You’re confused: you got chicken pox when you were eight, so does that now mean you’re going to get herpes? You got a cold sore once, and people made fun of you for it. Does that mean you’re doomed to carry a contagious STD for life? Why are there two diseases both called herpes? If you do have a cold sore, can you give someone herpes if you give them oral sex? All of these questions and more will be answered below.
First, let’s make things super clear.
First, you should tell your partner — honestly, directly, and early on. You should not conceal a herpes infection, because having sex would risk infecting them with an incurable disease. There is no cure for HSV-1 or HSV-2, but treatment can reduce symptom duration and suppress additional outbreaks.
If you’re going to have sex, do it carefully. You should use barrier methods such as condoms, femidoms, dental dams etc. Use of antivirals and condoms significantly reduce the chance of infection. If you can’t cover the ulcer with a condom, it's best not to have sex until the ulcer has healed, as there’s a good chance of contact infection. Herpes is most contagious immediately before and after an outbreak, as well as during one. You should be aware that you can infect someone with herpes even if you have no visible sores, this occurs during ‘asymptomatic shedding’ so there is always some risk of transmission. This is why it is so important that you discuss your infection with your partner.
Equally, if you’ve got a cold sore, while it’s not guaranteed, it is possible to infect someone with herpes by giving them oral sex. You ought to wait until it’s healed, and take antivirals in the interim.
If you do suffer from cold sores or have had shingles, you are not at all alone: 1 in 3 will adults develop shingles, and more than 1 in 2 Americans will have a simplex outbreak at least once in their life. Only a bit more than 1 in 10 Americans between the ages of 14 and 49 have genital herpes. The prevalence has significantly decreased from 1999, when a bit less than 1 in 5 Americans in that age bracket had genital herpes. Also, since we’re discussing zoster here as well, it’s probably important to mention that there are five other notable herpes pathogens, but you generally don’t have to worry about them.
If you got chickenpox as a child, there’s alway a chance it will come back later in life in the form of shingles unless you’re vaccinated.
The likelihood of you developing herpes simplex is dependent on who you come into contact with. You can minimize your risk by avoiding intimate contact with people who are experiencing an active outbreak.
Reviewed by Dr Roy Kedem, MD
Information last reviewed 12/06/21