What is HSV-1?

Herpes simplex 1 (HSV-1) is a type of herpes simplex virus. Sometimes people refer to HSV-1 as oral herpes. It can cause cold sores that are often around your mouth.

What is the difference between HSV-1 and HSV-2?

HSV-1 spreads through contact with the virus in saliva or skin. It usually affects your mouth and face. Herpes simplex 2 (HSV-2) spreads through sexual contact and usually affects the genitals. Either form of HSV can show up on any area of skin that comes into contact with the virus.

Who might get an HSV-1 infection?

Anyone can get HSV-1. Most people contract HSV-1 during childhood. It spreads when an adult who has the virus has close contact with a child, such as when a family member kisses a child.

Is HSV-1 an STD?

No, HSV-1 is not a sexually transmitted disease (STD). If you receive oral sex from someone with HSV-1, you may contract HSV-1 on your genitals. Although this infection is on your genitals, it is not the same as HSV-2.

How common is HSV-1?

The oral herpes virus is widespread around the world. More than two-thirds of people contract the HSV-1 virus by age 50.

How is HSV-1 transmitted?

People transmit HSV-1 through saliva or skin-to-skin contact. This might mean you touch a herpes sore or you have contact around the sore. People usually get it in childhood, from skin contact that isn’t sexual.

Even if you don't have an active sore, you can still spread the virus to someone else. Healthcare providers call this type of spread asymptomatic viral shedding.

You may contract or spread HSV-1 through:

• Kissing.
• Sharing utensils, cups or lip balm.
• Touching someone around the face or mouth, such as kissing a child.

You can also spread HSV-1 through oral sex. If you receive oral sex from someone who has a cold sore, it may spread a herpes infection to your genitals.

How contagious is HSV-1?

HSV-1 is most contagious when a person has an active cold sore. When cold sores heal, the virus is less contagious. However, a person can spread HSV-1 even with no symptoms.

How does HSV-1 affect my body?

Once you have HSV-1, it stays in your nerve cells. Usually, the virus stays dormant (inactive). Some people have the virus but never have symptoms. If the virus activates, it might trigger herpes symptoms. The symptoms are called an outbreak.

What are the signs of HSV-1?

The most common sign of HSV-1 is cold sores. Cold sores look like fluid-filled blisters. These lesions can also be inside the mouth, where they are often more painful.

You may notice tingling or burning around your mouth in the days before a cold sore appears. These blisters break open and ooze fluid before forming a crust. Usually, sores last for seven to 10 days.

How is HSV-1 diagnosed?

Your healthcare provider may diagnose HSV-1 by looking at a cold sore. You may have a cold sore swab. In these tests, your provider takes a small sample of the cold sore tissue and sends it to a lab for analysis.

If you don't have a cold sore when you visit your healthcare provider, you may have a blood test to confirm or rule out HSV-1.

How is HSV-1 treated?

People who don't have frequent or severe HSV-1 outbreaks may choose not to treat the infection. If you develop cold sores often, you may choose to take a daily antiviral medication. Antivirals can lessen the frequency and intensity of outbreaks. You may also take antiviral medication on an as-needed basis or only when cold sores appear.

Common antiviral drugs for herpes simplex 1 treatment include:

• Acyclovir (Sitavig®, Zovirax®).
• Famciclovir (Famvir®).
• Valacyclovir (Valtrex®).

Can I treat cold sores at home?

HSV-1 treatment may also include natural remedies to treat cold sores. Applying ice to the blisters can relieve discomfort. It also helps to keep your skin moist so it doesn’t crack.

You may use over-the-counter ointments such as L-lysine, benzocaine (Orajel™) or docosanol (Abreva®). Some people use patches to cover the cold sore and minimize its appearance. But you can still spread HSV-1 even if you’ve covered the sore.

You can also be aware of HSV-1 outbreak triggers and avoid them when possible. Common triggers include:

• Fever or illness.
• Menstrual periods.
• Exposure to ultraviolet (UV) rays.
• Stress.

Is there a cure for HSV-1?

There is no cure for HSV-1. Once you have the virus, it remains in your body.

How can I reduce my risk of HSV-1?

You can reduce your risk of contracting HSV-1 by avoiding contact with someone who has a cold sore. People can still spread HSV-1 when cold sores are not present, although it is less likely.

If someone has an active HSV-1 infection, avoid:

• Kissing.
• Oral sex.
• Sharing utensils, cups, lip balms or other personal care products.
• Touching the skin near the mouth.

What is the outlook for people with HSV-1?

HSV-1 is a lifelong infection. You may experience periodic cold sore outbreaks. Although the sores may cause pain or discomfort, HSV-1 doesn’t usually cause any major health risks.

If you have a weakened immune system, speak with your healthcare provider about the risks of herpes simplex.

What should pregnant women know about HSV-1?

In rare cases, young babies can contract HSV-1. Most often, this spread occurs when someone with a cold sore kisses the baby.

An oral herpes infection can be more serious for newborns because new babies don’t have a fully formed immune system. Remind anyone with a cold sore not to kiss your baby. Wash your hands before touching a baby’s skin.

What else should I ask my healthcare provider?

You may also ask your healthcare provider:

• How can I reduce the chances of passing HSV-1 to my partner?
• Are there other conditions that increase the health risks of HSV-1?
• What are the treatment options for HSV-1?
• What happens if I don’t treat a cold sore?

A note from Cleveland Clinic

HSV-1 is one of the two types of herpes simplex virus. If you have symptoms, you’ll most likely notice an occasional blister (cold sore) on your lips or face. Once you have HSV-1, it remains in your body for your whole life. Many people experience few to no symptoms of HSV-1. HSV-1 symptoms may be uncomfortable, but they usually aren’t a severe health risk. You may choose to take antiviral medication to keep herpes symptoms at bay.