Cold sores, also known as oral herpes, can pass through sexual contact. However, they are not technically a sexually transmitted infection (STI), as people most often acquire cold sores through nonsexual contact.
Cold sores are painful blisters that develop in outbreaks around the face. They develop in response to a herpes virus called herpes simplex virus type 1 (HSV-1), also known as oral herpes. Another type of herpes virus, herpes simplex virus type 2 (HSV-2), transmits through sexual contact with sores that develop on the genitals.
Cold sores are not STIs, as they spread through contact with saliva that contains HSV-1. STIs are infectious diseases that pass from person to person through sexual contact with either body fluids or skin sores. Conversely, HSV-2 is an STI.
Cold sores
Genital herpes is a different form of the herpes virus that only transmits through sexual contact. Oral herpes spreads through any nonsexual contact with saliva that carries the virus.
However, HSV-1 can also transmit during sexual contact. For example, during oral sex, HSV-1 may pass from the mouth of a person with oral herpes to the genitals.
According to the Centers for Disease Control and Prevention (CDC), people most often acquire HSV-1 through
According to the American Academy of Dermatology Association (AAD), most children with cold sores get them from the following sources:
- receiving a nonsexual kiss from an adult with cold sores
- sharing cutlery with someone who has cold sores
- sharing a towel with a person who has cold sores
Even though cold sores are most common in children, adults can also acquire HSV-1. People should avoid intimate contact or kissing until the cold sore forms a scab, as contact with the sores causes the virus to move from one individual to the next.
Evidence suggests that more than 50% of people ages 14 to 49 in the United States carry HSV-1.
The following table shows the
| Oral herpes | Genital herpes | |
|---|---|---|
| Causes | HSV-1 spreads through contact with the virus in sores, saliva, or surfaces in or around the mouth. | This spreads through sexual contact with a person who has HSV-2. |
| Symptoms | Blisters or ulcers will form in or around the mouth. | Bumps, blisters, or ulcers form around the genitals or anus. |
| Transmission | HSV-1 spreads through oral contact with the virus in sores, saliva, or surfaces. | HSV-2 spreads through contact with sores, skin, or fluids on the genitals or anus during sex. |
| Complications | HSV-1 might lead to brain inflammation or eye infection. | Rarely, HSV-2 may transmit from mothers to children during childbirth. People with HSV-2 also have an increased risk of HIV. |
| Prevention | To prevent oral herpes, avoid sharing eating utensils, lip balm, or towels with those who have HSV-1, as well as avoiding oral contact. | Using condoms, avoiding sexual contact during outbreaks, and taking antiviral medications can help sexually active people reduce their risk of genital herpes. |
| Prevalence | Over half of the worldwide population under 50 years old has HSV-1, but many are unaware. | Around 13% of people between 15 to 49 years old worldwide have genital herpes. |
During a person’s first infection, people may feel fever, aches, sore throat, headaches, and swollen lymph nodes where the virus enters the body. These symptoms are similar for both types. Outbreaks for both types end more quickly and are less severe after the first.
In most people with both types, herpes causes no symptoms at all.
Once the initial cold sores clear, the virus remains dormant on the nerves. Typically, the immune system is able to prevent flares of cold sores. However, specific triggers can
Triggers might include:
- extreme tiredness
- cold, fever, and flu
- injuries in the areas that have previously developed cold sores
- dental treatment
- laser treatment on the skin or cosmetic surgery
- intense sunlight
- dietary factors, such as acidic or salty foods
- hormonal shifts, including during menstruation
Different triggers may cause cold sore symptoms to develop in different people, but outbreaks generally occur less after a person reaches 35 years of age.
Read on to learn more about recurrent cold sores.
Cold sores usually start with a burning, tingling, or itching sensation. Within 48 hours, one or several small, painful, fluid-filled blisters may develop anywhere on the face.
They usually heal within 10 days but might cause irritation or pain during healing.
People may acquire HSV-1 but never get a cold sore or only experience one outbreak before the immune system learns how to respond to HSV-1.
Read on to learn more about how long cold sores may last.
Cold sores often heal without treatment. However, people with the following conditions or symptoms should receive medical treatment for cold sores:
- eczema
- sores near the eye
- many sores
- extremely painful sores
- sores more than six times per year
- suppressed immune systems, such as due to medications for severe psoriasis, drugs to prevent organ rejection after a transplant, chemotherapy, or conditions such as HIV
Treatment aims to heal the sores, relieve pain, and reduce the risk of complications. It often includes antiviral medications that people can apply to the sores as a cream or take by mouth as a capsule. Cold sore patches can protect the skin during healing, and creams may reduce irritation and pain.
Preventing cold sores is possible, but HSV-1 is highly contagious, especially when sores are showing. As such, it can be very difficult to prevent acquiring HSV-1. Avoid sharing utensils, razors, and towels with people with active cold sores. This can help reduce the risk of transmission. People can also avoid kissing a person who has active sores.
People may also be able to prevent cold sores from appearing if they notice the burning or tingling sensations that often show around 48 hours before the sores.
If sunlight triggers sores in certain individuals, using lip balm and sunscreen with a sun protection factor (SPF) of 30 or higher can help prevent them. Avoiding other triggers, such as stress, acidic or salty food, or sunbeds, can also prevent an outbreak if symptoms start.
Doctors recommend throwing away lip balms used during outbreaks of cold sores, as these will carry the virus and risk reinfection.
Cold sores are not technically an STI. The virus that causes them, known as herpes simplex virus type 1 (HSV-1) or oral herpes, most often transfers from one person to another through nonsexual contact. However, HSV-1 may transmit from the mouth to the genitals during oral sex.
HSV-1 passes between people through saliva, although the virus can transmit through contact with cold sores. To reduce the risk of HSV-1 transmission, people should try to avoid sharing utensils and personal items with someone who has active sores. Oral herpes mainly occurs in children and is much more common than genital herpes.