So canker sores or cold sores is that the same thing as Herpes? And I have patients come in and ask me that or sometimes parents ask me out of concern that they found a cold sore on their child and could it be through sexual activity? It's a little bit of a complex answer but let me try make it as straight-forward as possible. Cold sores and canker sores can be caused by a variety of different viruses including Herpes. So it is possible that Herpes virus can cause like a cold sore or some type of ulcer on the mouth area. Usually the traditional teaching has been that's caused by Herpes simplex type 1. Nowadays anything goes, so it may be be Herpes simplex type 1 but it could be Herpes simplex type 2. Type 2 is one that's been traditionally associated with genital Herpes. So vaginal or penal Herpes. If they have Herpes simplex virus type 2 in the mouth does that mean they are engaging in oral sex? The short answer is no. But they could have been. So it gets a confusing for medical providers and especially for patients and some parents. Do what do you do? I would recommend that you see a medical doctor, have the lesion examined, it would most likely want to obtain a culture so they will use a cut and swamp. And swamp the area, get a sample and they will send it off for testing. That would tell us whether it's Herpes simplex at all and whether it's type 1 or type 2. Now in terms if you find out whether it's type 1 or type 2, you just know that it's Herpes. What does it mean in terms of treatment - we use the exact same medications as we would use as if you had a Herpes infection in the genital area. In terms of what does it mean whether or not your child or you yourself are engaging in oral sex I mean only the child is going to really know the answer to that. I don't think there is a way you are going to have proof, because they could of gotten it from kissing their partner. It could of been from kissing you and you was exposed to HSV in your mouth. It's very easy to transmit Herpes between individuals because it likes mocusal. So surfaces which are inside your mouth, on the genital area. It's really hard to find where that Herpes came from. May be it's not that important. Really the important thing is to go ahead and get treatments so that the lesion can heal as quickly as possible and not be transmitted to other people.