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Recommended wait between cold sore healing and oral sex
June 20, 2014 2:00 PM   Subscribe

Is there a recommended waiting time between a cold sore healing and performing oral sex on someone who may not have HSV-1? Does the answer change if Abreva warded off the cold sore before it actually appeared?

I'm dating someone new, and I've disclosed that I get cold sores. I've also told her about the low-but-existent risk of oral HSV-1 causing genital infection. She still wants to date me, which is great, but I'm terrified of infecting her (or anyone for that matter).

Google has only told me not to kiss or perform oral sex when you have an active sore (gee whiz), but I sort of doubt there's no difference between virus shedding three days after a sore is healed/prevented by drugs and three months after. Is there a standard protocol here? Or a reasonably cautious one?

(Snowflake details: I average 3-4 Abreva-thwarted cold sores a year. I felt a definite pre-cold sore tingle about three weeks ago, applied 4-5 spaced doses, and no sore ever formed. But I'm scared that stopping 2 doses after the tingle was gone didn't really stop all the viral shedding. I have no hard evidence because there's no redness or anything, but occasionally I'll have a day where several times, I'll feel an ambiguous phantom tingle in the same spot, worry, and then calm down when I feel something similar on my cheek or something. Yesterday I caved, began 4 doses of Abreva, and haven't felt anything since, but that could be the placebo effect solving an imaginary problem. I have major hypochondriac tendencies, but the thing with those is, you could always be right.)
posted by anonymous to Health & Fitness (8 answers total) 4 users marked this as a favorite
 
I think that you have a lot of anxiety about this that it would be worthwhile to address with a therapist and/or a short acting anti anxiety drug to reduce your anxiety when you think you might feel a tingle.

Separately, if this is disrupting your life you could talk to your doctor about suppression therapy with an oral antiviral. It's usually used for more severe cases, but would provide more certainty. Otherwise, there are no certain guides on how to eliminate risk.
posted by mercredi at 2:20 PM on June 20 [1 favorite]


I don't know the definitive answer to your question, but I came in to suggest you go to your doctor and get a prescription for Valacyclovir (Valtrex). Valacyclovir will kill a cold sore dead in the blink of an eye. You can be free of the 3-4-cold-sores-per-year menace!

Bonus: Then, you can ask your doctor this question. He or she will be able to provide you with a better answer than the hive mind.

Also, do you know about L-Lysine? I've been taking it daily for about five years, and I've had only one cold sore that whole time. Before starting a Lysine regimen, I'd get one about once a year.
posted by sevensnowflakes at 2:21 PM on June 20 [2 favorites]


I also agree that you should talk to your doctor about Valtrex or Famvir. Much better than Abreva. You can also get a cream called Zovirax that has a similar active ingredient.
posted by radioamy at 2:22 PM on June 20


If I was HSV- and dating someone who was HSV+, I'd feel most comfortable if they were taking Valacyclovir (Valtrex) prophylacticly as it's proven to reduce chance of transmission to uninfected individuals.
posted by quince at 3:05 PM on June 20 [1 favorite]


If you are really concerned, you can use saran wrap as, kind of, an oral-vaginal ...condom...or, um, barrier...I guess.
posted by Michele in California at 4:15 PM on June 20


I am not a doctor and this is not medical advice. I would encourage you to ask your doctor about this, as I have done, but don't expect a whole lot out of them. ;)

I've had cold sores all my life. None of my 3 partners of either gender has ended up with sores or an apparent infection in any area after being my partner. I am not intimate with a partner when I have a cold sore - I wait for it to heal up completely. A lady I worked with once did the same and had the same result. Same with my mom.

People with herpes simplex who get cold sores are in the minority, but a huge vast incredible amount of the population already has the virus and just never get cold sores. A huge vast incredible amount.

I share your worries and here is the link I found most helpful:
http://www.wholehealthchicago.com/101/cold-sores/

Some of the links from a search of Go Ask Alice are also helpful:
Go Ask Alice

To avoid spreading the virus, don’t touch active blisters and don’t share personal items such as drinking glasses, toothbrushes, razors, or towels.

The italicized bit there is what I have found on every web site I have ever read about this, and it is the same answer I have gotten from every doctor I have asked (about 4). They all advise to wait until the sore heals (if there was just redness and it went away, you are probably okay).

You might try L-lysine and bee pollen for prevention. I take these daily and have hardly any cold sores now.

Valtrex or some other antiviral is also a good option. Discuss such a drug with your partner, and if she is going to be more comfortable if you just have less of the virus to shed, that might be a good way to go. Sex is not fun if you are worried about causing your partner grief. Look into possible side effects and drug interactions (if you are on anything) before taking them, though.

If you continue using Abreva, look into the little lip cover thingies - one brand is Quantum Lip Clear Invisible Cold Sore Bandage. Put a dot of Abreva on that, put the little plastic dot on the sore, and presto, Abreva that stays put.

Therapy, really? *incredulous look* This person is still doing what they want to do, regardless of their anxiety, so it is not interfering with their life. They are seeking information.
posted by AllieTessKipp at 4:51 PM on June 20 [5 favorites]


Your cold sores don't sound as bad as mine. I used to have a chronic cold sore on both sides of my mouth almost endlessly from November through May every single year. I tried Valtrex twice and it never did anything at all. Now, thankfully, I keep them away with a high daily dose of astragalus. Presumably because it is increasing my low wei chi. I now never get a sore as long as I take astragalus every day but if I run out and go more than a couple of weeks without it, then the cold sores come back. You may want to try it if Valtrex for some reason doesn't work for you either.
posted by Blitz at 5:17 PM on June 20


I'm not sure about the time line either, but I did want to throw another vote for valtrex/valacyclovir. I used to get terrible stress induced cold sores, which was very bad when I was student teaching and starting to look for jobs after college. I once had a series of successive cold sores for about 4 months. I finally asked my GP about valtrex and he wrote a prescription. That was three years ago and I haven't had a full on cold sore in that entire time. Repeat- I went from 6-8 cold sores a year to zero. I still occasionally feel a tingle in times of stress, but they never materialize.

Also, I have had cold sores my whole life and have been with my wife for 8 years and she hasn't ever showed symptoms. I'm pretty sure she's not someone who can get them, but still we have taken active precautions when i did get cold sores. (No kissing, no oral sex, no sharing of oral instruments, etc)

tl;dr- talk to your GP about valtrex. It's a tier 1 drug on my insurance, so it's only $15/month. WELL worth the cost.
posted by ThaBombShelterSmith at 7:23 AM on June 21


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