The term "cold sores" might suggest that the cold sore blisters around your mouth are due to the extremities of cold weather and that herpes, a disease commonly associated to sex, has nothing to do with it. However, cold sores and herpes are closely related as they are the most common symptom of herpes. We know this isn't reassuring to hear as the word "herpes" tends to immediately set off alarm bells in people's heads. But this is only due to the enormous stigma attached to the disease, all thanks to misinformation and lack of knowledge about what the herpes infection is.
According to a 2015 report by the World Health Organization, 2 out of 3 people under the age of 50 have Herpes Simplex Virus 1 (HSV 1 infection), also known as oral herpes. That accounts to over a billion people with an incurable virus! Its counterpart, HSV 2 or genital herpes, is less common, affecting about one-sixth of people aged between 14 and 49. So, if herpes is so common, why are we so misinformed about it?
The main reason is that people view herpes as an exclusively sexually transmitted disease (STD). However, only oral herpes is not necessarily spread through sex, it can even spread through non-sexual touch. Both types of herpes are spread through physical touches such as kissing, oral sex and bodily fluids. Due to the misinformed STD tag attached to the disease, people are quite judgemental about those infected with the virus. But it is highly treatable and is extremely common.
What is herpes exactly?
Herpes is the result of being infected by the herpes simplex virus (HSV) which causes sores or blisters to form around the mouth or genitals accompanied by other symptoms.
Herpes virus comes in two strains - HSV-1 which is the main cause of oral herpes or mouth sores and HSV-2 which triggers sores on or around genitals. Although the two strains have different behavioural characteristics, both can cause sores in both places. When a person becomes infected with the herpes virus, the first outbreak or episode usually starts about 2-20 days after one gets infected. However, according to Medical News Today, it can sometimes even take years for the first outbreak to happen.
How does herpes spread?
In an interview with Seventeen Magazine, Dr Natasha Bhuyan, a family physician at One Medical explains that herpes is spread by human touch, which means kissing (even on the cheek), oral sex or even sharing a lip balm can spread the virus. For example, if you have a cold sore and you perform oral sex on a partner, you could give the virus to them. You could also spread the virus by kissing someone on the cheek. But to spread the virus, you must be experiencing a breakout, so try to limit physical contact when you notice a cold sore around your mouth.
What are the symptoms of oral herpes?
The most prominent symptom of oral herpes is a cold sore. According to Mayo Clinic, a cold sore passes through three stages:
1. Itching around lips: You might feel a burning sensation, itching or tingling around the lips for a day. This means a small, hard, painful spot may be appearing around that area.
2. Cold sore blisters: These are small fluid-filled sacs that might appear along the border of your lips. But they could also form around the nose, cheeks or inside the mouth - so watch out for those too.
3. Oozing and crusting: This is when the small blisters burst and leave a shallow opening that oozes and then crusts over. Similar to bursting a pimple on your face.
If it is your first cold sore outbreak, you may also experience fever, painful gums, sore throat, headache, muscle aches and swollen lymph nodes. However, signs and symptoms vary from case to case. The sores on the face can last several days and the blisters can take two to three weeks to heal completely. The viral infection can also recur at the same spot but will most likely be less severe compared to the first outbreak.
Children can also get the herpes simplex virus but they may have a cold sore or lesion inside their mouths which can be commonly mistaken for a canker sore. So, be sure to double-check that with a doctor before arriving on a diagnosis.
If you have a cold sore, do you have herpes?
Yes, it means that you have been infected by the herpes simplex virus. But as spoken about earlier, there's no need to freak out, it's not the end of the world! If you're wondering how you got it when you've never had sex, again, it could have been through skin-to-skin contact. Even sharing spoons, cups, kissing on the cheek can transmit herpes - it doesn't always have to be sexual contact.
The slightly bad news is that the herpes virus has no cure. Once you get the virus, it stays in your body for life making rare or common visits. Some people may get herpes sores regularly, while others won't see a sore for years.
How to differentiate between a cold sore and a pimple?
You can tell the difference between a cold sore and a pimple by their appearance and sensations associated with them. Before a cold sore appears, you might feel a sharp pain that hurts more than a normal zit. Moreover, cold sores generally form near the mouth or on the lip; pimples never crop up on the lip. Cold sores form a blister or a cluster of blisters that look red and fluid-filled whereas pimples form a red raised bump that may develop a white head but not a blister. In rare cases, a cold sore can even look like a really dry area on your lip.
In case, you have genital herpes, the cold sore may develop on or around your genital area and you may also feel discomfort or pain while peeing. During the initial infection, you can also experience flu-like symptoms such as swollen glands, swollen lymph nodes in the groin area, headache, muscle aches and fever.
How to treat cold sores or herpes?
According to the Mayo Clinic, cold sores usually go away without treatment in two to four weeks. However, it is a good idea to still visit your doctor as they can prescribe you antiviral medicine to speed the cold sore treatment. Some of the medicines are pills and others are antiviral creams or a cold sore scream that is to be applied as prescribed. For a severe cold case, doctors may also recommend taking an antiviral drug through injection.
If this is your first outbreak, definitely get tested by your physician to figure out what type of herpes simplex virus you have as the medications and treatment will differ for oral and genital herpes. Additionally, your physician would also give you a daily suppressive antiviral medication to prevent future outbreaks.
Temporary relief for cold sores
Dr Bhuyan has some helpful tips for pain-relief at home. If the sore is on your face, hold a cool damp cloth on the area for a few minutes several times a day. This will help soothe the sharpness of the pain, decrease redness and scabbing. Apply a little Vaseline if it continues to sting or hurt and strictly avoid picking it as that can slow down the healing process. After touching the sore, remember to wash your hands thoroughly to avoid spreading.
Similarly, for a genital herpes infection, cool compresses will take you a long way. Hold a damp cloth on the area for relief and if it hurts while peeing, try urinating in the shower as the water can subdue the sting. Additionally, take a break from sex! Do not put your partner at risk of getting the virus.
Should you get tested for herpes?
If you're experiencing symptoms of an outbreak, get tested. Even if you don’t have symptoms but are sexually active, it's still a good idea to get screened for common STDs such as herpes or chlamydia. You can ask your doctor to do so at your next appointment.
Should you tell your partner that you have herpes?
You should definitely inform your partner if you experience herpes outbreaks or just got the infection. If you're going to engage in kissing, physical touch or sex, it's imperative you do so. It's understandable to feel nervous about disclosing such information considering the stigma attached to herpes. Dr H. Hunter Handsfield, M.D., a former member of the American Sexual Health Association's board of directors tells Seventeen Magazine, you could just start with a simple disclaimer. He suggests something like, "Hey, before we go any further, let's talk. I have herpes. The risk of passing on the virus to you is low, especially if we use a condom, but I just want to let you know."
However, be ready to face difficult responses as people may be misinformed about the disease or judge you for it. Terri Warren, an adult nurse practitioner and spokesperson for the American Sexual Health Association tells Health, “You are more likely to have a positive reception to that news if you have built some sort of relationship. If you tell too early and there’s no reason for this person to be invested in you, then you may get a negative response very quickly.”
However, don't let that bring you down. You can still try to educate your partner by suggesting readings, explaining it simply or having your doctor explain to them how to have safe sex with herpes. There are so many possibilities, all you need to do is communicate.