• Cold Sores; Genital Herpes; Herpes simplex
Principal Proposed Natural Treatments
• PREVENTION L-Lysine; Melissa
• TREATMENT Aloe vera; Melissa; Topical Zinc
Other Proposed Natural Treatments
• Adenosine Monophosphate; Astragalus; Bee Propolis; Cat's Claw; Elderberry; Eleutherococcus; Kelp; Sage /Rhubarb Cream ; Sandalwood; Tea Tree Oil; Vitamin C; Witch Hazel
Probably Not Effective Treatments
The common virus Herpes simplex, known as simply as herpes, can cause painful blister-like lesions around the mouth and in the genitalia. Slightly different strains of herpes predominate in each of these two locations, but the infections are essentially identical. In both areas, the herpes virus has the devious habit of hiding out deep in the DNA of nerve ganglia, where it remains inactive for months or years. From time to time the virus reactivates, travels down the nerve, and starts an eruption. Common triggers include stress, dental procedures, infections, and trauma. Flare-ups usually become less severe over time.
Conventional medical treatment consists of antiviral drugs, such as Zovirax. Such medications can shorten the length and intensity of a herpes outbreak or, when taken consistently at lower dosages, reduce the frequency of flare-ups. In addition, they can reduce transmission of the disease.
Principal Proposed Natural Treatments
Several natural treatment have shown promise for treating herpes. Note, however, that while conventional treatments can reduce infectivity and thereby help prevent the spread of the disease, no natural treatment has been shown to do this. Keep in mind that common sense methods used to prevent herpes transmission are not entirely effective: many people are infectious even when they do not have obvious symptoms, and use of a condom does not entirely prevent the spread of the virus. Therefore, if you are sexually active with a noninfected partner who wishes to remain that way, we strongly recommend that you use suppressive drug therapy.
Melissa officinalis (Lemon Balm)
More commonly known in the United States as lemon balm, Melissa officinalis is widely sold in Europe as a topical cream for the treatment of genital and oral herpes.
One double-blind, placebo-controlled study followed 66 people who were just starting to develop a cold sore (oral herpes).4 Treatment with melissa cream produced significant benefits on day 2, reducing intensity of discomfort, number of blisters, and the size of the lesion. (The researchers specifically looked at day 2 because, according to them, that is when symptoms are most pronounced.)
Another double-blind study followed 116 individuals with oral or genital herpes.3 Participants used either melissa cream or placebo cream for up to 10 days. The results showed that use of the herb resulted in a significantly better rate of recovery than those given placebo.
For more information, including dosage and safety issues, see the full Melissa article.
The succulent aloe plant is famous as a treatment for burns and minor wounds. However, while there is little evidence it is effective for those purposes, two studies suggest that aloe has potential value in the treatment of herpes infections.
A 2-week, double-blind, placebo-controlled trial enrolled 60 men with active genital herpes.7 Participants applied aloe cream (0.5% aloe) or placebo cream 3 times daily for 5 days. Use of aloe cream reduced the time necessary for lesions to heal and also increased the percentage of individuals who were fully healed by the end of 2 weeks.
A previous double-blind, placebo-controlled study by the same author enrolling 120 men with genital herpes found that aloe cream was more effective than pure aloe gel or placebo.8 The author theorized that the oily constituents in the cream improved aloe absorption.
For more information, including dosage and safety issues, see the full Aloe article.
Another famous treatment for herpes involves the amino acid L-lysine. Taken regularly in sufficient doses, lysine supplements appear to reduce the number and intensity of herpes flare-ups.9 However, a study evaluating lysine taken only at the onset of a herpes attack found no benefit.10 (Consider using melissa for this latter purpose.)
One double-blind, placebo-controlled study followed 52 participants with a history of herpes flare-ups.11 While receiving 3 g of L-lysine every day for 6 months, the treatment group experienced an average of 2.4 fewer herpes flare-ups than the placebo group—a significant difference. The lysine group's flare-ups were also significantly less severe and healed faster.
Another double-blind, placebo-controlled crossover study on 41 subjects also found improvements in the frequency of attacks.12 Interestingly, this study found that 1,250 mg of lysine daily worked, but 624 mg did not.
Other studies, including one that followed 65 individuals, found no benefit, but they used lower dosages of lysine.13,14
For more information, including dosage and safety issues, see the full Lysine article.
Zinc lozenges or nasal sprays are thought to be effective for fighting the viruses that cause colds. A recent study suggests that topical zinc may be helpful for herpes infections of the mouth and face as well. In this trial, 46 individuals with cold sores were treated with a zinc oxide cream or placebo every 2 hours until cold sores resolved.17 The results showed that individuals using the cream experienced a reduction in severity of symptoms and a shorter time to full recovery.
Other Proposed Natural Treatments
Eleutherococcus, incorrectly called Russian or Siberian ginseng, has shown promise for the treatment of herpes. A 6-month, double-blind trial of 93 men and women with recurrent genital herpes infections found that treatment with eleutherococcus (2 g daily) reduced the frequency of infections by almost 50%.18
A double-blind trial of 149 individuals with recurrent oral herpes compared the effectiveness of cream containing Zovirax against cream containing the herbs sage and rhubarb, and cream containing sage alone.26 The combination of sage and rhubarb proved to be equally effective to Zovirax cream; sage by itself was less effective, if at all.
One study suggests that topical treatment with a vitamin C solution may speed healing of oral herpes outbreaks.19 Oral vitamin C combined with bioflavonoids has also shown some promise for genital herpes.20
Other herbs and supplements sometimes recommended for herpes infections, but that lack meaningful supporting evidence, include adenosine monophosphate,28 astragalus, cat's claw, elderberry, kelp,22 sandalwood,23 tea tree oil,25 and witch hazel.
A product containing vitamins and minerals as well as the herbs paprika, rosemary, peppermint, milfoil, hawthorn, and pumpkin seed has been used in Scandinavia for many years as a treatment for various mouth-related conditions. However, a double-blind study of 50 people with recurrent oral herpes failed to find 4 months’ treatment with this product more effective than placebo.27
References [ + ]
1. Wolbling RH, Leonhardt K. Local therapy of herpes simplex with dried extract from Melissa officinalis. Phytomedicine. 1994;1:25-31.
2. Wolbling RH, Leonhardt K. Local therapy of herpes simplex with dried extract from Melissa officinalis. Phytomedicine. 1994;1:25-31.
3. Wolbling RH, Leonhardt K. Local therapy of herpes simplex with dried extract from Melissa officinalis. Phytomedicine. 1994;1:25-31.
4. Koytchev R, Alken RG, Dundarov S. Balm mint extract (Lo-701) for topical treatment of recurring Herpes labialis. Phytomedicine. 1999;6:225-230.
5. Wolbling RH, Leonhardt K. Local therapy of herpes simplex with dried extract from Melissa officinalis. Phytomedicine. 1994;1:25-31.
7. Syed TA, Afzal M, Ashfaq Ahmad S, et al. Management of genital herpes in men with 0.5% Aloe vera extract in a hydrophilic cream: a placebo-controlled double-blind study. J Dermatol Treat. 1997;8:99-102.
8. Syed TA, Cheema KM, Ashfaq A, et al. Aloe vera estract 0.5% in ahydrophilic cream versus Aloe vera gel for the management of genital herpes in males. A placebo-controlled, double-blind, comparative study [letter]. J Eur Acad Dermatol Venereol. 1996;7:294-295.
9. Flodin NW. The metabolic roles, pharmacology, and toxicology of lysine. J Am Coll Nutr. 1997;16:7-21.
10. Milman N, Scheibel J, Jessen O. Failure of lysine treatment in recurrent herpes simplex labialis [letter]. Lancet. 1978;2:942.
11. Griffith RS, Walsh DE, Myrmel KH, et al. Success of L -lysine therapy in frequently recurrent herpes simplex infection: treatment and prophylaxis. Dermatologica. 1987;175:183-190.
12. McCune MA, Perry HO, Muller SA, et al. Treatment of recurrent herpes simplex infections with L-lysine monohydrochloride. Cutis. 1984;34:366-373.
13. DiGiovanna JJ, Blank H. Failure of lysine in frequently recurrent herpes simplex infection. Treatment and prophylaxis. Arch Dermatol. 1984;120:48-51.
14. Milman N, Scheibel J, Jessen O. Lysine prophylaxis in recurrent herpes simplex labialis: a double-blind, controlled crossover study. Acta Derm Venereol. 1980;60:85-87.
17. Godfrey HR, Godfrey NJ, Godfrey JC, et al. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med. 2001;7:49-54, 56.
18. Williams M. Immuno-protection against herpes simplex type II infection by eleutherococcus root extract. Int J Alt Complement Med. 1995;13:9-12.
19. Hovi T, Hirvimies A, Stenvik M, et al. Topical treatment of recurrent mucocutaneous herpes with ascorbic acid-containing solution. Antiviral Res. 1995;27:263-270.
20. Terezhalmy GT, Bottomley WK, Pelleu GB. The use of water-soluble bioflavonoid-ascorbic acid complex in the treatment of recurrent herpes labialis. Oral Surg Oral Med Oral Pathol. 1978;45:56-62.
21. Vynograd N, Vynograd I, Sosnowski Z. A comparative multi-centre study of the efficacy of propolis, acyclovir and placebo in the treatment of genital herpes. Phytomedicine. 2000;7:1-6.
22. Carlucci MJ, Ciancia M, Matulewicz MC, et al. Antiherpetic activity and mode of action of natural carrageenans of diverse structural types. Antiviral Res. 1999;43:93-102.
23. Benencia F, Courreges MC. Antiviral activity of sandalwood oil against Herpes simplex viruses-1 and -2. Phytomedicine. 1999;6:119-123.
24. Vonau B, Chard S, Mandalia S, et al. Does the extract of the plant Echinacea purpurea influence the clinical course of recurrent genital herpes? Int J STD AIDS. 2001;12:154-158.
25. Carson CF, Ashton L, Dry L, et al. Melaleuca alternifolia (tea tree) oil gel (6%) for the treatment of recurrent herpes labialis. J Antimicrob Chemother. 2001;48:450-451.
26. Saller R, Buechi S, Meyrat R, et al. Combined herbal preparation for topical treatment of Herpes labialis. Forsch Komplementarmed Klass Naturheilkd. 2001;8:373-382.
27. Pedersen A. LongoVital and herpes labialis: a randomised, double-blind, placebo-controlled study. Oral Dis. 2001;7:221-225.
28. Sklar SH, Buimovici-Klein E. Adenosine in the treatment of recurrent herpes labialis. Oral Surg Oral Med Oral Pathol. 1979;48:416-417.
Last reviewed December 2015 by EBSCO CAM Review Board