Posted on by Anna C. A herpes simplex lesion on the lower lip on the second day after onset. CDC Herpes simplex virus is mystifying, fascinating, and sneaky. Mystifying because we have yet to unravel all of its secrets; fascinating because when we do uncover one of its mysteries, we are amazed by the capabilities of such a tiny, microscopic object; and sneaky because it enters our bodies by stealth and conceals itself in our cells, taking us by surprise when it comes out of hiding and causes outbreaks of blisters and other lesions.
It can also be confusing. Herpes simplex virus actually comes in two flavors: HSV-2 is associated more with genital herpes, which can cause blisters and other lesions in the genital area.
If HSV-1 enters the body in the genital area, it can cause a genital herpes infection — and likewise, if HSV-2 enters the body in the facial area, it can cause an oral herpes infection. Using condoms and dental dams during oral sex reduces risk of herpes transmission.
What exactly is a cold sore , anyway? A cold sore, also known as a fever blister, is a cluster of blisters that can pop up around the lips or even in the mouth.
Sometimes, cold sores are so painful that eating or drinking is difficult, and in extreme cases sufferers must be treated for dehydration. An especially severe infection could also cause high fever or swollen lymph nodes, and in young adults a first oral HSV-1 infection might be misdiagnosed as tonsillitis, possibly leading to unnecessary tonsillectomies. Most symptomatic first-time cold-sore outbreaks occur during childhood, and take about two or three weeks to clear up. Luckily, the first infection is almost always the most severe, and when the infection is reactivated it usually happens without symptoms.
Because both cold sores and genital herpes are caused by herpes simplex viruses, and because oral herpes is so common, many people are concerned that they might be more vulnerable to acquiring a genital herpes infection than they previously thought.
Can I get genital herpes if someone with cold sores performs oral sex on me? Because HSV-1, the virus responsible for most oral herpes infections, can also cause genital herpes, many people wonder if someone with cold sores can transmit the virus to someone else by performing oral sex, resulting in a genital herpes infection.
Other people wonder if HSV-1 can be transmitted via oral contact with the anus, resulting in a herpes infection in the rectal area. The answer to these questions is: While HSV-1 only accounts for around 30 percent of genital herpes infections overall, many research teams are finding that HSV-1 is the predominant cause of genital herpes in some countries such as Sweden and in some U.
For example, among students at a large Midwestern public university , researchers found that HSV-1 caused 31 percent of genital herpes cases in and grew to 78 percent in The increase was even more pronounced in females. This trend, in which HSV-1 infections in the genitals predominate over HSV-2, seems to be most common among younger people, women, and men who have sex with men.
This might sound like terrible news, since most of us are infected with HSV-1 and we might enjoy oral sex. But there is some good news. First of all, HSV-1 likes to live in the trigeminal ganglion — in the face. So, if you are infected with HSV-1 in your genital area after receiving oral sex, recurrences will be uncommon and your infection will be milder than if you were infected with HSV-2, which is a related virus that is more strongly associated with genital herpes.
Just as HSV-1 can pass from the mouth to the genitals to cause a genital herpes infection, so too can HSV-2 pass from the genitals to the mouth to cause an oral herpes infection. Furthermore, just as a genital HSV-1 infection is milder and less prone to recurrences than an HSV-2 infection in that area, so too is an oral HSV-2 infection milder and less prone to future outbreaks. Another study of 50 people found that 90 percent of them had HSV-1 in their saliva at least once during a day period.
Shedding patterns can be further influenced by what triggered the virus to reactivate — for example, higher-than-average amounts of virus are found in saliva samples from patients with oro-facial fractures. Some people think that already being orally infected with the cold sore virus makes them immune to HSV-1 infections in their genitals.
More study is needed to answer this question more fully, but the short answer is that yes, reinfection in the genitals is possible. As mentioned previously, most of us are orally infected with HSV-1 as children. Those who already have an HSV-1 infection are much less likely to experience symptoms upon an initial HSV-2 infection.
When HSV-1 infects the genitals, it usually got there as a result of oral sex. Because genital HSV-1 infections have fewer recurrences and are associated with less asymptomatic shedding , the genital-to-genital spread of HSV-1 is not as common.
We can also answer any questions you have about herpes and discuss antiviral medications with you.