Oral vs genital Herpes: what’s the difference?

Herpes is caused by the Herpes simplex virus, which has two types: type 1 (HSV-1) and type 2 (HSV-2). Oral Herpes means cold sores around the mouth and nose. Genital Herpes means blisters or sores on or around the genitals, anus, thighs or bottom.

For years, people were told that type 1 causes cold sores and type 2 causes genital Herpes. That’s no longer the case in the UK. UK guidelines say type 1 is now the most common cause of genital Herpes, especially in women under 50 and men under 35.

Where the sores are doesn’t always tell you which type you have. Cold sores on the face are caused by type 1, but genital Herpes can be either type. The type matters because type 2 is more likely to keep coming back.

Most people catch type 1 as children, through close contact such as a kiss from someone with a cold sore. The World Health Organization estimates that, in 2020:

• 64% of people under 50 worldwide had type 1, about 3.8 billion people
• 13% of people aged 15 to 49 had type 2, about 520 million people

In the UK, about 70% of people have a Herpes infection somewhere on their body by the age of 25. In England, there were 28,779 diagnoses of a first outbreak of genital Herpes in 2025, up 3.1% on 2024.

Most people with Herpes don’t know they have it, because they have no symptoms or only mild ones.

Herpes spreads through skin-to-skin contact with the infected area. You can catch it:

• by kissing someone with a cold sore
• through oral sex, from mouth to genitals or from genitals to mouth
• through vaginal or anal sex
• by sharing sex toys, or on fingers from someone else’s sore to your genitals

Oral sex is the main way type 1 reaches the genitals. Herpes is easiest to pass on from the first tingle or itch of an outbreak until the sores have fully healed, but it can also pass on when there are no symptoms. With genital Herpes, this risk is higher in the first 6 months and rare after 2 years.

You can’t catch Herpes from towels, swimming pools, saunas or toilet seats. Read more in “How long after a cold sore can you give oral sex?”

After the first infection, the virus stays in a nerve near where you caught it for the rest of your life. It can cause new outbreaks in the same area, although for most people these don’t happen very often.

Genital Herpes caused by type 2 comes back much more often than type 1. UK guidelines say that after a first outbreak with symptoms, genital type 2 typically comes back about four times a year, four times as often as genital type 1. For most people, outbreaks get milder and less frequent over time.

Things that can trigger an outbreak include:

• sunlight or sunbeds
• friction, for example from sex or tight clothing
• stress, being unwell or a weakened immune system
• smoking or drinking alcohol
• your period

There’s no cure for Herpes, but treatment can help.

Cold sores

Antiviral creams from a pharmacy can speed up healing if you use them as soon as you feel the first tingle, but they don’t always work once blisters appear. Cold sore patches protect the skin while it heals. Cold sores should start to heal within 10 days, and if yours are large, painful or keep coming back, a doctor may prescribe antiviral tablets.

Genital Herpes

Genital Herpes is treated with antiviral tablets, such as aciclovir or valaciclovir, started within 5 days of the symptoms appearing, so see a doctor as soon as you can if you think you have a first outbreak. If outbreaks come back, a short course started as soon as symptoms appear can shorten each one by 1 or 2 days. Antiviral creams work less well than tablets and add nothing to them.

If you have frequent outbreaks, daily tablets can help. People who have more than 6 outbreaks a year may benefit from taking antiviral medicine for 6 to 12 months, which also lowers the chance of passing Herpes on.

If you’re pregnant and have had genital Herpes, or think you have symptoms of it now, tell your midwife or doctor. Women who had genital Herpes before pregnancy can usually expect to have a healthy baby and a vaginal delivery.

The highest risk is catching Herpes for the first time late in pregnancy. If you get genital Herpes for the first time in the last 3 months of pregnancy, particularly the last 6 weeks, your baby is at risk of catching it, and a caesarean is recommended. This applies to both types: about half of neonatal Herpes in the UK is caused by type 1.

Neonatal Herpes is rare in the UK, at around 7 in every 100,000 live births. Don’t kiss a baby if you have a cold sore.

If you have a sore or blister, a swab test is the best way to find out. Fluid from the sore is tested for the virus’s genetic material, and UK guidelines say the type should be checked for everyone with newly diagnosed genital Herpes. The test needs a visible sore, so get tested while it’s there.

Blood tests look for antibodies to each type. They can show you’ve had Herpes at some point, but not where on your body or when you caught it. They can take time to turn positive, and false positive results are more common in people at low risk.

UK guidelines don’t recommend routine Herpes tests for people without symptoms. Read more in “Swab, blood or urine: which Herpes test should you choose?”

Better2Know offers:

• Herpes Simplex Type 1 and 2 (Swab): a swab from a sore or blister on your genitals or mouth that shows whether it’s caused by Herpes 1 or Herpes 2, with results in 5 days. You can book it at one of our clinics, have a nurse visit you or order a home test kit.
• Blemish Screen: if you’re not sure what a sore or lump is, it tests swabs from it for Herpes 1, Herpes 2, HPV and Syphilis, with results in 5 days. You can also order a home test kit.

Not sure which test you need? Our Patient Care Team is available 24/7 on 020 7099 0955.

Can you have both types of Herpes?

Yes. Having type 1 doesn’t stop you catching type 2, but UK guidelines say it usually makes a first type 2 outbreak milder.

Can a cold sore give my partner genital Herpes?

Yes. Type 1 can pass from a cold sore to your partner’s genitals during oral sex, so don’t give oral sex until your cold sore has completely healed.

Can Herpes spread to other parts of my body?

It won’t spread through your body to cause blisters somewhere else. You can sometimes pass it to your fingers or nearby skin by touching a sore, mostly during a first outbreak, so wash your hands after touching one.

Oral and genital Herpes are caused by the same virus, and type 1, the cold sore virus, now causes most new cases of genital Herpes in the UK. Knowing which type you have helps you understand how often it’s likely to come back and how to protect your partners.

If you have a sore, get it tested while it’s there. Book a Herpes swab test or find a clinic near you. Our Patient Care Team is available 24/7 on 020 7099 0955.

Not in the UK? Choose your country from the selector at the top of the page for local tests and prices.

This article originally appeared on 14 November 2014 and was last updated on 1 October 2026.

This article is general information and not a substitute for personal medical advice.

Sources

1. NHS, Genital herpes, reviewed 27 June 2023. https://www.nhs.uk/conditions/genital-herpes/
2. NHS, Cold sores, reviewed 19 February 2024. https://www.nhs.uk/conditions/cold-sores/
3. NHS, Neonatal herpes (herpes in a baby), reviewed 24 July 2025. https://www.nhs.uk/conditions/neonatal-herpes/
4. British Association for Sexual Health and HIV, UK national guideline for the management of anogenital herpes, 2024. https://www.bashh.org/_userfiles/pages/files/pateletal2024britishassociationofsexualhealthandhivuknationalguidelineforthemanagementofanogenital.pdf
5. British Association for Sexual Health and HIV, Genital herpes: patient information leaflet, February 2026. https://www.bashh.org/_userfiles/pages/files/genital_herpes_pil_print_version.pdf
6. British Association for Sexual Health and HIV and Royal College of Obstetricians and Gynaecologists, National UK guideline for the management of herpes simplex virus in pregnancy and the neonate, 2024. https://www.bashh.org/_userfiles/pages/files/clarkeetal2024jointbritishassociationforsexualhealthandhivandroyalcollegeofobstetriciansand.pdf
7. World Health Organization, Herpes simplex virus, 30 May 2025. https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus
8. UK Health Security Agency, Sexually transmitted infections and screening for chlamydia in England: 2025 report, 2 June 2026. https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables/sexually-transmitted-infections-and-screening-for-chlamydia-in-england-2025-report
9. British Association for Sexual Health and HIV, Summary guidance on testing for sexually transmitted infections, 2023. https://www.bashh.org/_userfiles/pages/files/resources/bashh_summary_guidance_on_stis_testing_2023.pdf