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Oral HSV 2

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Recently while reading up on blood tests and discovered that there are 2 different blood tests to determine HSV, IgG and IgM and that the IgG was more accurate in determining type 1 or 2. I know I contracted in 06 or 07, but didn't have any oral outbreaks untilabout2010 or2011 then got tested in 2013 and the result determined type 2. (I get cold sores, never any physical or visual indications of genital) Have not had an outbreak in nearly 2 years thanks to the Suppressive meds which I take daily. So I decided to get tested again and requested the IgG due to the fact that I wasn't sure which test was implemented in 2013. The results were the same, type 2. From all that I have read, this is sort of a rare scenario. So my first question is, though It's Still HSV 2 just a different location, are all precautions still the same when considering sex and she has tested negative? 2nd question, Will going to an immunologist or dermatologist be beneficial in order to gain a better insight to what life would be like on a day to day basis, the level of risk involved, how much will H be a hindrance for a negative S/O within a marriage, and does the risk for the negative partner increase when considering oral sex and HSV2 ( I have it orally) prefers the genital region? Thanks

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Hey SC066!


Yes, oral HSV-2 is super rare, but the occasional person comes through here saying they have it, so it's possible. It's also possible that the tests are incorrect since IgG is known to be pretty inaccurate. The gold standard is what's known as the Western Blot, but it's more rare to find it near you. Here's more info on that:



So if it does end up being oral HSV-2, then it's important to know that you being the giver of oral sex is just as much risk as having genital-to-genital sex with genital HSV-2. So it is helpful to know a definitive diagnosis to know the risk of transmission and asymptomatic shedding levels. Here's the spreadsheet showing the numbers breakdowns depending on the type of herpes and where the outbreak is located on the body:



Here are a few things to read that will further help flesh out the answer to your question, but if you need more clarification, please come on back and ask!




This content is for informational purposes only. This information does not constitute medical advice or diagnosis. I'm not a medical professional, so please take this as friendly peer support. 

Helpful resources:

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Thanks Adrial, the links you provided are helpful. One area where my G/F and I have conflicting information is concerning her receiving oral sex. To my understanding, the risk or transmission avenue during an outbreak or during shedding is my skin (area where the outbreak occurs, is always in the same spot, though I have not had one in nearly 2 years) against her skin. My understanding is, its not in the salvia, inside the mouth, nor the tongue. Her understanding is just the opposite.

Also, this was my second IgG test both resulted in +hsv2. Since this is rare, would you recommend a western blot test just to be sure?

Also since HSV2 prefers the genital region, thought I have never experienced any physical or visual symptoms is there any chance that experience asymptomatic shedding genitally? As you mentioned above, in an oral sex scenario, (me the giver) the risk is the same as genital to genital, but it isn't increased. Sorry for all the ?'s We just got off the phone. With HSV 2 orally, is there less than normal risk when kissing?

Thanks for your time Adrial

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Oral hsv-2 sheds 1% of the time when its not active...and since you're on suppressives, that should cut it by another 50%. So that means, that on any given day you could shed 14 minutes, and on suppressives it's down to 7 random minutes. That's not exactly right, but that's one way to think about it. There's just no way to tell which minutes it might be happening.

Additionally, that shedding should go down the longer you have it I think.

Those numbers go out the window the second you experience any symptoms - then you're actively shedding.

From my understanding, you don't just shed in that one spot you outbreak, it could be any part of your mouth. It wouldn't be in the saliva as herpes is pretty fragile, but it could be on your lip.


This isn't meant to scare you, just put the risk in perspective. Theres a risk, but it's slim.


Igg tests are the accurate tests - igm are inaccurate for herpes.


When you say "no symptoms of genital"...are you sure? Never a redness, jock itch, ingrown hair? 80% of people have "no symptoms" but it's actually that they're super mild. I'd also recommend trying to think through if you've ever had anything like that.


Personally, I think the risk for oral to genital in your case is small. If you both are unsure, for a little while you could try dental dams.

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