely normal to not share a toothbrush with friends, so consider getting into the same habit with lip balm or lipstick, which falls into a similar category, according to the Mayo Clinic. Another pro tip? “If you use a lipstick when you have a cold sore, you should discard it afterwards,” said Dr. Zeichner.
Whether or not you have a cold sore, the bad news first: “Unfortunately, once you have been infected by the cold sore virus, your body cannot fully clear it,” said Dr. Zeichner. Thus, cold sores can’t be “cured.” But with a product like Abreva Cream, you can heal cold sores and get rid of them in 2.5 days, when used at the first sign2.
1When used at the first sign, median healing time of 4.1 days. 25% of users healed in 2.5 days.
2When used at the first sign, median healing time of 4.1 days. 25% of users healed in 2.5 days.
Herpes From Kissing: & Other Weird Middle School Myths
You all remember that one kid in middle school? You know, the one that seemed like he just owned a bunch of cargo shorts and no regular pants. He didn’t necessarily know what STDs were, but the only “bad” sexual word that he knew was herpes. So he really liked talking about it. Like, a lot. Herpes can be SO fun to randomly whisper in the middle of a silent classroom… When you’re a twelve-year-old boy.
This kid wasn’t really your friend per-say, but he would always find you in the hall and tell you these weird sex tidbits: Your substitute teacher with the mustache was a porn star back in the day, the head cheerleader got pregnant from giving a blow job, that one guy gave a major hickey to that one girl and you can like totally see it all over her neck.
You know, regular ol’ kid stuff.
Remember when kids used to run up to you in the cafeteria and ask if you, “liked your biscuit buttered,” or they would pinch your arm to “see what your sex noise sounded like.” Sometimes you’d be asked, “do the curtains match the drapes?” or you’d be prompted to “smell my finger” from some dumb kid who had probably just put his finger in his armpits to trick all the other 6th graders who were none the wiser.
There’s always that instant flush of shame when you feel like you’re on the outside of an inside joke. You even started to wonder if you missed that chapter of health class, where they taught you all the really weird dirty jokes? Half the time you’d laugh along with everyone else, just so you wouldn’t look like a total nerd.
And as far away as middle school seems, perhaps there are some sexual rumors that have stuck around, even past the 90s/early 2000s. Are these rumors still around because we never bothered to look them up? Perhaps the biggest rumor that lives on from middle school is the notion that herpes is just a funny word that you can joke around about, but you never have to worry about getting? Are we maybe all just laughing along with the joke that is called a life of never considering the possibility of STDs?
We’re here to clear up some of the confusion.
Let’s start with that kid who was obsessed with herpes. He probably informed you that you could get herpes from kissing someone with bad hygiene, or that you could get it from sharing a drink, or scariest of all, you could maybe get herpes just from sitting on the toilet seat. That last one led you to many years of hovering.
Can You Get Herpes From Kissing?
PSA, You can 100% acquire herpes just by kissing someone (or getting kissed by someone) who has the herpes virus.
Unfortunately, in this case, weird-cargo-shorts kid was right.
The herpes simplex virus (herpes’ formal name) is most often transmitted through direct contact with a person who’s been infected. This can mean lip-locking with someone who has an open sore or swapping saliva with that one cutie, even though they have no visible sores.
The strand of herpes that is normally responsible for developing directly from kissing is HSV-1, but occasionally, it can be HSV-2.
When HSV-1 or 2 is contracted through oral practices, this referred to as “oral herpes.” Oral herpes most commonly presents itself as cold sores or fever blisters.
Common Oral Herpes Symptoms
- Cold Sores/Fever Blisters
- Tingling Sensations
- Flu-Like Symptoms
- Muscle Aches
- Swollen Lymph Nodes
- Pain When Swallowing
However, in many cases, people are unaware that they even have herpes, due to the fact that this disease can be asymptomatic, meaning there are no symptoms at all.
The good news is if you’ve been infected, you aren’t in the minority!
It is believed that 75-80 percent of Americans carry at least one of the two herpes simplex viruses. That’s right; a whopping 80 percent of the U.S. has been affected by those pesky smooch sores.
Unfortunately, these statistics drastically increase your odds of locking lips with someone who has herpes at some point in your life.
Let’s face it; we’ve all been there. Sometimes you’ve just gotta have a rando make-out sesh. You meet a cute guy at your cousins’ wedding. He seems really into you, you guys have a few drinks, and before you know it, you’re hardcore kissing on the dance floor in plain sight of your grandma, as “The Chicken Dance” blares in the background.
Oh wait, we haven’t all been there? Just kidding. Awkward. Anyways, so yeah, you’ve kissed someone new, and for whatever reason, you’ve started to feel funny… and you begin to feel your inner middle-school-self reemerge, as you panic, and start to wonder, is it herpes?
A good indicator as to whether you’ve recently gotten bit by the herpes bug would be the “prodrome” or the early symptoms indicating the onset of herpes. Many can tell when a cold sore is forming, based on a tingling or burning sensation that may be present a few days prior.
The first cold sore outbreak can be the worst. It can be accompanied by nausea, fever, or muscle aches. As your body experiences more outbreaks, it will begin to build a stronger immunity to the virus, thus causing the symptoms to lessen with time.
The Short Answer: again, yes.
Unfortunately, there is currently no cure for herpes.
The herpes virus specifically behaves in a way that makes it difficult to cure. When the virus is latent or not active, it hides within the nervous system.
When herpes is latent, it’s pretty much invisible. It doesn’t cause any damage to your nervous system; it just hangs out there until it finds a time it wants to pop up and say hello. Even when the virus becomes active, there is still always a portion of it that is hiding within the nervous system.
Secure and Confidential
STD testing services
The fastest results possbile – available in 1 to 2 days
Get Tested Today
So Why Care?
It’s important to be aware of your status because the herpes virus can sometimes cause meningitis or encephalitis. Herpes viruses have been linked to Recurrent Lymphocytic Meningitis (Mollaret’s meningitis), which is characterized by sudden attacks of meningitis symptoms that last for 2-7 days and are separated by symptom-free (latent) intervals lasting for weeks, months or years.
Additionally, being unaware of your status can cause further spread of the virus and may negatively impact those closest to you. Oral herpes is often transferred to small children or babies when older family members give them kisses. In this case, the child may never even be aware that they have developed the virus until they start getting cold sores.
Can You Get Herpes From Sharing Drinks?
Okay, so we cleared up all that herpes from kissing business. But… you can’t get it out of your head, that one time that Chad from homeroom told you that it was disgusting when you took a drink from your BFF Cynthia’s milk carton. BECAUSE HERPES.
Bad news guys, Chad was onto something. You can indeed catch herpes by sipping from the same straw.
If it involves virus-infected saliva, you best believe that you are susceptible.
Apply everything you learned above to this. Oral Herpes symptoms will vary from person to person, but they will sometimes show no symptoms at all. Herpes is a lifelong disease, but it’s important to still get tested to prevent spreading the disease.
We know you’re probably on the edge of your seat for this one (metaphorically):
Can You Get Herpes From The Toilet Seat?
Last, but definitely not least, on the scale of weird things that you heard about herpes as a kid: Can you get herpes from a particularly grody bathroom experience?
Herpes is most commonly transmitted through contact with open sores or infected bodily fluids. If the virus was left on a toilet seat, and it was kept at a very specific temperature, then immediate contact could result in developing herpes.
However, It is highly unlikely to contract herpes from a dry inanimate object.
The Center for Disease Control (CDC) states, “You will not get herpes from toilet seats, bedding, or swimming pools, or from touching objects around you such as silverware, soap, or towels.”
So, safe to say, don’t think twice about getting comfortable in the “wiz palace” because UTIs are totally a thing, and you should never hold back the need to pee.
Though we have established that it is very unlikely, HSV-2 would be the strand of herpes most likely to be contracted during your potty time. Due to the location of exposure, this would be considered genital herpes.
Common Genital Herpes Symptoms
- Vesicles (a small fluid or air-filled cavity sack in the skin)
- Painful Ulcers
- Itching or burning in the genital area
These symptoms seem to be pretty apparent or noticeable, but two out of every three people with genital herpes are unaware that they possess the virus at all. Many people with genital herpes experience no symptoms. When symp-
toms are not apparent, is when viruses are most likely to be spread.
How Common are Genital Herpes Anyways?
The CDC has estimated that 776,000 U.S. citizens are infected annually by HSV-2. It is difficult to determine how many of these cases are oral herpes or genital herpes, especially due to the rising number of genital herpes brought on through oral pleasure.
Congratulations, You Passed Middle School Sex Ed!
So it turns out everything you heard in middle school wasn’t all total bunk, and even though Cargo Shorts Mcgee didn’t know how to spell “orange,” he did know a few surprisingly true ways that you could contract herpes, like kissing or sharing straws. Which makes you kind of wonder if he was right about buttering biscuits, But that’s best saved for a different blog post.
Now go forth, and live your life, no longer in the dark. The cloudy fog of middle school uncertainty has been lifted. If you think you may have come into contact with herpes, get tested sooner rather than later, to prevent the spread of disease.
What Should You Do?
If you’re worried that you might have herpes, get tested! We recommend ordering both the HSV-1 test and HSV-2 test.
Our doctors at STDcheck.com suggest waiting to get tested at least 4-6 weeks after potential exposure. It is important to wait because the body needs time to develop the antibodies which our tests search for. If a test is taken before the antibodies develop, it could cause a false negative result.
Once you find out your status, there are antiviral medications available that can reduce the frequency and severity of herpes symptoms. Medications, such as acyclovir, famciclovir, and valacyclovir, are the most effective medications available for people with herpes. Our doctors can even prescribe medication for you.
Get tested now for HSV-1 and HSV-2.
Herpes labialis (Oral herpes simplex)
Oral herpes is an infection caused by the herpes simplex virus, characterized by an eruption of small and usually painful blisters on the skin of the lips, mouth, gums or the skin around the mouth. These blisters are commonly called cold sores or fever blisters.
Causes, incidence, and risk factors
Herpes labialis is an extremely common disease caused by infection of the mouth area with herpes simplex virus, most often type 1. Most Americans are infected with the type 1 virus by the age of 20.
The initial infection may cause no symptoms or mouth ulcers. The virus remains in the nerve tissue of the face. In some people, the virus reactivates and produces recurrent cold sores that are usually in the same area, but are not serious. Herpes virus type 2 usually causes genital herpes and infection of babies at birth (to infected mothers), but may also cause herpes labialis.
Herpes viruses are contagious. Contact may occur directly, or through contact with infected razors, towels, dishes, and other shared articles. Occasionally, oral-to-genital contact may spread oral herpes to the genitals (and vice versa). For this reason, people with active herpes lesions on or around the mouth or on the genitals should avoid oral sex.
The first symptoms usually appear within 1 or 2 weeks—and as late as 3 weeks—after contact with an infected person. The lesions of herpes labialis usually last for 7 to 10 days, then begin to resolve. The virus may become latent, residing in the nerve cells, with recurrence at or near the original site.
Recurrence is usually milder. It may be triggered by menstruation, sun exposure, illness with fever, stress, or other unknown causes.
Warning symptoms of itching, burning, increased sensitivity, or tingling sensation may occur about 2 days before lesions appear.
Skin lesions or rash around the lips, mouth, and gums
Small blisters (vesicles) filled with clear yellowish fluid
Blisters on a raised, red, painful skin area
Blisters that form, break, and ooze
Yellow crusts that slough to reveal pink, healing skin
Several smaller blisters that merge to form a larger blister
Mild fever (may occur)
Signs and tests
Diagnosis is made on the basis of the appearance or culture of the lesion. Examination may also show enlargement of lymph nodes in the neck or groin.
Viral culture or Tzanck test of the skin lesion may reveal the herpes simplex virus.
Untreated, the symptoms will generally subside in 1 to 2 weeks. Antiviral medications given by mouth may shorten the course of the symptoms and decrease pain.
Wash blisters gently with soap and water to minimize the spread of the virus to other areas of skin. An antiseptic soap may be recommended. Applying ice or warmth to the area may reduce pain.
Take precautions to avoid infecting others (see Prevention).
Herpes labialis usually disappears spontaneously in 1 to 2 weeks. It may recur. Infection may be severe and dangerous if it occurs in or near the eye, or if it happens in immunosuppressed people.
Spread of herpes to other skin areas
Secondary bacterial skin infections
Recurrence of herpes labialis
Generalized infection—may be life-threatening in immunosuppressed people, including those with atopic dermatitis, cancer, or HIV infections
Herpes infection of the eye is a leading cause of blindness in the US, causing scarring of the cornea.
Calling your health care provider
Call for an appointment with your health care provider if symptoms indicate herpes labialis and symptoms persist for more than 1 or 2 weeks.
Call if symptoms are severe, or if you have a disorder associated with immunosuppression and you develop herpes symptoms.
Avoid direct contact with cold sores or other herpes lesions. Minimize the risk of indirect spread by thoroughly washing items in hot (preferably boiling) water before re-use. Do not share items with an infected person, especially when herpes lesions are active. Avoid precipitating causes (especially sun exposure) if prone to oral herpes.
Avoid performing oral sex when you have active herpes lesions on or near your mouth and avoid passive oral sex with someone who has active oral or genital herpes lesions. Condoms can help reduce, but do not entirely eliminate, the risk of transmission via oral or genital sex with an infected person.
Unfortunately, both oral and genital herpes viruses can sometimes be transmitted even when the person does not have active lesions.
Our thanks to the NIH for allowing us to reprint this article: http://www.nlm.nih.gov/medlineplus/ency/article/000606.htm
Important disclaimer: The information on pkids.org is for educational purposes only and should not be considered to be medical advice. It is not meant to replace the advice of the physician who cares for your child. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.
How Contagious Are Cold Sores?
How to Avoid Spreading Cold Sores
Here’s how you can avoid spreading cold sores to others:
- Don’t pucker up. You can spread cold sores simply by getting up close and personal with your loved ones. Give a kiss anywhere, but especially the mouth, and you could easily pass on the virus.
- Don’t share. If you put it in your mouth, don’t share it. You can easily pass on your cold sores by sharing food, eating utensils, drinking straws, cups, and glasses. That goes for lip balm or lipstick, toothbrushes, and razors as well. Even towels you use to dry your face can be harbingers of the virus when you have a cold sore. “The virus can survive for a little while on non-living items like these,” Dr. Kaufmann explained. Tell your friends and family: Get their own if they don’t want your cold sore.
- Don’t touch. “We touch our faces about a million times a day,” Kaufmann said. But, every time you touch your cold sore with your hands, you could be spreading the virus. If the virus gets on your hands and you don’t wash them right away, it could spread to whatever you touch next — your keyboard, the phone, a doorknob. “That’s why you should use a hand sanitizer a lot when you have cold sores,” he said.
- Don’t engage in oral sex. The same virus that causes cold sores also can be responsible for blisters and sores in the genital area. When you have a cold sore, you don’t want your mouth to come in contact with your partner’s genitals.
- Use hot water. Wash any items you use in boiling hot water to kill the virus.
- Avoid triggers. One of the best ways to avoid spreading cold sores is to avoid getting them in the first place. Some things that may trigger an outbreak are stress, sunburn, fever, and illness. Apply sunblock to avoid getting a sunburn and lip balm to prevent your lips from getting too dry. Ease stress with meditation and other relaxation techniques.
- Consider cold sore treatment. Left untreated, it can take a week or more for cold sores to run their course. Over-the-counter creams can speed healing somewhat. You also can ask your doctor for a prescription medication. A study in the journal Postgraduate Medicine shows that acyclovir and hydrocortisone cream (Xerese) shortens the time it takes for cold sores to heal. Apply a cold sore treatment with a cotton-tip swab to prevent it from spreading to other parts of your body. If you treat your cold sore and it heals faster, you’ll be contagious for a shorter time. A cool compress or ice may help ease the pain. Never squeeze or pick at your cold sore because that will delay healing.
Many people get warning signs that a cold sore is about to appear, Kaufmann said. So as soon as you feel that familiar tingling, itching, or skin sensitivity, going into contagion prevention mode can help keep it from spreading to others.
Herpes Simplex Virus Infection
Herpes simplex virus (HSV) is a very common and easily transmitted virus. In fact, 80% or more of people have been infected with herpes simplex virus-1. Most of us acquire the virus early in childhood from our parents, relatives, or childhood contacts through normal kissing, etc. Most of the time, the first infection is associated with few or no symptoms, but sometimes primary herpes simplex virus infection can produce mild to severe pain and difficulty in swallowing. Lesions resolve and pain decreases usually after 8 to 16 days.
Picture 2. Crusting that appears several days after the initial lesion.
Picture 1. Blisters or vesicles from early cold sore on lip.
After initial infection, the virus remains dormant deep inside the nerves. Many individuals go their entire life without realizing they carry HSV. However, around 20% of those with HSV will have a recurrent infection. Outside the mouth these are known as “cold sores” and are most commonly seen on the lips. It is also possible to have recurrent HSV infections around the nose, eyes, and inside the mouth. In the mouth, these infections appear as small painful ulcers on the hard palate, gums, and the top of the tongue.
Cold sores usually begin as a small cluster of blisters or fluid-filled swellings (Picture 1). These quickly rupture to leave behind open “weeping” sores or ulcers. In a few days, these will begin to crust over and scab (Picture 2). After a week or a little more, the cold sores will heal completely and usually there is no scarring or known long-term effect.
Q: When do people acquire a primary herpes simplex virus infection?
A: Usually in infancy or childhood. However, many people acquire the disease later on when they kiss an infected person during adolescence or adulthood.
Q: What does the initial primary herpes simplex virus outbreak look like?
A: The initial outbreak is most common in children, but can be seen in adults. The initial infection is accompanied by painful sores on the lips, cheeks, gums, and tongue. The presence of lesions can be accompanied by fever and swollen glands under the neck. Swallowing can be difficult and if liquids are not taken, dehydration can result.
Q: What is the treatment for primary herpes?
A. The best treatment is (as with any virus infection) is to ensure adequate nutrition and hydration while it runs its course (usually around a week). If this is diagnosed very early your doctor may be able to prescribe an antiviral medication to shorten this process.
Q: Are cold sores contagious?
A: Yes. They can easily be transmitted by contact from one person to another, including through oral-genital contact. It is also possible to spread the virus from one site to another, such as the eyes, nose, or around the fingernails. You should minimize any contact with the sores. After contact with a cold sore you should wash your hands and be careful not to accidentally touch your eyes or wipe your nose.
Q: What can cause a cold sore breakout?
A: Common causes are exposure to sunlight, cold, wind, stress, trauma, and medications or conditions that impair the immune system such as prednisone, Enbrel or cancer therapy. If you know what triggers a cold sore for you, you should tell your doctor. It may be possible to apply a cream or ointment or take an antiviral pill that can either prevent or abort cold sores in these circumstances.
Q: Is there a cure for herpes simplex?
A: Not yet. The virus remains in nerve cells in the body even between breakouts. In this hiding place, it is difficult to eliminate.
Q: Can anything prevent cold sores if I am getting a lot of them?
A: Sunscreen applied before sun exposure can help prevent the development of cold sores on the lips. It is possible for your doctor to prescribe antiviral medications that may help to reduce the number of cold sore episodes that you experience. Most of these medications are taken by mouth on a regular basis.
Q: Are medications available?
A: Nonprescription agents such as lysine, Carmex, and Docosanol (Abreva) can help reduce virus replication and may speed healing. Lip emollients can help keep the lips moist, but should only be used after the lesion is no longer weeping fluid (i.e., in the scab phase or between episodes). Antiviral medications can be prescribed by your doctor or dentist. These medicines help to reduce the severity and duration of lesions and can prevent the formation of lesions. Prescription antiviral medicines include:
- Acyclovir (Zovirax)
- Valacyclavir (Valtrex)
- Famciclovir (Famvir)
Prepared by the AAOM Web Writing Group
Updated 22 January 2015
The information contained in this monograph is for educational purposes only. This information is not a substitute for professional medical advice, diagnosis, or treatment. If you have or suspect you may have a health concern, consult your professional health care provider. Reliance on any information provided in this monograph is solely at your own risk.
What is herpes?
Herpes is a common virus that causes sores on your genitals and/or mouth. Herpes can be annoying and painful, but it usually doesn’t lead to serious health problems.
X in a circle
Want to get tested for herpes?
Find a Health Center A right arrow in a circle
Herpes is a common infection.
Herpes is a super-common infection that stays in your body for life. More than half of Americans have oral herpes, and about 1 out of 6 Americans has genital herpes. So chances are a few people you know are living with herpes.
Herpes is caused by two different but similar viruses: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Both kinds can make sores pop up on and around your vulva, vagina, cervix, anus, penis, scrotum, butt, inner thighs, lips, mouth, throat, and rarely, your eyes.
Herpes is spread from skin-to-skin contact with infected areas, often during vaginal sex, oral sex, anal sex, and kissing. Herpes causes outbreaks of itchy, painful blisters or sores that come and go. Many people with herpes don’t notice the sores or mistake them for something else, so they might not know they’re infected. You can spread herpes even when you don’t have any sores or symptoms.
There’s no cure for herpes, but medication can ease your symptoms and lower your chances of giving the virus to other people. And the good news is, outbreaks usually become less frequent over time, and even though herpes can sometimes be uncomfortable and painful, it’s not dangerous. People with herpes have relationships, have sex, and live perfectly healthy lives.
What’s the difference between genital herpes and oral herpes?
Because there are 2 different kinds of herpes simplex viruses (HSV-1 and HSV-2) that can live on many body parts, lots of people are confused about what to call these infections. But it’s actually pretty simple:
When you get either HSV-1 or HSV-2 on or around your genitals (vulva, vagina, cervix, anus, penis, scrotum, butt, inner thighs), it’s called genital herpes.
When you get either HSV-1 or HSV-2 in or around your lips, mouth, and throat, it’s called oral herpes. Oral herpes sores are sometimes called cold sores or fever blisters.
HSV-1 usually causes oral herpes, and HSV-2 usually causes genital herpes — each strain prefers to live on its favorite area. But it’s totally possible for both types of herpes simplex to infect either area. For example, you can get HSV-1 on your genitals if someone with a cold sore on their lips gives you oral sex. And you can get HSV-2 in your mouth if you give oral sex to someone with HSV-2 on their genitals.
How do you get herpes?
Herpes is easily spread from skin-to-skin contact with someone who has the virus. You can get it when your genitals and/or mouth touch their genitals and/or mouth — usually during oral, anal, and vaginal sex.
Herpes can be passed even if the penis or tongue doesn’t go all the way in the vagina, anus, or mouth. You don’t have to cum to spread herpes. All it takes is some quick skin-to-skin touching. You can also get herpes from kissing someone who has oral herpes.
The skin on your genitals, mouth, and eyes can be infected easily. Other areas of skin may get infected if there’s a way for the herpes virus to get in, like through a cut, burn, rash, or other sores. You don’t have to have sex to get herpes. Sometimes herpes can be passed in non-sexual ways, like if a parent with a cold sore gives you a peck on the lips. Most people with oral herpes got it when they were kids. A mother can pass genital herpes to a baby during vaginal childbirth, but that’s pretty rare.
You can spread herpes to other parts of your body if you touch a herpes sore and then touch your mouth, genitals, or eyes without washing your hands first. You can also pass herpes to someone else this way.
Herpes is most contagious when sores are open and wet, because fluid from herpes blisters easily spreads the virus. But herpes can also “shed” and get passed to others when there are no sores and your skin looks totally normal.
Most people get herpes from someone who doesn’t have any sores. It may live in your body for years without causing any symptoms, so it’s really hard to know for sure when and how you got it. That’s why so many people have herpes — it’s a pretty sneaky infection.
Because the virus dies quickly outside the body, you can’t get herpes from hugging, holding hands, coughing, sneezing, or sitting on toilet seats.
Was this page helpful?
Help us improve – how could this information be more helpful?
How did this information help you?
You’re the best! Thanks for your feedback. Thanks for your feedback.
- Larger text sizeLarge text sizeRegular text size
What Is a Cold Sore?
Cold sores are small blisters that are reddish and a little painful. They’re usually on the outer edge of the lip or inside the mouth.
Cold sores can appear one at a time or in little bunches. They’re filled with fluid, but crust over and form a scab before they go away. They last a week or two and usually don’t need any special treatment.
Although they’re called cold sores, you don’t need to have a cold to get one. Some people call them fever blisters, but you don’t have to have a fever to have one, either.
Cold sores are caused by a virus called herpes (say: HUR-peez). Herpes is one of the most common viral infections in the world. The medical name for the virus that causes cold sores is herpes simplex.
There are two types of herpes simplex infection: herpes simplex virus one (called HSV-1 for short) and herpes simplex virus two (called HSV-2 for short). Although both can cause cold sores around a person’s mouth, most are caused by HSV-1.
HSV-1 is so common that most Americans get infected with it, although many never have any symptoms. People can catch HSV-1 by kissing a person with a cold sore or sharing a drinking glass or utensils, so it’s easy to see why there are so many cold sores around.
Kids who get infected with HSV-1 may get cold sores occasionally for the rest of their lives. That’s because even after the sores themselves dry up and go away, the virus stays in the body, waiting around for another time to come out and cause more sores. When a cold sore reappears, it is often in the same place as the last one.
How Can I Keep From Getting Cold Sores?
HSV-1 isn’t a big deal. But it’s a good idea to try to keep cold sores as far away as possible. If someone you know has a cold sore:
- Don’t kiss him or her.
- Don’t drink out of the same glass or use the same knife, fork, or spoon.
- Don’t share towels, washcloths, or napkins.
If you’ve had cold sores before, it can be hard to tell what might make them come back. For some kids, too much stress, too much time in the sun, or getting sick can cause cold sores to reappear. Eating well, getting enough rest, and learning how to deal with stress are important things for any kid to do, especially a kid who is likely to get cold sores.
Putting on sunblock lip balm and sunscreen on the face before going out in the sun may help prevent cold sores from reappearing in kids who tend to get them.
What Can I Do if I Have a Cold Sore?
For most kids, the sores go away on their own without any special treatment from a doctor. If you get a cold sore, try holding some ice wrapped in cloth or a cool washcloth on the sore. It also might help to eat a popsicle.
Sometimes, if the cold sores are making a kid sick, a doctor may prescribe a special medicine that fights the herpes simplex virus. Some kids may take acetaminophen or ibuprofen if their sores are painful.
While you’re waiting for the cold sore to go away, wash your hands well and often and don’t pick at it. You’ll only get in the way of your body’s natural healing process. Picking at a cold sore is also bad news because it’s easy to spread the virus to other parts or your body, like your fingers or eyes. Worse yet, you might spread the virus to other people. No one will thank you for giving them a cold sore!
Reviewed by: Larissa Hirsch, MD Date reviewed: February 2019
Mayo Clinic Q and A: Direct Contact With Cold Sore Could Spread Virus
DEAR MAYO CLINIC: My husband frequently gets cold sores. Most of the time, it seems they are due to stress. We’ve been together for two years. I’ve never had cold sores, and I’d like to avoid ever getting them. I always assumed we should just avoid kissing until the cold sore is gone, but I recently heard that even touching can spread the virus as long as it’s visible. Is this true? Also, are there things he can do to keep from getting cold sores so often?
ANSWER: The virus that causes cold sores usually is spread to other people through saliva. So, your inclination to avoid kissing while your husband has a cold sore is a wise move. But, it’s also true that some active virus is present at the site of a cold sore. That means any direct contact with the sore could spread the virus. There are a number of steps your husband can take to reduce the chance of spreading the virus that causes the sores and lower his risk for developing cold sores frequently.
Cold sores are tiny, fluid-filled blisters on and around the lips. The blisters often are grouped together. After the blisters break, a crust forms over the resulting sore. Cold sores typically heal within one week without leaving a scar.
The medical term for cold sores is herpes simplex labialis. You also may hear them referred to as fever blisters. The sores usually are caused by a herpes simplex virus, HSV-1. Most people who get this virus are first infected during childhood, and the initial infection typically produces few symptoms.
Once HSV-1 is in a person’s body, however, it doesn’t go away. Instead, it remains dormant in the nerve cells of the skin. Over time, the virus can reactivate and cause other cold sores to appear. Cold sores that come back in otherwise healthy people are thought to be triggered by stress, fatigue and sunlight.
To keep the virus from spreading, your husband should be careful to avoid kissing and other skin-to-skin contact with you and with anyone else while he has a cold sore. He also should keep his personal items, such as towels and lip balm, separate from other people in your household during the time he has a sore. Do not share utensils, cups or other dishes either.
As in your husband’s situation, stress is a common trigger for recurrent cold sores. Sunshine exposure also may lead to cold sores in many people who have had them before. Regularly using a lip balm with a broad-spectrum sunscreen may help reduce his number of cold sore outbreaks.
Cold sores generally clear up on their own without medical treatment. But, if your husband continues to get them regularly, he may want to talk with his doctor about medications that are available for cold sores. Several kinds of prescription oral medication can be used to speed the healing of cold sores. They don’t have an effect on the transmission of the virus to other people, though. For individuals who often develop cold sores, or for those at risk of serious complications from the sores, a daily dose of an antiviral medication may be useful to help prevent frequent outbreaks. — Dr. Jason Sluzevich, Dermatology, Mayo Clinic, Jacksonville, Florida
Cold Sores (HSV-1)
- Larger text sizeLarge text sizeRegular text size
What Are Cold Sores?
Cold sores are small painful blisters that can appear around the mouth, face, or nose. Cold sores (or fever blisters) are very common. They usually go away on their own within 1 to 2 weeks.
What Are the Signs & Symptoms of Cold Sores?
Cold sores first form blisters on the lips, around the mouth, and sometimes inside the mouth. The blisters then become sores, which can make eating painful. They’re filled with fluid, but crust over and form a scab before they go away.
Sometimes the virus causes redness and swelling of the gums, fever, muscle aches, a generally ill feeling, and swollen neck glands.
After someone first gets HSV-1, the virus can lie quietly in the body without causing any symptoms. But it can wake up again later from things like:
- other infections
- a fever
- cold weather
- menstrual periods
- stress, like before a big test at school
When the virus reactivates, it can cause tingling and numbness around the mouth before blisters appear.
The herpes simplex virus type 1 (HSV-1) causes cold sores. This is a different
from herpes simplex virus type 2 (HSV-2). HSV-2 causes lesions in the genital area called genital herpes. Even though HSV-1 typically causes sores around the mouth and HSV-2 causes genital sores, these viruses can cause sores in either place.
How Do People Get Cold Sores?
People can get HSV-1 by kissing or touching someone with cold sores, or by sharing eating utensils, towels, or other items with an infected person. Many people with HSV-1 got it as kids during their preschool years.
How Are Cold Sores Treated?
Cold sores usually go away in about 1 to 2 weeks. No medicines can make the virus go away. But some treatments can help make cold sores less painful and not last as long:
- Cold compresses can help with discomfort.
- Prescription or over-the-counter treatments are sometimes recommended by the doctor.
- Cool foods and drinks can help make eating more comfortable.
- Taking acetaminophen or ibuprofen may ease pain. Don’t take aspirin, as it’s linked to a rare but serious illness called Reye syndrome.
When Should I Call the Doctor?
If you have a cold sore, it’s important to see your doctor if:
- you have another health condition that has weakened your immune system
- the sores don’t heal by themselves within 2 weeks
- you get cold sores often
- you have signs of a bacterial infection, such as fever, pus, or spreading redness
Can Cold Sores Be Prevented?
The virus that causes cold sores is very contagious. To help prevent it from spreading to others:
- Keep your drinking glasses and eating utensils, as well as washcloths and towels, separate from those used by other family members and wash these items well after use.
- Don’t kiss others until the sores heal.
- Wash your hands well and often, especially after touching a cold sore.
Be especially careful not to touch your eyes. If HSV-1 gets into the eyes, it can cause a lot of damage.
Reviewed by: Larissa Hirsch, MD Date reviewed: February 2019
Many people confuse canker sores with cold sores or they assume they are the same thing, but they’re not.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
First, these mouth sores show up in different places: Canker sores appear inside your mouth; cold sores happen outside, says Todd Coy, DMD, Director of Cleveland Clinic’s Department of Dentistry.
Also, while canker sores are not contagious, cold sores involve a very contagious virus. You risk passing cold sores along when you kiss someone, drink out of the same container or share silverware with other people.
What you need to know about canker sores
While the cause of a canker sore is often hard to pinpoint, stress is one possible cause. Or they may sometimes develop after a mouth injury — such as when you accidentally bite your lip or tongue, says Dr. Coy.
Acidic fruits and vegetables, including lemons, oranges, pineapples, apples, tomatoes and strawberries, can trigger canker sores or make them worse. It also may surprise you to learn that nonsteroidal anti-inflammatory drugs, such as Motrin® or Advil®, sometimes cause canker sores.
You may have common canker sores if you notice any of these symptoms:
- A painful sore or sores inside your mouth — on the tongue, soft palate (the back portion of the roof of your mouth), or inside your cheeks
- A tingling or burning sensation (prior to sores’ appearance)
- Round sores in your mouth that are white or gray, with a red border
- Fever, physical sluggishness and swollen lymph nodes (with severe attacks)
Treating canker sores: Use salt water
Canker sores will usually go away by themselves after a week or so, but they can make it difficult to eat or talk, so you may want to seek relief in the meantime.
“Rinsing your mouth out with highly concentrated salt water several times a day is one of the easiest ways to reduce the pain and inflammation caused by canker sores,” says Dr. Coy.
Mix about 1 teaspoon of salt into a half-cup to a cup of warm water. Swish the solution around in your mouth, but then spit it out (don’t swallow it).
How are cold sores different?
Cold sores (also called fever blisters) show up as groups of painful, fluid-filled blisters, typically under the nose, around the lips or under the chin. The herpes simplex virus (HSV) type 1 causes them. While HSV type 1 is closely related to the virus that causes genital herpes, HSV type 2, it’s not the same.
Symptoms of a cold sore outbreak may include a tingling sensation on your lips, followed by emerging small, fluid-filled blisters. The blisters may ooze, and then scab over.
HSV type 1 flare-ups often emerge at the same place every time there is an outbreak. Other symptoms may include fever, sore throat or swollen lymph nodes.
If you suspect that you have cold sores, avoid sharing cups or utensils with others. You should also avoid kissing while you have open sores as HSV type 1 is most often spread when someone is having an outbreak. It is much less likely but still possible to pass the virus along to others when you don’t have signs or symptoms, says Dr. Coy.
“Stress is one of the primary triggers of cold sore outbreaks because it decreases your body’s resistance to disease,” he says. “Changes in weather, particularly exposure to sunlight, can also cause outbreaks.”
Symptoms are typically most severe during an initial outbreak, and lessen somewhat during subsequent flare-ups, he says.
How to soothe a cold sore
Cold sores typically stick around for about two weeks, but there are steps you can take to shorten flare-ups:
- Apply ice to the sore to reduce swelling and pain
- Use a topical numbing medicine to reduce pain and soften scabs
- Apply an over-the-counter topical cream, such as Abreva®, to help promote healing
- Talk with your dentist or physician about prescription antiviral medications
If you have had cold sores in the past, it’s a good idea to wear lip balm with an SPF of 30 to help protect your lips against sun exposure, which may cause outbreaks, says Dr. Coy.