CARNAL NATION

A majority of people have oral herpes, which is usually acquired during childhood. Though not as ubiquitous, genital herpes is one of the most common sexually transmitted infections, and one of the hardest to prevent.

"Cold sores" or "fever blisters" are typically caused by herpes simplex virus type 1 (HSV-1), while genital herpes is usually caused by herpes simplex virus type 2 (HSV-2). But both viruses can infect either location, and yes, you can transmit herpes from the mouth to the genitals—or vice versa—through oral sex.

Herpes simplex lies dormant in the nerves, reactivating periodically to cause skin blisters that break to form open sores. The virus is spread through sex, kissing, or other skin-to-skin contact (herpes is not transmitted via semen). Touching the sores can spread HSV from one part of the body to another.

Many people with oral or genital herpes have no symptoms and do not even know they are infected, but they can still transmit the virus to others. Some experience only one or a few outbreaks over a lifetime, while others have them several times a year. Frequent episodes can be a sign of compromised immunity—so an HIV test is a good idea—but otherwise healthy people have them too.

Outbreaks can be triggered by a variety of factors including sun exposure, menstruation, and dips in immune function due to stress. As the name implies, herpes blisters often crop up when a person has a fever or is fighting another infection. But outbreaks may occur without warning—with no obvious triggering factors—so they are difficult to reliably predict.

Herpes can spread through intact skin even before an open sore develops. Many people feel a tingling, itching, or burning sensation (known as the prodrome) before lesions erupt. As you noted, emerging herpes blisters can look and feel like acne. But other people don't have advance clues, making it a challenge to protect their partners. While condoms offer some protection—reducing the risk by 30%, according to one recent study. However, this protective effect only applies to areas that are actually covered.

Herpes outbreaks can be treated with antiviral medications, usually acyclovir (Zovirax or generic) pills or ointment or valacyclovir (Valtrex) pills. Regular suppressive therapy can reduce recurrences in people with frequent outbreaks. It is not routinely used to prevent occasional outbreaks, however, since this could lead to drug resistance. While treatment can reduce the length and severity of outbreaks—and also lower the risk of transmission, it does not "cure" or permanently get rid of the virus. However, many people find that the frequency of outbreaks diminishes over time.

If you have not already done so, have a frank talk with your boyfriend and tell him you have oral herpes with regular outbreaks. Do avoid sexual or other skin-to-skin contact during active outbreaks, but both of you should be aware that this will only reduce—not eliminate—the risk of transmission.

 

Unfortunately, herpes is a challenging one to deal with. That’s because the skin sheds the virus, which means you’re contagious, even before you know you’re having an outbreak. But there are some things you can do.

Generally, Herpes Simplex Virus-1 (HSV-1) is a cold sore, while HSV-2 generally affects the genitals. But they can both infect the face and the genitals, so it’s quite possible that you have HSV-2. It’s not too clear from current medical information how common transmission from oral to genital herpes is, but it definitely happens.

And for the record, it’s estimated that about 1 in 6 people has herpes without knowing it. It’s also possible to have a herpes outbreak in the deeper parts of the vagina and not know it, so anyone who says that they definitely don’t have herpes doesn’t know what they’re talking about. The most that anyone can say is that they’ve never had an outbreak (that they’ve noticed). Fortunately, while herpes can be annoying, it’s not nearly as scary as a lot of other sexually transmitted infections (STIs). And while it doesn’t go away, there are steps you can take to reduce the odds of having an outbreak.

First, take care of yourself. Herpes tends to show up when you’re stressed out or tired because your immune system is weaker. Since you’ve had so many outbreaks in a short time, perhaps you’ve made some changes recently that are making your body less able to keep things in check. Anything you can do to reverse that could help.

Second, there are anti-viral medications available. Some people take them when they have occasional outbreaks, while others who are prone to more frequent outbreaks take them on a regular basis. Some people swear by creams or gels to make the outbreaks heal faster, although many medical professionals don’t recommend them. And if your outbreaks are painful, some folks use topical anesthetics such as Dilocaine or Nervocaine.

Third, you can use a condom for oral sex. Add a little lube inside the condom to make it feel better and make sure you change the condom if you decide to move on to intercourse. Otherwise, you risk transmitting the virus from your mouth to your vagina, even if you keep it off his penis. You’ll also improve your odds (and his) a lot if you stop giving him blow jobs when you have an outbreak.

Fourth, some people try to avoid foods that contain high levels of arginine because it can increase the likelihood of an outbreak. This page has some useful information about that, although I’d suggest doing a bit more research before making a big diet change.

I hope this helps. I know that there are companies working on better treatments, but in the meantime, the best thing you can do is use condoms for oral sex and take care of yourself to minimize the odds of an outbreak.

Cold sores, which you know come from the Herpes Simplex Virus, are very common among the adult population. The frequency of outbreaks can vary from one individual to the next and are connected to the strength of the immune system and the length of time someone has had the virus. Most people notice a decrease in outbreaks over the years, but any number of things from stress to sunlight can be a trigger for outbreaks. Take note of what's been happening in your life lately, especially things that might be different. Then talk to a doctor about medication that can help treat herpes and decrease the risk of transmission.

HSV 1&2 can infect someone outside of their "site of preference," but the risk is lower. Most infections occur during viral shedding, which may or may not be followed by an actual outbreak. Herpes meds, attempting to identify outbreak triggers, boosting the immune system, and taking lysine supplements are all tactics that have been reported as helpful. You can also add in a barrier (e.g., condoms and dental dams) for oral sex to limit contact with infected skin.

Talking to your doctor can be helpful as can doing your own research. I recommend Herpes Online, which has articles, book references, and an online community as well that can help you try to minimize outbreaks, keep your partners safer, and give you support from the many, many, many other people in your situation.