How long after a Herpes Simplex Virus (HSV) lesion appears can someone safely kiss?

How Long After HSV Lesion is Present Can Someone Kiss Safely

You should avoid kissing until the herpes simplex virus (HSV) lesion is completely healed with a well-adherent scab, with no moist or draining areas present. 1, 2

Timeline for Safe Kissing After HSV Lesion

The Centers for Disease Control and Prevention and sports medicine guidelines provide clear recommendations regarding HSV lesions and close contact:

1. Active lesion phase (unsafe for kissing):

   • When lesions first appear
   • When lesions are moist, weeping, or draining
   • When systemic symptoms are present (fever, malaise)

2. Safe to resume kissing when:

   • All lesions are completely dry and covered by a firm, adherent crust 1
   • No new lesions have appeared for at least 72 hours 1, 2
   • All systemic symptoms have resolved 1

Antiviral Medication Considerations

Taking antiviral medication can help speed healing and reduce the infectious period:

• If on appropriate systemic antiviral therapy (acyclovir, valacyclovir, famciclovir), you should still wait until lesions are completely healed before kissing 1
• Valacyclovir is not a cure for cold sores, and contact should still be avoided when lesions are present 3
• Early treatment at the first sign of a cold sore (tingling, itching, burning) can reduce the duration of the outbreak 2, 3

Important Prevention Measures

To reduce transmission risk:

• Avoid oral contact with others while lesions are present 2
• Do not share items that contact the mouth (utensils, cups, lip balm) 2
• Inform close contacts about HSV status 2
• Remember that asymptomatic viral shedding can still lead to transmission, though the risk is highest when lesions are present 2, 4

Common Pitfalls to Avoid

1. Don't rely on covering the lesion: Covering active lesions does not make kissing safe 1
2. Don't assume medication makes immediate contact safe: Even while on antiviral therapy, you should wait until lesions are completely healed 1, 3
3. Don't mistake "improving" for "healed": Partial healing is not sufficient - lesions must be completely dry with a firm scab 1, 2
4. Don't ignore prodromal symptoms: Tingling or burning sensations can indicate an impending outbreak, and kissing should be avoided even at this early stage 2, 3

Following these guidelines will help minimize the risk of transmitting HSV through kissing and other forms of close contact.