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Genital Herpes vs. Cold Sores: What's The Difference?

Donald Grant
Dr Donald GrantMB ChB DRCOG MRCGP Dip.orth.medGP & Clinical Advisor

Reviewed on 24 Jan 2024

Itchy, irritable, and an inconvenience for those who suffer from them, cold sores and genital herpes are among the most common infections on the planet. But while you may have some knowledge, or even experience, of them, what’s the difference between the two? Below we explain all.

What are they?

Both cold sores and genital herpes are both members of the Herpesviridae family of DNA viruses, a group that shares the characteristic of producing recurring infections in their host.

Cold sores and genital herpes are strands of the herpes simplex virus (HSV), with cold sores being classed as herpes simplex virus type 1 (HSV-1) and genital herpes being caused by herpes simplex virus type 2 (HSV-2).

Genital herpes are different from genital warts, to find out how to identify the differences read our advice on genital warts symptoms.

What genital herpes look like?

Genital herpes appears as small blisters which burst and then become painful ulcers. They are found primarily on your genitals, thighs, anus, or buttocks.

You can find out more information about genital herpes on the NHS’s page about genital herpes.

How can you spot a cold sore?

Cold sores are sores that are characterised by the cold burning sensation that they give those infected with them. You will find them most often on and around your lip.

What are the differences?

While both cold sores and genital herpes are part of the same family of viruses, there are some differences beyond where they typically appear:

  • Cold sores are usually spread through non-sexual contact, such as kissing. Genital herpes (as you might expect from their name) is typically spread through sexual contact.
  • Cold sores will often scab over, while genital herpes will often disappear without scabbing over.

What are the similarities?

The major similarity between cold sores and genital herpes is that both are incurable; once you have been infected with either HSV-1 or HSV-2, the infection will then stay with you for the rest of your life.

However, that’s not the only similarity. The two also:

  • Are contagious
  • Are recurring
  • Are dangerous to unborn and young babies. They can be passed on and cause neonatal herpes. This is particularly serious, as their immune systems are not developed enough to fight off the infection. If your child contracts widespread herpes and it isn’t treated immediately then there is a high risk of them dying. Thankfully, it is very treatable. You can find out more information about cold sores on the NHS’s page about neonatal herpes.

How do you treat cold sores and genital herpes?

While neither cold sores or genital herpes can be cured, there are a number of treatments to help those who are suffering from them:

Cold sores:

  • Fenistil Cold Sore Cream: this helps to promote the healing of your cold sores and can also reduce the pain you experience.
  • Aciclovir 5% Cream: this is used to treat recurrent cold sores. If applied at the early stage of an outbreak it can reduce the severity and length of the cold sores you develop.
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Genital herpes:

  • Lidocaine: this ointment is able to reduce the soreness you experience from the blisters that come from your genital herpes
  • Aciclovir: taking these tablets can help to hold back the symptoms of genital herpes, while also countering the growth the infection
  • Valaciclovir: available in both generic and non-generic form (with the latter being more expensive than the former), these tablets can lower (but not remove) the chances of you passing on HSV-2. The tablets are also used to suppress recurrence of genital herpes
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While there are both similarities and differences between cold sores and genital herpes, the important thing is that treatment is available to treat them.

If you think that you may have either cold sores or genital herpes, seek advice on the best course of action to take by speaking to a registered healthcare professional.

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