Can a cold sore cause genital herpes?

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).

RELATED: How to get rid of a cold sore FAST.

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?

Kissing is out of bounds... but what about sex?


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.

RELATED: This is what it's like to have herpes.

"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.

RELATED: Meet the woman telling the world about her genital herpes.

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.

Be aware, not alarmed.


"With oral sex, some people just aren't aware that it's the same thing [as intercourse] and you can contract a virus that way. Sometimes people are unaware that they carry the virus. They don't even know they have a cold sore, it'll be just starting and that's how they can give it to their partner."

To prevent the spread of herpes, Dr Fielder recommends couples use barrier birth control methods like condoms, which can reduce the risk of STIs by around 70 per cent. "Also, make sure you wear the condom not just during the actual penetrative intercourse, but  before that as well — herpes can be spread through any touching," she says.

RELATED: Your cheat sheet to the HIV treatment you didn't know existed.

For carriers of HSV-1 or HSV-2, it's best to avoid any sexual contact (including oral sex) from the moment you notice any tingling or numbness, and then for at least two days after any lesions have healed. (Post continues after video.)

While there is currently no cure for the herpes virus — once you contract it, you'll always have it — there are effective treatments available that help to suppress the symptoms, and ease your concerns about spreading the virus.

"If you do have genital herpes, and you would like to have a lesser chance of spreading it to your partner, you can speak to your doctor about going on suppressive medication. It's just a simple tablet you take every day, and it virtually eliminates the chance of you spreading it," Dr Fielder says.


RELATED: This woman caught an STI after getting a common salon treatment.

There are also good treatments for oral herpes; Dr Fielder says anti-viral medications can suppress cold sores at a very early stage and stop the onset of those painful lesions, so you don't have to put up with them for days on end.

There's no cure for cold sores, but you can suppress them.


Being diagnosed with genital herpes in particular can be quite traumatic, Dr Fielder says, and having 'The Talk' with a new partner can be daunting for someone who is a carrier. The best approach here is to be open and communicative, and set rules about not having intercourse when symptoms present.

"It certainly opens a can of worms when you're in a new relationship and all of a sudden you have an ulcer in your private area and you start to worry. It's best to be open about it," Dr Fielder says.

RELATED: Finally, some good news about STIs - there could soon be a chlamydia vaccine.

"The important thing is putting thought into it, and being aware of how easy it is to spread herpes. It's not just sex; mothers spread it to their babies because they kiss them. We just have to be careful."

Do you have cold sores? Do you have any tricks for relieving them?