Get Real! I’m Hopping Mad About Herpes

Many people have oral herpes but don't know it, and don't know that cold sores are a symptom. Most get it in childhood and don't remember their first sores; some people will never see a sore again, though they have and can possibly transmit Herpes.

This column appears as part of a partnership with Rewire and Scarleteen.

Sunlitx asks:

I’ve been reading Scarleteen since I was at
least 16, and the vital knowledge has kept me safe thus far…
UNFORTUNATELY after getting through high school and college completely
unscathed and mostly responsible, I finally dropped my guard for a
nice, geeky, Christian boy who’d never kissed a girl EVER. And now I
have oral herpes. I’m pissed. Really, really pissed. One day he greeted
me with a kiss and when he pulled back I noticed his lips were a bit on
the gross side. When he said, "Oh, I just have a cold sore," I
completely freaked. Apparently his whole family caught it from his
parents and they never made it clear to them that A) Cold sores/Fever
blisters ARE Herpes and B) they can be spread to others. They act like
it’s completely normal. The last time I went to his house I saw a BULK
sized bottle of Lysine on the kitchen sink. When my boyfriend asked his
mom about why they never warned him, she replied that I was simply
overreacting and that I should get over it.

I want to know how I can get through this without hating him and his
generally very nice family. He’s a great guy, and he didn’t do it on
purpose (I’ve never met anyone who has), but I’m just so pissed at him
and at myself. I feel dirty, ashamed, and like I should have known
better.  Thanks, Newly Blistered Sister

Heather Replies:

When I was in high school, I was — as I still am now — in the
habit of hugging friends and warmly kissing them on the cheek, the
sides of their mouth or on the mouth entire when greeting them, passing
them in the halls, or just because I loved them and liked to
demonstrate my affection. You can imagine how much everyone loved me
during the week we all found out the hard way that I had mononucleosis
and had spread it to nearly the entire junior class in the span of
around fifteen minutes of kissy-greetings.

I couldn’t have known I had mono, mind you, because I hadn’t had
symptoms yet, and even if I had, I likely wouldn’t have been able to
figure out that’s what it was until I was sick for a week or more,
despite growing up with a healthcare professional. But too, mono is so
common, and chances are good that if it wasn’t me who passed it around,
someone was going to eventually and most of us were going to get it.
It’s very common in young adult populations, it’s highly contagious,
and people who get mono usually don’t know they have until after they
have already been in the most contagious period.

Oral herpes is a lot like this, despite the fact that cold sores or
"fever blisters" are a common symptom and are sometimes present and
visible among those with Herpes. I can’t begin to tell you how many
people in the world don’t know that they have oral Herpes, and don’t
know that cold sores are a symptom of oral herpes. Most people get it
in childhood and have no memory of sores (some won’t have them at all)
back then when they contracted it, and some people will never see a
sore again, even though they have and can possibly transmit Herpes.
Chances are very good this is not even your first exposure to HSV-I:
you’ve probably already been exposed to it many times in your life
before this without even knowing, and for all you know, you already had
it yourself and are only seeing a sore now due to re-exposure. And if
your whole family had it, you might very well have the same attitudes
about it as his do.

Getting mad at laymen about this only makes so much sense to me,
even though I understand your disappointment at contracting a virus you
can’t ditch.

Plenty of doctors will refer to oral herpes as "cold sores,"
and not explain that those sores are Herpes symptoms, and that the
emergence of those sores — and the time just before — also signals
the period of the highest risk of transmission. Plenty of doctors do
not tell people with oral Herpes about potential risks of genital
transmission (in part likely because some really aren’t comfortable
talking to people, especially young people, about oral sex, nor are
many people comfortable talking about sex with their doctors, either).
Of course, for doctors to even have these kinds of responses at all,
they have to either see a sore when a patient has a visit with them or
be asked by a patient about cold sores, so we can only hold doctors so
responsible, too. Often a doctor won’t see active sores or be asked
about them by their patients. But when even healthcare pros and others
in the know don’t pass this information along to laymen, we can only
hold laymen so responsible.

Some of that "Oh, it’s nothing," stuff comes from the fact that oral
Herpes is one of the most common and benign viruses out there. As many
as 80% of people in the U.S. people have it, and most contract it in
childhood from casual, everyday contact. If people act like it’s
normal, it might have to do with the fact that it is normal: more
people have Herpes than not, and it’s pretty safe to say that
all of us have been exposed to it in life, usually multiple times
before we’ve even started being worried about cooties, let alone Herpes.

As a regular reader of Scarleteen, I hope I don’t have to tell you
the this guy’s (lack of) sexual experience, his geekiness or his
religion have squat to do with any of this, and that we can’t figure
someone is somehow free of illness based on things like this. There is
no one kind of person who has — or does not have — Herpes or any
other virus. For sure, it’s sound to figure our risks of, say, Syphilis
are very minimal if we have sex with someone who has never had any kind
of sex with anyone else, because that’s an infection that is often only
sexually transmitted.

But oral Herpes isn’t Syphilis, not when it comes to its epidemiology, and also not when it comes to the possible severity of effects it can have on your life. Heck, for most people even Syphilis isn’t Syphilis anymore in that respect.

Oral herpes really isn’t likely to be that big of a deal when it
comes to your health and the health of others. I swear. Yes, you can
transmit it easily (and often it is passed around in families
nonsexually as happened with this guy and his folks), and yes, there
can be a risk of transmitting oral Herpes genitally. However, that is
relatively uncommon: genital Herpes, or HSV-2, is usually the type of
herpes one gets and transmits genitally.

Let me share some basic information with you from the American Social Health Association on this, as well as what you need to know now so far as protecting yourself and others:

Oral herpes is transmitted through direct contact
between the contagious area and broken skin (a cut or break) and mucous
membrane tissue (such as the mouth or genitals). Herpes can also be
transmitted when there are no symptoms present. There are several days
throughout the year when the virus reactivates yet causes no symptoms
(called asymptomatic shedding, viral shedding, or asymptomatic

If a person is experiencing symptoms orally, we recommend abstaining
from performing oral sex and kissing others directly on the mouth until
signs have healed and the skin looks normal again. Because most adults
have oral herpes, we do not advise that a person stop giving or
receiving affection altogether between outbreaks (when there are no
signs or symptoms) simply because they have oral herpes. However, using
a barrier (such as a dental dam) or condom when performing oral sex
(even though there are no symptoms present around the mouth) can reduce
the risk of contracting genital herpes.

By performing oral sex on someone who has genital herpes, it would
be possible to contract oral herpes – but this is rare. Most cases of
genital herpes are caused by HSV-2, which rarely affects the mouth or
face. Also, and even more importantly, most adults already have oral
HSV-1, contracted as a child through kissing relatives or friends.

(A geeky aside of my own: ASHA, originally called the
American Social Hygiene Association, was the first official sex
education organization in the United States. Around the turn of the
century, despite some profound differences in attitudes around
sexuality and sex ed, the ASHA was basically Scarleteen for Victorians.

In many ways Herpes really IS no big deal for most people. In
immunosuppressed (in case it’s not obvious, people whose immune systems
are suppressed, or not functioning well) people, Herpes, like many any
virus, can present some serious health risks. Having herpes — though
more often this is about genital herpes, rather than oral — can also
up the risks of us acquiring other infections sometimes. But for the
most part, not only is there nothing dirty about it, there’s not
usually anything dangerous about it either. It’s unlikely to impact
your health or your life, though how you think about it can certainly
have an impact.

You say that you feel dirty and ashamed, despite the fact that the
virus you contracted has nothing to do with cleanliness, and is about
as common as the common cold. It is no more or less dirty than cold
viruses, leukemia, the flu or chicken pox (which is in the same family
as the Herpes virus). I understand why you feel that way, but only
because our culture has stigmatized some viruses rather than others,
often based on all kinds of isms and phobias, and in this case, based
on the fact that Herpes viruses can be sexually or intimately
transmitted, which is the case for a ton of illness including, again,
things like colds and flus.

We can probably factor in, too, that
looksism is a factor, as Herpes sores are visible. Sure, it makes sense
in some degree for all of us to want to be healthy, and not have
illnesses, and to view illness as something we want to avoid. But if
you didn’t feel this way if and when you got the chicken pox, and don’t
feel this way when you get the seasonal sniffles, I think your feelings
about this illness probably have more to do with stigmatization coming
from a not-so-great place than with worries about your health. I’m not
wagging fingers at you, by the way: none of us are immune (no pun
intended) from these attitudes, and we do live in a world where we have
to deal with these notions.

I’d implore you to do what you can to diffuse your anger about this:
I’d say those feelings are more likely to bum out your life than a cold
sore now and then, or than letting someone know you’ve got oral Herpes
like most people do. Stress presents more health risks than HSV-I does.
I’d also try to let go of your anger towards him, his family and
yourself. None of you did anything wrong, nor is there anything wrong
with you besides being human and being people who don’t live in a
plastic bubble. We pick up viruses in life, and while there absolutely
are plenty of things we can do to reduce our risks, there really is
nothing we can do to remove those risks completely. This is just the
world we live in, whether we have never kissed anyone before or we
volunteer to run the kissing booth every year without fail.

You say you should have known better, but what I wonder is what you
mean when you say that. How would you have behaved instead? I think
it’s safe to say that most of us don’t ask everyone we kiss, be it
romantically or platonically — and that would include relatives and
friends — if they have ever had a cold sore before we kiss them. We
don’t also tend to give people we’re used to kissing a super-close
inspection of their mouth before we kiss them. And I think we all know
how often a friend will have us taste something they’re drinking, or we
share water bottles, without many of us giving it any thought at all.
Now, if Herpes was very dangerous to us (and again, for some groups of
people it is), it would make sense to do and ask things like that,
though we’d likely also be asking then if they had been sick with
anything else lately, too, if it was safe for us to have that close of
contact at all. But a lot of why we don’t tend to engage in those kinds
of behaviors is because it’s usually not dangerous, because our quality
of life (which includes relaxed affection with people) is also a factor
in the choices we make, and because in a lot of ways, there is just
very little we can do to avoid being exposed to oral Herpes, and we’re
either going to get it or not, which is also often based on pretty
random factors.

My advice to you at this point, beyond trying to adjust your
headspace on this, is just to talk to you own doctor about oral Herpes.
You absolutely can discuss and consider treatments, if you like, which
reduce outbreaks for you. There are also some support groups out and
about on the web for people with either type of Herpes who are having a
tough time adjusting, so if this stays hard for you, you might want to
seek one of those out for yourself.

An etiquette point: I don’t know what "freaking out" is for you, but
when I say I freaked out on someone, I’m usually talking about some
pretty high-key behavior on my part where I am not being particularly
sensitive to the feelings of others. If that’s what it means for you,
too, and it involved any shame or blame to this guy or his family about
their Herpes, I would personally say an apology is likely in order. It
feels pretty crappy to be treated like a leper, even if you have
lepracy, and all the more so when you don’t. I don’t know what your
feelings are per if this is still a relationship you want to pursue,
but whether you do or you don’t, I’d make some peace. After all, you
clearly don’t like how you’re feeling right now, so you can imagine how
they probably don’t like feeling that way, either.

Okay? You’re not dirty, and neither you nor this guy have anything to be ashamed of. Seriously, this will
be okay, and if you let yourself, I think you’ll get okay with it, too,
in fairly short order. I’m going to leave you with a few extra links I
hope can help you get there: