Cold Sores and Transmission

Hey Doc,

First of all thanks for the valuable service you offer here. It's a great site. Secondly, I was wondering if you could shed some light on a subject that has a huge grey area and up for some debate between who you ask.

I may become intimate soon with a woman who has had cold sores (I believe HSV-1) as a younger child. She has said she has not gotten them at all recently, but used to get them when she, well, had a cold. She always worries when she gets a cold now they'll come back, but she swears they haven't.

So obviously my question is two fold. What is the likelihood of getting HSV-1 (cold sores, whatever) if I kissed her on a random day (heavy kissing, not just a quick kiss on the lips). And secondly, how likely would oral to genital transmission be, again, if no visible sores are present and she swears she hasn't gotten them in years. What would be the scientific possibility and in your experience, the real world possibility? There's a lot of misinformation out there, so to have a clear answer from an expert doctor would be much appreciated. I have only recently started to worry about this as I have learned someone with cold sores could give you genital herpes.

Thanks.

[Alan Rockoff, MD]

The risk is very low.  Because there may theoretically be shedding of virus when no sore is present, the risk isn't zero.  My own attitude toward risks like these is that, first of all, nothing is risk-free, including crossing the street.  Second, certain things in life are not worth giving up to to avoid small risks.  Intimacy requires kissing.  Avoiding it forever, or using scotch tape to cover the mouth as a recent questioner said he and his partner were doing, makes very little sense, at least to me.  It's a matter of balance and judgment.  Your choice.

Best.

Dr. Rockoff

[swatelite]

I agree with you. Thanks Doctor.