I kissed someone with a cold sore. What should I do?

The dos and don’ts

Herpes Simplex Virus (HSV for short) is a viral infection that can either result in oral cold sores, genital cold sores, or both. HSV can come in 2 forms, type 1 and 2. The World Health Organisation estimates that 3.7 billion people under 50 have HSV-1 globally, while 491 million people aged 15-49 have HSV-2. 

HSV-1 usually causes cold sores, and HSV-2 typically results in genital herpes. However, either type of infection can result in cold sores and genital herpes. HSV-1 is usually contracted through oral-to-oral contact but can sometimes be acquired after oral-genital contact, in or around the genital area. HSV-2 is exclusively contracted during sex and is a sexually transmitted disease.

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Individuals contracting HSV-1 usually are asymptomatic until they develop their first cold sore. Adults are less likely to develop symptoms after primary infection compared to children. The usual symptoms to look out for are sore throat, swollen glands, painful sore in and around the mouth. Along with these symptoms, individuals might also have flu-like symptoms such as fever, nausea, and headaches. 

Cold sores are tiny blisters and sores usually emerging on and around the lips. With 2.5 out of every 1,000 people experiencing a cold sore outbreak, this is a widespread occurrence. While cold sores do tend to heal independently, they can persist for 1 to 2 weeks before clearing up. You can experience multiple cold sore outbreaks in your life as the virus remains dormant in your body, even without any symptoms or outbreak. Cold sores are highly contagious, so doing something like kissing is quite risky. The risk of contracting HSV-1 is significantly higher when kissing someone with a cold sore. 

 

Stages 

There is a cold sore healing process from when the sore appears, becomes an open sore, then heals and disappears. There are eight stages to this healing process:

  1. Latent period - when the virus is dormant 
  2. Prodromal stage - usually experience tingling and skin reddening around the lip 
  3. Inflammation stage - the start of the cold sore process
  4. Pre-sore stage - painful cold sores begin to develop around the lip
  5. Open herpes lesion stage - the cold sores will open and become an exposed sore 
  6. Crusting stage - active healing of the cold sore to form a brown crust
  7. Healing stage - scab has now fully covered the sore, and new skin is forming underneath 
  8. Post-scab stage - the sore has now healed, and skin should be returning to normal

While cold sores usually develop around the lips (herpetic labialis), they might sometimes form inside the mouth (herpetic stomatitis). While you might think it is safe to start kissing your partner from stage 6, all 8 of these stages are infective, and kissing (or any other HSV spreading method) should be avoided at all costs.
Spreading the virus

Cold sores spread through contact. HSV-1 can lay dormant for years, and individuals might not even realize they have contracted herpes until their first cold sore outbreak. Events like stress, being unwell, and having a period can trigger a cold sore outbreak. You can get HSV-1 through an innocent kiss, using utensils with shared saliva, or being intimate with your sexual partner. 

Only a very minute percentage of people with an HSV-1 or HSV-2 infection develop cold sore symptoms. You might have an HSV infection and not even know it! It is important to take precautions with your partner even if you are pretty sure you both have or don’t have an HSV infection. 


To kiss or not to kiss

It is a definite no to kissing someone with a new cold sore. You might be tempted to when the cold sore is still scabby. Still, it is best to just be abstinent for just a little longer until the sore has completely disappeared before kissing or partaking in oral sex. Without a completely healed cold sore, the virus can continue shedding in the late stages of the virus, even if there is no viral fluid present. Post-outbreak, the longer you wait, the lower your chances of contracting or passing on the virus. 

 

Healing and treatment

Cold sores not only acts as a hindrance to intimacy, but it also carries a heavy social stigma and can make casual social situations awkward and stressful. Antiviral medications are the most effective medications used for HSV. These antivirals include acyclovir, famciclovir, and valacyclovir. These medications can reduce the frequency and severity of the outbreak symptoms. Sadly, HSV is a lifelong infection. There is currently no cure for it, just a treatment regimen to suppress the virus's symptoms. 

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