Natural Medicines for Herpes Simplex

Melissa_Peterson's picture
Cold sore, herpes simplex on lip

Cold sores are one of the most common recurrent viral infections in the world, with 20 to 40% of adults infected at some point during their lifetime.[1] The herpes simplex virus type 1 (HSV-1) usually causes cold sores and herpes simplex virus type 2 (HSV-2) causes genital herpes; however, recent data shows that more than 50% of genital herpes is due to HSV-1.[2] The figures vary but it is believed that around 25% of the Australian population have positive antibodies to HSV-2; whereas, 80% of adults carry HSV-1.[3]

The main prescriptive treatment is the antiviral agent acyclovir, with studies showing improved efficacy when combined with topical corticosteroids.[1] However, there is a major concern for drug resistant viral strains to develop[4], along with the potential side effects of these pharmaceuticals. Therefore, researchers have evaluated the efficacy of natural alternatives, such as lysine, zinc, Echinacea purpurea (echinacea) and Melissa officinalis (lemon balm).

Research collated in a systematic review, shows Melissa officinalis to be strongly anti-HSV.[4] At low concentrations this herb interacts directly with free particles of acyclovir-resistant and acyclovir-sensitive strains of HSV-1, inhibiting viral attachment to the host cells by over 95%.[5] A 2014 in vitro study provided evidence that rosmarinic acid is the main active constituent responsible for its virucidal effect and significant inhibition of herpes virus attachment.[5]

A well-known treatment for cold sores is the essential amino acid lysine. Numerous clinical trials have shown supplementation reduces HSV symptom severity, infection recurrence and duration.[6]

Some of the studies also included a low arginine diet.[6] Arginine is a necessary amino acid for immunomodulation; however, pathogens can interfere with its metabolism and alter host immune responses.[7] HSV requires arginine for its replication.[7] In vitro studies show lysine inhibits the growth promoting effect of arginine on HSV by competing for intestinal absorption, renal reabsorption and cellular transport, and inducing the production of arginase, the enzyme which results in arginine degradation.[6]

Immune health is very important for HSV infections as immunocompromised individuals may experience longer and more severe outbreaks.[8] The benefits of zinc and echinacea in immune modulation are well-known and documented. However, they also have a direct effect on HSV.

Experimental research shows Echinacea purpurea is a very potent virucidal agent, inhibiting HSV-1 replication and reducing infection latency rates. It has also been found to induce arginase in activated macrophages and has a broad spectrum of activity in viral infections, which minimises the development of resistant mutations.[9,10,11]

In vitro studies show zinc inhibits HSV-1 and HSV-2 replication,[12] with zinc supplementation reducing infection recurrence and recovery time in a human pilot study.[13] Additionally, salivary zinc levels have been found to be low in both acute and convalescent stages of HSV infection, compared to healthy controls.[14]

References

  1. Arain N, Paravastu SCV, Arain MA. Effectiveness of topical corticosteroids in addition to antiviral therapy in the management of recurrent herpes labialis: A systematic review and meta-analysis. BMC Infect Dis 2015;15:82. [Full text]
     
  2. Australian ST I management guidelines. Herpes 2016. Viewed March 2017, http://www.sti.guidelines.org.au/sexually-transmissible-infections/herpes.
     
  3. SA Health. Cold sores (herpes simplex type 1) - including symptoms, treatment and prevention. Viewed March 2017, http://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+I...
     
  4. Moradi MT, Rafieian-Kopaei M, Karimi A. A review study on the effect of Iranian herbal medicines against in vitro replication of herpes simplex virus. Avicenna J Phytomed 2016;6(5):506-515. [Full text]
     
  5. Astani A, Navid MH, Schnitzler P. Attachment and penetration of acyclovir-resistant herpes simplex virus are inhibited by Melissa officinalis extract. Phytother Res 2014;28(10):1547-1552. [Abstract]
     
  6. L-lysine. Monograph. Altern Med Rev 2007;12(2):169-72. [Full text]
     
  7. Gogoi M, Datey A, Wilson KT, et al. Dual role of arginine metabolism in establishing pathogenesis. Curr Opin Microbiol 2016;29:43-48. [Full text]
     
  8. Viera MH, Amini S, Huo R, et al. Herpes simplex virus and human papillomavirus genital infections: new and investigational therapeutic options Int JDermatol 2010;49(7):733-749. [Abstract]
     
  9. Ghaemi A, Soleimanjahi H, Gill P, et al. Echinacea purpurea polysaccharide reduces the latency rate in herpes simplex virus type-1 infections. Intervirology 2009;52(1):29-34. [Abstract]
     
  10. Zhai Z, Solco A, Wu L, et al. Echinacea increases arginase activity and has anti-inflammatory properties in raw 264.7 macrophage cells indicative of alternative macrophage activation. J Ethnopharmacol 2009;122(1):76-85. [Full text]
     
  11. Hudson JB. Applications of the phytomedicine Echinacea purpurea (purple coneflower) in infectious diseases. J Biomed Biotechnol 2012;2012:769896. [Full text]
     
  12. Gaby AR. Natural remedies for herpes simplex. Altern Med Rev 2006;11(2):93-101. [Full text]
     
  13. Femiano F, Gombos F, Scully C. Recurrent herpes labialis: a pilot study of the efficacy of zinc therapy. J Oral Pathol Med 2005;34(7):423-425. [Abstract]
     
  14. Khozeimeh F, Jafari N, Attar AM, et al. Comparative analysis of salivary zinc level in recurrent herpes labialis. Dent Res J (Isfahan). 2012;9(1):19-23. [Full text]

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Melissa_Peterson's picture
Melissa_Peterson

Melissa Peterson has been a writer and educator in the health and medical science fields for over 15 years. Naturopathically trained, Melissa also has postgraduate qualifications in literature research and reviewing. Her business, Words On Therapy, provides many services to industry including technical articles, white papers, blogs, SEO content, copywriting and research collation.