Is It a Cold Sore or Herpes?

There are various names for cold sores, including oral herpes since cold sores are caused by the same virus that causes genital herpes—the herpes simplex virus (HSV). While there are two types of HSV, both can cause sores on the face and genitals.

Herpes simplex virus 1 (HSV-1) is very common, with 50%–80% of adults in the United States having it. Knowing more about HSV, its symptoms, and how to treat it can help you manage your symptoms and outbreaks.

Read on to find out more about HSV, cold sores, and genital herpes.

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Close-up of woman's lips with cold sores

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Cold Sore vs. Herpes

Most cold sores are caused by a virus called the herpes simplex virus. For cold sores, the virus is HSV-1. Herpes simplex virus type 2 (HSV-2) usually causes genital herpes, but either kind of HSV can cause sores on the face and genitals.

Cold Sores Are Herpes

Although cold sores aren't what you typically think of when you think of herpes, cold sores are considered a type of herpes—oral herpes.

Herpes Simplex

Herpes simplex is a common virus. It can cause cold sores and genital herpes.

Symptoms

Many people who have HSV never have any symptoms. If you do have symptoms such as blisters, you may feel a tingling or itchiness before the blisters appear. Where they occur depends on the type of HSV you have, which includes:

  • Oral herpes (HSV-1): Blisters typically are around the mouth or lips but can be on the tongue. Less commonly, the sores are found on the skin in any area
  • Genital herpes (HSV-2): The sores usually are found on the penis, vagina, vulva, buttocks, or anus, but they can appear on any area of the skin.

Other symptoms can include:

  • Flu-like symptoms
  • Pain, burning, or trouble urinating
  • Eye infection: If the herpes virus has spread to the eye (herpes keratitis), it can cause discharge or “gritty” feeling—without treatment, it can scar the eye

Causes

Most people with HSV-1 are exposed as a baby or child through skin-to-skin contact with an adult with the virus. HSV-2 is transmitted through sexual contact. The virus is spread through skin-to-skin contact, with or without any sores or blisters on the skin. This can include:

  • Kissing
  • Touching the skin
  • Sharing things like lip balm, razors, or silverware

Mothers can also transmit HSV to their baby during childbirth.

How Long Are Cold Sores Contagious For?

Cold sores are contagious from a day or two before they are visible (you may have symptoms like burning or tingling in that area) until the sore falls off and the sore is healed. But it is important to remember that even if you aren't symptomatic, you may still be able to transmit the virus.

Treatment

There is no cure for HSV, but treatments are available. Sores and blisters typically clear on their own, but treatment is often used to reduce the severity and duration of outbreaks.

Antiviral creams and ointments can help with itching, and antiviral medications can be taken orally or intravenously to shorten an outbreak. When medication is orally taken on a daily basis, it not only can help with outbreaks, but it also can prevent those who are infected from infecting others.

Genital Herpes

Genital herpes is a sexually transmitted infection (STI) that can be caused by HSV-1 or HSV-2. It is a common STI. About 1 in 6 people in the United States ages 14–49 are living with genital herpes.

Genital herpes can cause sores and blisters that are sometimes painful, but it doesn't always cause any visible symptoms. You can have HSV and not know it. There is no cure, but there is treatment available.

Symptoms

Some people don’t even know they have genital herpes if they have a mild outbreak since the sores can look like ingrown hairs or pimples. The first outbreak typically happens within two to three weeks after having sex with an infected partner.

First symptoms can include a headache, fever, fatigue, and muscle pain. Then you may start to notice raised patches of red skin that develop into blisters that turn into sores. The sores can appear on the genitals, hips, anus, buttocks, or thighs. They may be tingly or itchy as well.

Some people also have pain with urination.

Subsequent outbreaks tend to be less severe than the first one, with the sores clearing more quickly. These outbreaks are often triggered by things like stress, fatigue, sickness, surgery, or sex.

Causes

Genital herpes is caused by the herpes simplex virus and often spreads during sex. This includes vaginal, oral, and anal sex. Even if someone has no visible signs of genital herpes, they can still spread the virus.

It can also be spread through saliva from someone with an oral herpes infection. If one person has oral herpes and performs oral sex on you, you can get genital herpes. This is why some genital herpes is HSV-1 and not HSV-2.

What if I Kissed Someone With a Cold Sore?

If you kissed someone with a cold sore, call your healthcare provider. You may be able to use a topical cream to help minimize the virus or symptoms.

Treatment

There is no cure for genital herpes, but there are treatments to help manage it and reduce the risk of spreading it to another person. Antiviral medication is often prescribed. This medication is taken daily. Common antivirals prescribed include:

These are especially recommended for people with weakened immune systems because without these medications, their bodies would not be able to get rid of the sores on its own. You may need to take antivirals only when you have an outbreak or every day. If taken every day, the medicine can reduce the likelihood of outbreaks by 70%–80%.

Some home remedies for genital herpes can ease symptoms and aid in healing. When you have an outbreak, steps you can take at home include:

  • Keep the area clean and dry.
  • Wear loose-fitting cotton underpants.
  • Use cold compresses to ease pain.
  • Soak in an Epsom salt bath for 10–20 minutes if sores are painful or itchy.

Diagnosis

Healthcare providers like dermatologists (medical doctors specializing in conditions of the skin, hair and nails) and gynecologists (medical doctors specializing in the female reproductive system) can typically diagnose a case of herpes by looking at the sores. A swab may be taken and sent to a laboratory for confirmation. Without any sores, a blood test can detect HSV.

When to Talk to Your Healthcare Provider

If you have had sex or skin-to-skin contact with someone living with HSV, talk with your healthcare provider about your risk and what you should be aware of. If you notice any blisters or sores on your body, along with any other symptoms, call your healthcare provider for an appointment.

Summary

Cold sores and genital herpes are both part of the herpes simplex virus (HSV) family. Both can cause sores and blisters, along with other symptoms. While there is no cure for HSV, there are treatments like antiviral creams and medications that you can take to help shorten the outbreak, address symptoms, and reduce the likelihood of infecting others. 

A Word From Verywell

Getting a cold sore can be embarrassing, especially due to the stigma associated with herpes. Keep in mind that the herpes simplex virus is very common, and having it is nothing to be ashamed of. Knowing what causes it and how to manage it can help you take care of the outbreak more quickly, as well as address any other symptoms.

Frequently Asked Questions

  • What does a cold sore look like?

    Cold sores look like small, fluid-filled blisters. They can be in clusters or a single blister. While they usually are on the lips and around the mouth, they can be anywhere on the face.

  • How long after a cold sore can you give oral sex?

    You should wait until the sore is healed completely and after the scab falls off before giving oral sex. To be safe, using condoms or a dental dam during oral sex can help reduce the likelihood of infection even more.

  • How does a cold sore start?

    Cold sores typically start out with redness, swelling, pain, tingling, or itching where the cold sore will appear. If this is your first outbreak, you may also have significant flu-like symptoms like swollen glands and a headache.

  • Can you prevent a cold sore?

    Avoiding skin-to-skin contact with others is one way to prevent it. If you are already infected, taking an antiviral medication can help to stop the virus from replicating and may help to prevent or reduce the risk of cold sores.

  • How can you hide a cold sore?

    You can hide a cold sore using concealer, but before you do, treat the area with your prescribed topical cream or a cold compress to help reduce swelling. The process is similar to covering up a pimple. Do not pop or pick at a cold sore or blister.

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13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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