Oral herpes, commonly known as cold sores or fever blisters, is a widespread viral infection typically caused by the herpes simplex virus type 1 (HSV-1). It usually manifests as sores around the mouth. This article explores the considerations and risks associated with kissing when one has oral herpes.
How Oral Herpes Spreads
Oral herpes primarily spreads through direct skin-to-skin contact, particularly with active sores, blisters, or saliva from an infected person. The fluid within these blisters contains a high concentration of the herpes simplex virus. This direct contact can occur through activities like kissing.
The virus can also be transmitted even when no visible symptoms are present, a process known as asymptomatic shedding. During this time, the virus is present on the skin or in saliva without causing noticeable sores. Studies indicate HSV-1 can be detected in the saliva of some individuals even without symptoms.
Assessing Kissing Risk
The risk of transmitting oral herpes through kissing varies significantly. During an active outbreak, when cold sores or blisters are visible, the risk is substantially higher. This is due to the high viral load within the lesions, making them highly contagious. Direct contact with these sores can easily transfer the virus.
Even without visible sores, transmission risk exists due to asymptomatic shedding. While viral concentration during asymptomatic shedding is lower than during an active outbreak, the virus is still present and can be transmitted. Many individuals shed HSV-1 asymptomatically from their mouth, sometimes frequently. Therefore, the risk is reduced when no symptoms are present, but not eliminated.
Reducing Transmission Risk
To minimize transmission risk through kissing, avoid direct oral contact during an active outbreak. This is especially important when cold sores or blisters are present, or a tingling sensation signals an impending outbreak. This also includes avoiding oral sex.
Refrain from sharing personal items that contact the mouth, such as lip balm, utensils, drinking glasses, or straws, as the virus can survive on these surfaces. While the risk from inanimate objects is generally low, transmission is still possible.
Open communication with partners about one’s herpes status can help manage expectations and reduce potential transmission.
Special consideration should be given to kissing babies and young children, whose immune systems are still developing. Kissing an infant, especially on the mouth, when one has an active cold sore or even during asymptomatic shedding, poses a risk of serious infection for the child. The safest approach is to avoid kissing babies near their mouth, nose, or eyes. While HSV-1 can cause genital herpes through oral-genital contact, the primary concern related to kissing is oral-to-oral spread.