What Happens If You Have Oral Sex With A Cold Sore?

Illustrated by Anna Jay.
Pesky little cold sores love to sprout up at the most inconvenient times, huh? Maybe you got yours right before your wedding, the first day at a new job, or — perhaps the most infuriating — the night when you were finally planning to seal the deal with a new sexual partner. You already don't feel like your best self when you have a scabby cold sore on your lip, but does that sore mean you also have to skip having oral sex? Sadly, the answer is probably yes.
We know that we get cold sores as a result of the herpes simplex virus, which comes in two forms: the aptly named HSV-1 and HSV-2. In general, HSV-1 is referred to as the "oral type" because it tends to cause cold sores on the mouth. And HSV-2 is predominantly thought of as the "genital type," says Shree Chanchani, MD, clinical assistant professor in the Department of Obstetrics and Gynecology at NYU Langone Medical Center.
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But the annoying thing is that both types cause blistering sores that can appear around your mouth and on your genitals. So it's not as easy to distinguish between the two types as you might think, Dr. Chanchani says. Both types are also treated in basically the same way, with a combination of antiviral medications (e.g. Valtrex) and topical pain-relieving gels to make the healing process more bearable. So it's actually not that crucial to know which type you have. Regardless of where they are, if you have cold sores, you need to get them checked out.
Herpes is a sexually transmitted virus, but that doesn't mean that it's impossible to have safer sex if you have the virus. However, you do have to be extremely cautious about all of your sexual encounters, because there is no cure for herpes — and it's very contagious. Both types of herpes can be transmitted from person to person through oral, vaginal, penile, or anal contact, Dr. Chanchani says. And, although you can spread the virus at any time, it's much more contagious when you're in the middle of an active outbreak (i.e. when you have a cold sore). That's because there is a bit of live virus hanging out in your sores.
That's why it's an especially good idea to abstain from having oral sex when you have a sore. What's the worst that could happen? You can spread herpes from your mouth to your partner's genitals — even if you have the "oral type" of the virus, Dr. Chanchani says. You can use a dental dam or condom if you're really intent on having oral sex with someone while you have a cold sore. But in most cases, the safest thing to do is keep your mouth away from someone else's genitals until after the cold sore is treated.
Beyond genital-touching, you should also avoid kissing and sharing eating utensils while you have an outbreak, she says. When you have a cold sore, it's important to make sure you get enough sleep, practice good hand hygiene, and avoid triggers (e.g. stress, sunlight, and alcohol). These are all habits that can help your sores heal and prevent more from coming back.
The virus is so frustratingly easy to pass to someone else because it "lives in nerve cells and can be dormant for a while and then reoccur," Dr. Chanchani says. You may have one outbreak and never see the sores again, or you could be managing outbreaks for the rest of your life. But just because you don't see the sores doesn't mean the virus is gone for good.
However, as annoying and painful they may be, cold sores aren't actually a huge deal — especially when you consider that 80% of people have HSV-1. "Not everyone gets cold sores, because most of us have immune systems that are strong enough to suppress an outbreak," Dr. Chanchani says. But when you're fighting a cold or are just extra stressed, your immune system is already taxed. That makes it more likely for a cold sore to get through your usual defenses, she says.
So, any time you notice new or painful sores on your mouth or genitals, you should see a doctor, and break the news to your partner that they're not receiving oral for a few days. You might as well take this extra time to research some oral sex tips for when you're eventually in the clear.
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