Although the risk is low, you can get a sexually transmitted infection (STI) — often used interchangeably with a sexually transmitted disease (STD) — from kissing.
Herpes, cytomegalovirus (CMV), human papillomavirus (HPV), and syphilis can be spread through active lesions (ie cold sores) or saliva. In contrast, you cannot get sexually transmitted infections such as chlamydia, hepatitis, human immunodeficiency virus (HIV), or trichomoniasis from kissing.
Read on to learn about sexually transmitted infections that can be transmitted through kissing and their symptoms and treatments.
It is possible to transmit certain STDs – including herpes, HMV, HPV and syphilis – through kissing.
“There are sexually transmitted diseases that can be spread through non-sexual contact (such as kissing) that are also transmitted through sexual contact,” Martha Rac, MDassistant professor of obstetrics and gynecology at Baylor College of Medicine, told Health.
However, kissing is generally a low-risk activity compared to anal, oral and vaginal sex.
“This is definitely a possibility, and there are some (STIs) we worry about more than others when it comes to kissing,” Michael Angaron, DOassociate professor of infectious diseases at Northwestern Feinberg School of Medicine, told Zdravstvo.
Mouth-to-mouth kissing increases the risk of certain sexually transmitted infections, but some can be passed on by kissing someone’s cheek, eyes and head, Christine Greves, MDsaid a gynecologist at Winnie Palmer Hospital for Women and Babies Health.
Herpes
Two similar viruses—herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2)—cause cold sores. You can get herpes through skin-to-skin contact, for example during anal, oral or vaginal sex and kissing. Most people get HSV-1 before the age of 20.
HSV-1 usually causes cold sores or cold sores on the gums, lips, mouth or throat, also known as oral herpes. Herpes on the lips can be red or yellow and crusty. They may break open and release a clear or yellow liquid. You may have many small sores that grow into one large cold sore.
Other symptoms of oral herpes include:
- Burning, itching or stinging near the lips or mouth
- Fever
- Pain when swallowing
- Sore throat
- Swollen glands
HSV-2 usually causes genital herpes, but it can cause herpes around or on the mouth if you have oral sex, Dr. Graves said. Then you can spread HSV-2 through mouth-to-mouth contact.
cytomegalovirus (CMV)
CMV is a herpes virus that can be spread by saliva during kissing. About 50% to 80% of people in the United States have CMV by age 40. Many people with CMV do not know they have the infection because CMV often causes no symptoms.
CMV sometimes causes flu-like symptoms such as:
- Fatigue
- Fever
- Loss of appetite
- Weakness or general malaise
- Pain in the muscles
- A rash
- Sore throat
- Swollen glands
HPV
There are over 200 types of HPV, some of which are spread through deep tongue kissing and oral sex.
Oral HPV often causes no symptoms, so many people don’t know they have the infection. As a result, oral HPV can easily pass from person to person. HPV can cause oral cancer in some people.
syphilis
Syphilis is spread by direct contact with a sore, usually on or around the anus, lips, mouth, penis, rectum, or vagina.
Symptoms of syphilis may include:
- Skin rash
- Fever
- Firm, round and painless sores at the site of infection
- Swollen lymph nodes
The risk of contracting syphilis from kissing is low, Dr. Graves said.
gonorrhea
Gonorrhea is a common STI among adolescents. Gonorrhea is usually spread through unprotected anal, oral or vaginal sex and can be passed from mother to fetus during pregnancy. You can get gonorrhea if you touch your eyes with infected fluid.
Research has found that oral gonorrhea can be spread through kissing. Oral gonorrhea usually causes no symptoms, and most cases clear up within seven days.
Some STIs are not transmitted by casual contact, including kissing, such as:
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- chlamydia: Bacteria Chlamydia trachomatis causes this common STI. You can get chlamydia through unprotected anal, oral or vaginal sex. Pre-ejaculatory fluids, semen and vaginal fluids can carry C. trachomatis. You can get chlamydia if you touch your eyes with infected fluid. Chlamydia can be transmitted from mother to fetus during pregnancy.
- hepatitis: This causes inflammation of your liver. There are several types of hepatitis, such as hepatitis B and D, which can be spread through unprotected sexual contact. Saliva does not carry hepatitis B, so you cannot get infected by kissing. You also can’t get hepatitis D from kissing.
- Human immunodeficiency virus (HIV): This virus can be spread through blood, breast milk, rectal fluids, pre-ejaculatory fluids, semen and vaginal fluids. You can get HIV if you have unprotected anal or vaginal sex or share drug paraphernalia like needles. HIV is not spread through saliva, sweat or urine. Rarely, HIV is spread through kissing if both people have bleeding gums or sores.
- trichomoniasis: Pre-ejaculatory fluids, semen and vaginal fluids can carry parasites that cause trichomoniasis or “trichomoniasis”. Trich is often spread through unprotected vaginal sex and vulva-vulva contact. You can also get trich by touching your eyes or using sex toys with infected fluids.
Treatment depends on the cause of oral STIs.
For example, cold sores caused by oral herpes often go away on their own within one to a week.
Home treatments that can help reduce symptoms include:
- Applying ice or a warm cloth to the affected area to relieve pain
- Cleaning herpes with antiseptic soap and water
- Eating fruit flavored ice cream
- Cold water rinse or salt water rinse
- Do not consume citrus fruits, hot drinks, salty and spicy foods
- Using Tylenol (acetaminophen) for pain relief
You can take antiviral medications, including acyclovir, famciclovir, and valacyclovir, to reduce the frequency of herpes outbreaks. However, oral herpes is a chronic infection, so antiviral drugs cannot cure it. You may need to take antiviral medication continuously if you get cold sores frequently.
Like oral herpes, CMV and oral HPV often resolve without medication. You can take pain medication or gargle with salt water to help treat CMV. People with weak immune systems may need antibody therapy or antiviral drugs.
Penicillin, an antibiotic, helps treat syphilis. You can take doxycycline if you are allergic to penicillin.
Preventing oral STIs can be difficult. It is unlikely that people will often ask for someone’s complete sexual history before the first kiss.
However, health professionals say there are several ways to reduce your risk, such as:
- Ask questions: Kissing is usually spontaneous and you are unlikely to discuss your sexual history before kissing someone. Still, it’s more than okay to ask about sexual health and be open about it before kissing someone, noted Dr. Graves.
- Don’t kiss someone with herpes: You are less likely to get herpes or syphilis if someone does not have an outbreak than if they have an active lesion.
- Practice monogamy: Being monogamous with one partner who doesn’t have an STI means you won’t be exposed, Dr. Graves said.
Kissing is generally a low-risk activity compared to anal, oral and vaginal sex. However, STIs such as herpes, HMV, HPV and syphilis can be transmitted through active lesions or saliva.
Most oral sexually transmitted infections go away on their own. Taking pain relievers and rinsing with salt water can help treat oral herpes and CMV. Some people may need antibiotics or antiviral medications to treat oral STIs. Consult a health care professional if you develop symptoms of an oral STI or have recently been exposed to an STI.