When you think of herpes, your mind’s eye might immediately conjure up images of bumps on your vagina. It makes sense, since those ulcers are often the hallmark symptom that tips people off to the fact that they have herpes in the first place. But cold sores, or painful lesions on the lips, mouth, and surrounding area, are another telltale sign of herpes. What’s more, they’re a symptom people might suffer through without understanding that the sores are saying something important about their health.
Someone experiencing a cold sore may think it’s something else entirely.
“People sometimes pick up [herpes] and get a cold sore but don’t realize what it is,” Brian A. Levine, M.D., and New York practice director for the Colorado Center for Reproductive Medicine, tells SELF. “The classic herpetic lesion is like a bit of rain or dew on top of the skin,” he explains. “Once it ruptures, that’s when you get a crater and crustiness.” People may think their cold sores are instead canker sores, aka angry, noncontagious lesions that aren’t linked with herpes, or exceptionally painful pimples, at least at the start before the blister opens up. They might even recognize them as cold sores but not pinpoint herpes as the cause.
That’s especially true because, as Levine explains, “people can get infected when they’re kids.” Sharing things like utensils can spread the herpes virus, as can a relative giving you a kiss in the mouth area. If you grew up always getting cold sores, it’s easy to not equate them with a sexually transmitted infection.
In addition to not realizing cold sores are herpes, there’s another common blind spot people experience with the virus.
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See, the herpes virus comes in two forms: herpes simplex 1 and herpes simplex 2. Although conventional thinking says herpes simplex 1 causes cold sores and herpes simplex 2 causes genital outbreaks, that’s not always the case, Jamil Abdur-Rahman, M.D., board-certified ob/gyn and chairman of obstetrics and gynecology at Vista East Medical Center in Waukegan, Illinois, tells SELF. He explains that even when his patients know why they’re getting cold sores, they assume that genital herpes is one thing and the type that causes cold sores is different. “They don’t realize both [strains] can cause either oral or genital herpes.”
Sometimes people ask for a swab test that tells them which type of herpes they have because they wonder how they got it, says Abdur-Rahman. But as he explains, “testing positive for type 2 just means [the herpes] is caused by the virus that usually causes genital herpes, it doesn’t mean that you didn’t get it from kissing someone.”
The distinction doesn’t matter much in the practical sense—wherever your herpes shows up is where it shows up, independent of which strain brought it about or how you got it. But it’s key to know that if you have herpes, you can give it to someone else through kissing or oral sex, no matter which strain you have.
But, since nothing in life is simple, it’s common to have herpes without any symptoms at all.
That’s why most people with herpes have it without knowing it, according to the CDC. About two-thirds of the global population under age 50 has herpes simplex 1, according to the World Health Organization, and around one in every six people between ages 14 and 49 has genital herpes, according to the CDC. In fact, because it’s so common, doctors often don’t even test for it in the usual STI workup.
Source: SELF
