Image: The Glow.
Anyone who suffers from cold sores knows there are several golden rules that will protect loved ones from being infected while the sore is active.
The drill goes something like this: Don’t kiss someone while you have a cold sore. Don’t share cutlery, lip balm, creams, face towels or anything else that could have come into contact with the infected area. Keep your hands clean so the virus can’t be transmitted to other parts of your body (or someone else’s).
So where does that leave us where sex is concerned? You can still have intercourse without kissing someone directly on the mouth, so… that’s safe, right?
Nice optimism there, but it's actually quite risky business due to how the two herpes viruses — HSV-1 and HSV-2 — interact.
"There are two different types of herpes virus — herpes type 1, which is on the lips traditionally; and herpes simplex type 2, which is in the genital area," explains Dr Dasha Fielder from Sapphire Family Medical Practice in Sydney's Bondi Junction.
"But because of the different types of sexual practises [like oral sex], it obviously can be interchanged, and somebody who has a cold sore can potentially give genital herpes to someone who has never been exposed to the virus if the right sexual activity is performed."
You've probably figured by now that oral sex is a bit of a danger zone here. Herpes is a highly contagious virus, and you don't even need to have an 'active' lesion to spread it — a tingling or numb sensation on your face (hello, impending cold sore) indicates risk of infecting a sexual partner. (Post continues after gallery.)
"Usually people who get cold sores will know a day before, or 10 hours before you get the ulcer on your lip; you get a little tingle, a numbness, and then you get the lesion after that. [It's] the same thing with the genital area — you may just feel a bit of an itch or discomfort, but don't have a lesion yet and engage in sexual intercourse with your partner," Dr Fielder says.
Interestingly, Dr Fielder says people who have herpes type 1 (i.e. cold sores) have a reduced chance of contracting the genital form, because they've already got immunity to a type of herpes virus. "But if you don't have cold sores and you engage in sexual activity [like oral sex] with someone who does, they can absolutely give you genital herpes," she adds.
Genital herpes is extremely common in Australia; it's estimated to affect between one in six and one in four people, whether they're aware of it or not, and it's on the rise. Dr Fielder believes this is linked to an education gap with regards to the different forms of contraception and the protection they offer for different sexual acts.
"Since we've introduced the oral contraceptive pill and women are using it for contraception, they're forgetting to use barrier methods for contraception, like condoms," she says.