[Question #4491] Prevention of HSV1

31 months ago
I hoping to get some solid advice. I have three girls ages 24. 28. and 29 and I do not want them to have to deal with what I have dealt with - 20 years or so of cold sores. I've heard that based on your genes you either do or don't get cold sores after exposure so obviously I'm concerned about my kids. None of them have ever had a cold sore. What is the best advice to give them to prevent this in the future? I'm really stressed out over this asymptomatic shedding and don't know what to tell them. Thanks for any help.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
31 months ago
They may well be infected already - about 70% of those infected with HSV 1 do not know they are infected as they don't have outbreaks or confuse their outbreaks with other things.  It would be wise not to kiss someone with a cold sore and certainly not receive oral sex from them.  But HSV 1 can be transmitted when there are no symptoms present so there is no perfect solution here.  But there are very effective medications to treat cold sores.  I get cold sores but taken antiviral medicine the moment I feel one coming on and have not had an actual cold sore in probably 10 years - used to get them all the time! 

Terri
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31 months ago
Thanks. I guess what I'm concerned about is that - if they haven't been exposed - a situation where someone with a cold sore would greet them with a kiss on the lips before they could realize he had one. They know not to "make-out" with someone who has one. Thoughts?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
31 months ago
What you seem to be describing is a brief kiss, yes?  If there is an active cold sore present on the person doing the kissing, this presents some risk of infection.  But often a brief kiss does not have enough contact to spread the virus.  And if there is no cold sore present, transmission is unlikely if the kiss is brief rather than passionate and extended. 

Terri
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31 months ago
 I guess it seems like mixed messages. On the one hand, I'm reading HSV1 is not easily transmittable and on the other hand it seems rather easy.  I was at a concert this past weekend with literally 10's of thousands of people and didn't notice one person with a cold sore. I would like to know: 1) is it true we see photos of the worst cases of cold sores and most aren't often noticeable?; 2) just because I get cold sores doesn't mean my children will if they're infected correct?;  3) Sounds like you're saying in most cases Valtrex can prevent the re-occurence of cold sore for most people, correct? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
31 months ago
1) I think more and more people who get cold sores are treating them effectively with antiviral medicine right away and that keeps many of them from getting very noticeable.
2) No, just because you get them does NOT mean your children will get them.  Just avoid kissing them with a cold sore.  But as they grow up, they may well passionately kiss someone who gets cold sores and get them later or get the virus genitally when receiving oral sex because they have no immune response from getting them orally.  Protecting our children so carefully from getting cold sores as children seems to be resulting in more and more cases of genital HSV 1 infection due to lack of immunity acquired in childhood from cold sores.  It's a mixed bag for sure
3) Yes, these medicines are effective in stopping cold sores before they erupt.

Terri
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