Mary Jo Podgurski

Column Mary Jo Podgurski

Dr. Mary Jo Podgurski is the founder and director of the Washington Health System Teen Outreach. She responds to 68 questions from young people daily and has written 'Ask Mary Jo' since 2005.

Bad info about cold sores is common

January 15, 2014

Q.I kinda ran into an issue out here that I never really faced back at home. I’ve had cold sores since I was little, and growing up it seemed everyone around me also dealt with them. I feel like back at home they were treated as typical, and it was something people just dealt with. I realize it is HSV-1, and I’ve never officially been tested for it since I haven’t had any outbreak for the past couple years. Then I started looking at pictures online, and I don’t remember them ever looking like blisters or scabbing. Mine have usually just been one bump that was really sensitive on my lip. Could it have been pimples? Sometimes the sores were on my tongue or the roof of my mouth. But the main issue I’m facing out here is with the person I’m with right now. We were talking about STD testing and I mentioned I used to get cold sores, and he was immediately mean and told me that it’s disgusting. I’ve never kissed him during an outbreak because I haven’t had one in years, and on top of that, as bad as it sounds, I kinda forgot I got them. I don’t know how to feel or even explain to him that it’s not a horrible disease and that it’s more common than he thinks.


Mary Jo’s response: Cold sores are common; misinformation about oral blisters or lesions is equally common. First, let’s clear up some myths. I’d also like to address your partner’s reaction.

Not all blisters around the mouth or lips are caused by a herpes virus, but most are. Typically called “cold sores” or “fever blisters,” an open oral sore is usually caused by Herpes Simplex Virus-1. The Centers for Disease Control research states nearly 60 percent of Americans show antibodies for HSV-1. Typically, a person is infected with HSV-1 in childhood.

HSV-2 causes genital herpes. Although HSV-1 will most commonly produce oral symptoms, this form of the virus can also cause genital herpes. HSV-1 infection of the genitals can result from oral-to-genital or genital-to-genital contact with a person living with HSV-1. Recent research shows young people today may be at higher risk of contracting genital herpes simply because they don’t have enough immune system antibodies to shield them from the herpes virus. Fewer teens are being exposed in childhood to HSV-1 through cold sores. HSV-1 is now the predominant herpes strain causing genital infection, with nearly 60 percent of genital herpes caused by HSV-1.

Another type of oral sore often confused with HSV-1 is a canker sore. Cold sores caused by herpes are typically groups of painful, fluid-filled blisters appearing outside the mouth, usually under the nose, around the lips or under the chin. Canker sores usually occur inside the mouth.

Canker sore symptoms are:

• Painful sores inside the mouth, on the tongue, soft palate (the back portion of the roof of the mouth), or inside the cheeks;

• Tingling or burning sensation before the sores appear;

• And round white or gray sores in the mouth with a red edge.

HSV-1 symptoms are:

• Usually pain around the mouth and lips;

• A fever, sore throat or swollen glands in the neck;

• Once the blister appears, it may break open, leak a clear fluid and then crust over;

• Tiredness or muscle aches may occur;

• Some people experience tingling/burning a few hours or days before the sore appears;

• And the sore usually disappears after several days to two weeks.

Doctors or health care providers can diagnosis a sore.

Remember, HSV is a contagious virus.

The virus is spread person to person by kissing or other close contact with sores or apparently normal skin that is shedding the virus. HSV-1 can be passed to another person even when a sore is not present since the virus is sometimes shed in saliva. It is almost impossible to contact herpes from contaminated surfaces, towels or washcloths.

After the first infection, the virus enters the nerve cells and travels up the nerve until it comes to a place called a ganglion, which is a collection of nerve cells. It enters a stage called a “dormant” or “latent” period.

In more active stages, the virus starts multiplying again and travels down the nerve to the skin, causing recurring cases of blisters.

Factors influencing a recurring case of HSV sores:

• The common cold or the flu;

• UV radiation (exposure to the sun);

• Stress ;

• Immune system changes;

• Hormonal changes (like menstruation);

• And damaged skin.

No matter the cause of an oral sore, communication between partners is vital. Many, many individuals have satisfying relationships after a herpes infection. I suggest an open conversation with your partner where feelings about illness and sexually transmitted infections are shared.

All people are worthy of respect.



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