Oh, that tingle on the lip, or was it there at all? Do I feel a cold sore coming on or was it nothing? What can one do to reduce the severity or frequency of cold sore outbreaks?
Here I would like to call upon my three areas of expertise on the subject: 1) personal experience with cold sore outbreaks, 2) experienced clinical herbalist and 3) as a HSV-1 & HSV-2 virology researcher.
As a personal sufferer of cold sore outbreaks caused by HSV-1 (herpes virus-1), I have learned to take queues from my body for when to expect an outbreak. As a child, they would show up and be an embarrassment for weeks. As an adult, I have learned that an outbreak will follow 2 to 3 days after a cold with fever, after a sun burn, or after an exhaustive or stressful life episode (reference 1). The single most important thing is to pay attention to the first sign of an impending outbreak, the tingle. This is the best time to begin treatment(s).
My go-to therapies were to apply CARMEX balm liberally. As an herbalist, I now turn to licorice and lemon balm (both internally and topically) and L-lysine supplements (1000 mg TID). There are several controlled studies that document the efficacy of the phytochemical constituents of these herbs for treatment of herpesvirus family infection and outbreaks. More about this below.
As a researcher, I learned that we are infected with the HSV-1 virus at a young age; it is usually transmitted through familial contact by age 5 (reference 2). If one escapes infection at a young age, one is not likely to acquire infection later in life. It is estimated that approximately 50% of the U.S. population is infected with HSV-1. The related virus HSV-2 (herpesvirus-2) is transmitted sexually and with estimated infection rates of 18-20% in the U.S. Both viruses infect the nerve tissues and lay in a latent stage until conditions are appropriate for reactivation. This is similar to the varicella virus which is also in the herpes virus family and is the cause of chicken-pox and shingles.
The FDA has approved Abreva as an effective over-the-counter, topical therapy for HSV-1, this is an ointment that contains Docosanol (reference 3). It is not intended for the treatment of children under 12, pregnant women, or people with HSV-2 or shingles. It’s mechanism of action is unclear; however, clinical trials demonstrate that HSV-1 outbreaks are reduced by one day.
To the contrary, there is an abundance of literature on the mechanism of action for lemon balm, licorice and lysine effecting the HSV-1 virus replication, latency stage and immune system response to viral infection.
The antiviral properties of lemon balm, Melissa officinales, have been attributed to the phytochemicals: caffeic and rosmarinic acids when taken in both oral and topical forms. A German study showed that rosmarinic acid prevented attachment of the virus to host cell walls, thus preventing infection (reference 4). Lemon balm helps to reduce redness of lesions, pain, itching and reduces the healing time of a herpesvirus outbreak (reference 5).
Licorice root (Glycyrrhiza glabra) , this gentle, is an effective antiviral that can be used as a topical treatment four or five times a day. You can also take it in capsule form twice a day during a herpes outbreak.
Prepare a lemon balm and licorice tea to drink (reference 9). The taste is a minty, lemony flavor with mild sweetness from the licorice root. When done steeping the herbs, take the cooled herbal mash and apply it directly to the lesion. This is an effective healer. Alternatively, you can consume and apply a blend of equal volumes of licorice and lemon balm tinctures.
An interesting (in vitro) study on the licorice constituent, glycyrrhizic acid, was found to change the expression level of two proteins in viral host cells that are responsible for keeping the virus in latent state (reference 6). While the quantity of purified glycyrrhizic acid used in this in vitro study are not reasonably scalable to human consumption, the study is indicative of potential mechanism of action for licorice in the treatment of herpesvirus infection.
Other important elements in the control of herpes virus infection are the amino acids lysine and arginine. An individual’s dietary balance of these two amino acids has a direct effect on the virus life cycle (reference 7). Arginine is a non-essential amino acid, created in our body, is a food-source for the virus and encourages HSV replication, leading to an outbreak. Lysine is an essential amino acid that can neutralize the body’s production of arginine, whereby starving the virus. Our bodies cannot make lysine, so it is important to consume foods that are high in lysine and/or take supplements to control the virus (reference 7).
During an outbreak, reach for the 1000 mg tablet supplements and take 3 a day. Alternatively, increase your lysine intake through supplements or good food sources (reference 8) which include fish, eggs, cheese, lima beans, potatoes, red meat, milk, and yeast. Avoid foods high in arginine if suffering from frequent herpes outbreaks.
By listening to your body, and quick application of these dietary supplements, you can kiss that cold-sore good-bye in a matter of days.
2. HSV Mother-to-child transmission, 2014 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164179/
4. Akram, et al; Attachment and Penetration of Acyclovir‐resistant Herpes Simplex Virus are Inhibited by Melissa officinalis Extract; https://doi.org/10.1002/ptr.5166
6. Minerd, J 2005, Licorice Compound May Fight Latent Herpes Infection; https://www.medpagetoday.com/infectiousdisease/stds/646