Ask Doctor T

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Am I going to pass on HSV1 without a coldsore present?

To directly answer your question, yes, it’s possible but less likely (especially if it’s been years since your last outbreak). But before I go into detail I want to explain your terminology to those who are unfamiliar.

HSV1 is a herpes virus that generally causes coldsores of the mouth, while HSV2 is a herpes virus that generally causes herpes lesions of the genital region. While the majority of HSV1 infections are of the mouth and the majority of HSV2 infections are of the private area, it IS possible to swap (meaning you can have HSV1 of the private area or HSV2 of the mouth). This happens through oral sex.

The second thing to address is that herpes is, duh, a virus. Generally speaking, viruses are not “treatable” (meaning we don’t totally get rid of the virus once we catch it) but they are manageable. Sometimes our own immune systems keep the virus in check while other times it’s necessary to take a medication to keep the virus under control. Herpes infections generally “flare” with triggers (like stress) — our bodies are pretty good at controlling the virus until our immune systems allow a “flare.” This is when you have coldsores or genital lesions. It’s also worth mentioning that you never have a herpes infection without first having a coldsore or genital lesion, so don’t worry that you have herpes and don’t know it.

Now, back to the question. There’s something called “viral shedding” that can happen whether it’s HSV1 or HSV2, which describes spreading the virus without an active lesion. So while it’s much more common to spread HSV infections while you have active lesions (coldsores or genital sores), it is possible to spread the virus without any sores at all. For HSV1, to avoid spreading, avoid kissing when you have an active lesion or use barrier protection when performing oral sex. For HSV2, talk with a doctor about a regular medication that can help reduce the risk of spreading to your partners