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Why don’t I have my herpes on face and genitals?

A common question by callers on our helpline (0845 123 2305) is often “Why didn’t I catch herpes on my face and genitals? We did oral sex as well as regular sex. So surely I should have seen symptoms in both places instead of only on my genitals.”  

We have not found any medical papers on this topic, although “having herpes on genitals as well as face” is something that is mentioned in reported case histories of individual patients.

Two possible reasons that I have thought up:

Scientifically known that herpes simplex type 1 is common on the face:

1. You already had one type on the face. (But didn’t know it.) This means that in that region, there was a concentration of herpes simplex antibodies – the ‘soldiers’ that fight herpes simplex (ganglionic protection). These were ready to zap the new virus. Since two out of three people who have caught herpes don’t know that they have it, it would have been quite normal for you not to have known that you had cold sores already. So, a herpes simplex type 1 infection of the face – which you didn’t know about – has done a good job of protecting you from type 2.

In fact, studies have found that many people who have genital infection with herpes type 2 have actually caught the infection in the mouth and occasionally shed from the mouth (HSV2) but rarely develop cold sores.

A more fanciful reason why you don’t have it in both places

2.  Both areas received a dose of herpes simplex virus during your sexual activities. Mouths however have evolved to deal with germs of all sorts. Up till a few centuries ago, humans drank impure water and ate food that wasn’t fresh. Our bodies expected to have kill these germs that we routinely met in our food and drink. And our mouths were (and still are) prepared with strong protective mechanisms…

I will come back and amend this blog post if/when there is more information.

HISTORICAL NOTE:

In the UK, as late as 1854, some 10,000 Londoners died because there was cholera in their supposedly clean pump water. Dr John Snow, a local doctor, took the handle off the pump to stop the outbreak.

In earlier years,  A Plan for the Conduct of Female Education, in Boarding Schools published 1797, writer Erasmus Darwin wrote that “For the drink of the more robust children water is preferable, and for the weaker ones, small beer …”. And small beer provides around 2% alcohol content. (I’ve added the bold to highlight the counterintuitive wording!)

Posted 16-1-2024

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