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STDs  (Expert Forum)
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Already get cold sores on my lips can I contract genital herpes through oral sex
Answered by
H. Hunter Handsfield, M.D. -
University of Washington Seattle - WA
This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomoniasis, Warts, Yeast Infection.All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
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MedHelp Member's Question

Already get cold sores on my lips can I contract genital herpes through oral sex

by GymBoiNC, Apr 05, 2006 12:00AM
Ok here is my question.  I occassionally get cold sores or fever blisters as they are called on my lips.  I have since I was a teen and I am 27 now.  Last night someone I have been seeing performed oral sex on me.  After I noticed a scab/bump above their lip.  I could not say for sure it was a cold sore but it resembled one.  I have heard that if you already get cold sores on your lips then you can not contract genital herpes from someone performing oral sex on you who has it on their lips.  Because you already have the herpes virus in your system.  Is this true?  If not what are the chances that I have contracted gential herpes.  Thank you for your help.
Doctor's Answer

by H. Hunter Handsfield, M.D., Apr 05, 2006 12:00AM
People who already are infected with HSV-1 or HSV-2 in general are immune from catching it again, anywhere on the body.  The immunity probably isn't absolute, and there may be exceptions.  You would be wise to not permit people with overt (i.e., visible) oral herpes lesions or other sores around the mouth perform oral sex on you.  But even if you slip up on this, as you might have done, you are very unlikely to get a new genital HSV-1 infection.



Good luck--  HHH, MD
Member Comments (26)

by gracefromHHP, Apr 05, 2006 12:00AM
If this was hsv1 orally then you have significant protection against acquiring it genitally.  There is more active virus present in an active cold sore though so it's always best to avoid performing oral sex on someone with an active cold sore present.  Should you develop any genital symptoms within the next 3 weeks then see your doctor within 24-48 hours for a lesion culture and typing.  You can also ask the person who you were with if they know they get cold sores or if they've ever been tested for herpes.



grace

by passedHSV1, Apr 06, 2006 12:00AM
To: Forum MD H.H.H.
I have noticed a distinct change in the advice you are giving people inquiring if they can contract HSV-1 genitally after having it orally. You have also corrected the FAQ section of this webiste to reflect this change in attitude. I am wondering what prompted this change in advice?



Before you were advising everyone who asked the question of this posting, that one is "immune" and can't catch HSV-1 in a new location on the body (unless it was through the original 1st exposure) "even if they tried". Have you had a sudden "change of heart" or have you consulted with the other experts in your field like Dr. Anna Wald or Grace from ? (and I mean this as a stinging remark since I asked you specifically and in no unclear terms to define the level of immunity and you mislead me)



I applaud your new, more cautious advice, even if it comes too late for some people like me.Maybe all the others who think the $10 advice on this section from an "expert" is a bargain should reconsider how they spend their money. First rule as a doctor, DR. HHH, is "do no harm".... remember?



I think you should fully explain yourself  and why you didn't change your cavalier advice until another MD challenged your facts....Sorry if it sounds rough, but it is the truth and you are very lucky not to face a serious lawsuit. Make a note of this in your conscience as you give thousands of opinions to desperate people seeking your advice.



And yes, I should have known better. No answer from you required DR. H.H.H!!!

by t1234, Apr 06, 2006 12:00AM
To: Passed HSV1
Those are strong comments--How do you know you passed or

acsquired HSV1 genitally when you or they were already

infected?



Many people interpret Cold Sores, cuts, fusions, etc on the mouth as HSV1 when it may not be.



So unless you or they had a "swab" tested and typed you

can not be sure.  An anti-body test can't tell you for

certain where the infection is and they are prone to

false positives.



Im not saying it didn't happen--nothing in biology is

certain to an absolute degree--but it's more probable

than your underlying assumptions about the prior HSV1

infection were wrong.

by who_is_this, Apr 06, 2006 12:00AM


Just for reference passedHSV1's first couple posts were:



http://www.medhelp.org/forums/STD/messages/1429.html

and

http://www.medhelp.org/forums/STD/messages/1434.html

by GymBoiNC, Apr 06, 2006 12:00AM
First, when I said After I meant after we had sex.  I did not notice the person had a scab until then.  I feel better knowing that I maybe immune.  But I am also confused.  You said it is unlikely I would devlope genital herpes.  But in the FAQ you do state if you already have HSV-1 you can not contract it anywhere else on your body and you can not contract HSV-2 orally.  Now is this correct or is there a chance I can get genital herpes even though I have HSV-1 already.

by gracefromHHP, Apr 06, 2006 12:00AM
gymboi - Reread what  Dr H wrote to you - he said "But even if you slip up on this, as you might have done, you are very unlikely to get a new genital HSV-1 infection. "





Your hsv1 oral infection provides you with significant but not 100% protection against acquiring the virus elsewhere - like your genital area.  There are a few folks who are unlucky enough to have a well established oral hsv1 infection and then contract the virus either genitally or elsewhere later on. It doesn't happen very often thankfully but it can.  Avoiding contact with an active cold sore on your genital area is always a good idea - just to err on the side of caution.  





passedhsv1 - I am not an expert but I play one on tv ( not really but it's the best line I could come up with ).





grace

by t1234, Apr 06, 2006 12:00AM
To: GracefromHHP


My understanding it may not be 100 per cent but it's probably greater than the accuacy rate of any HSV test--greater than 95 per cent.



So for all practical purposes it's zero.



Also, I don't think there's any fairly documented cases of transmission except for multiple site exposures during the initial infection or shortly thereafter before the body

has a chance to build up the antibodies.



Of course, if you other problems with your immune system,

because of another desease, all bets are off, but you'd

be pretty sick.

by H. Hunter Handsfield, M.D., Apr 07, 2006 12:00AM
To: passedHSV1
Good grief.  You're interpreting my comments and advice to individual questioners too rigidly.  Generalizations always have there exceptions.  In fact, here is another generalization, which probably has its exceptions--but still serves the purpose:  there are no absolutes in biology or medicine.  But in general, the "even if they tried" comment still is valid (as a generalization).



Anna Wald and I are close friends and in personal contact at least once a week.  But we have had no discussions or communications about the level of immunity to new infection with the same HSV type.  Gracefromhpp is a herpes-knowlegeable health professional but we have not met; I know her only from this forum.



Your comment is on the edge of appropriateness and you are very close to being excluded from further participation here.  Not because I take your criticism personally, but because no ad hominem attacks are permitted on this forum.  Mellow out, my friend.



HHH, MD