Why Calling Oral Herpes Cold Sores Can Cause Problems

Men's Sexual Health
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Many people are surprised to learn that their cold sores can cause genital herpes infections. That is, in part, because the innocuous name makes it easy to forget that cold sores are caused by a herpes virus. Some people don't know that cold sores, or fever blisters, are infectious. Others assume that they're a side effect of having a cold. However, cold sores are just another type of herpes. As such, maybe it's time to stop calling oral herpes "cold sores" and start referring to it as oral herpes.

Unlike cold sores, that option is both simple and easy to understand. 

Herpes is an infection that people can live happily with. It's important for educators and doctors to do everything we can to make that as easy as possible. Talking honestly and accurately about cold sores as oral herpes may be one way to help. Accurate labeling is also an important step in prevention. Many people don't even realize that cold sores are something they even need to discuss when they're having conversations about testing and safe sex. That means that they don't practice safe sex at times where it might be a good idea. For example, they don't use barriers for oral sex -- even during an outbreak. 

HSV-1 usually causes cold sores/oral herpes and HSV-2 usually causes genital herpes, but either virus can infect either site. This means that oral sex puts people at risk of transmitting herpes from the mouth to the genitals and vice versa.

In fact, some researchers estimate that more than half of all genital herpes cases are caused by HSV-1. At one time, genital HSV-1 infections were thought to be rare. That is no longer the case. A lot of that change is thought to be due to higher numbers of people having oral sex. 

As with other highly stigmatized topics, there is a fine line to walk between accuracy and clear communication.

Still, it's my opinion that, in many ways, calling oral herpes lesions "cold sores" does people a great disservice. When people are ignorant of their oral herpes infections, they also don't realize that these infections can be transmitted sexually as well as casually. The term "cold sore" may reduce stigma. However, it also reduces comprehension. 

It particularly bothers me that calling oral herpes lesions cold sores makes them seem so different from genital lesions. In many social groups, genital herpes is highly stigmatized in a way that oral herpes is not. That problem reflects, in part,  a lack of understanding about how similar the two infections are. Calling oral herpes "cold sores," while genital herpes has no similarly camouflaged name, encourages the perception that the conditions should be thought of differently. However, the main difference is just that  one infection is usually sexually transmitted when the other is predominantly spread through more casual contact.

Even for people who have lived happily with cold sores and an oral herpes infection for years, the additional stress caused by a genital infection is sometimes significant enough that people talk about their lives being over.

In truth, viruses are viruses, no matter how people get them. Genital herpes isn't a significantly more serious infection because of biology. It shouldn't become one because of social stress. Accurately naming cold sores as oral herpes may be able to help reduce both stigma and transmission. 


Cherpes TL, Meyn LA, Hillier SL. Cunnilingus and vaginal intercourse are risk  factors for herpes simplex virus type 1 acquisition in women. Sex Transm Dis. 2005 Feb;32(2):84-9.

Jin F, Prestage GP, Mao L, Kippax SC, Pell CM, Donovan B, Templeton DJ, TaylorvJ, Mindel A, Kaldor JM, Grulich AE. Transmission of herpes simplex virus types 1  and 2 in a prospective cohort of HIV-negative gay men: the health in men study. J Infect Dis. 2006 Sep 1;194(5):561-70.

Wald A. Genital HSV-1 infections. Sex Transm Infect. 2006 Jun;82(3):189-90.

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