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Herpes Simplex

 

Herpes Introduction

Herpes Simplex is a condition caused by the HSV-1 and HSV-2 viruses. These viruses are small DNA viruses that infect mucocutaneous cells. The conditions manifests as lesions, which mainly affect areas surrounding the mouth, lips, eyes, and genitals, though they can appear anywhere on the skin or mucosa.

HSV-1 primarily causes lesions on the oral mucosa. HSV-2 primarily affects the genitals. Herpes simplex virus is extremely contagious. The virus is spread by direct contact with an individual in the active or prodromal stage. Lesions are usually small fluid filled blisters (vesicles) that can be single or multiple on a raised erythematous (red) base. The initial eruption is usually self resolving and of short duration. After that, the virus remains dormant in the nerve cell ganglia, until a trigger causes recurrence of the outbreak. Triggers can include stress, illness, high fever, sunburn, hormonal alterations, or immune system compromise. [1]

It is estimated that 20-40% of the US population has recurrent HSV infections. It is more common among individuals in the lower socioeconomic class. Men have a greater recurrence rate than women. HSV-2 is four times more likely to recur verses HSV-1. The site of recurrence is always the site of the original outbreak, though lesions may spread. [2]

Herpes Signs and Simplexs

Lesions may appear anywhere on the skin or mucous membranes, and are most likely to appear on the mouth (gingivostomatitis), lips (herpes labialis), conjunctiva (herpes keratoconjunctivitis), and genitals (vulvovaginitis or progenitalis). It is a distinction of herpes simplex, that recurring lesion are always at the same site as the initial outbreak.

Each outbreak is preceded by a prodromal period that is characterized by tingling, itching, and burning over the site of the outbreak. 1-2 days later, the vesicle will appear. These vesicles are usually 0.5 to 1.5 cm in size and often grow together to form a larger lesion. As they grow, the fluid increases and eventually the vesicles break open and crust over. Healing will begin after 10-12 days, but it may take as long as three weeks for complete resolution of the outbreak.

The lesions are usually very painful. Primary outbreaks are worse than recurrences. Other symptoms (simplexs) that may accompany the outbreak include; fatigue, fever, muscle aches, weakness, headache, and swollen lymph nodes. [3]

Herpes Treatment

Conventional treatments for breakouts and suppression of herpes simplex (hsv-1) include; the alteration of one’s diet, and the use of prescription medications, such as acyclovir, valacyclovir, and famciclovir. These drugs work to inhibit the herpes virus replication. They can be used to treat a current outbreak by decreasing its duration, as well as be used prophylactically, to prevent future outbreaks. [4]

Alternative treatment has been very successful for treating both current outbreaks and as a prophylactic treatment. Nature provides us many effective, naturally occurring anti-viral nutrients, which have proven their effectiveness in various clinical trials.

Supplements helpful for Herpes Treatment

Flavonoids

Flavonoids from plant sources have been effective at preventing virus replication in the Herpes Simplex virus. Certain flavonoids have also been proven effective at reducing infectivity of cells by hsv-1. In one study of propolis, a compound from the hives of honeybees, the flavonoid compounds were found to be twice as effective than acyclovir at reducing the healing time and promoting a reduction in localized symptoms. [5]

In another study, quercitin was shown to reduce infectivity of hsv-1 and inhibit replication, while hesperiden was shown to reduce replication of hsv-1. [6] Other studies using quercitin found that this particular flavonoid enhances TNF (tumor necrosis factor), a component responsible for inhibiting the replication of hsv-1. [7]

Vitamin C

Both oral and topical delivery forms of vitamin C have been studied as a possible treatment for hsv-1. Vitamin C has been shown to increase healing rates. In a study on patients with herpes labialis (hsv-1), supplementation with vitamin C mixed with citrus bioflavonoids for three days reduced vesiculation and disruption of the membrane (less crusting), as well as caused remission of symptoms in less time (2-4 days). [8] Other studies have included patients whom were treated with topical vitamin C over the duration of an outbreak. The topical application of vitamin C caused a decrease in virus replication as well as decrease in severity of symptoms. [9]

Lysine

Lysine is an amino acid that has anti-viral activity against hsv-1. The mechanism is competition with another amino acid, arginine, that is necessary for replication of the herpes virus. In study, Lysine has been rated better than placebo as a treatment for hsv-1. One particular study noted that the supplementation with lysine for six months caused a decrease in symptoms and a decrease in healing time in test subjects. Patients had 2.4 less outbreaks compared to placebo. Lysine was effective at reducing the occurrence, severity, and healing time. [10]

Zinc

Zinc has proven to be effective oral and topical anti-viral treatment for the herpes simplex virus Zinc has been shown to inhibit the replication of hsv-1 in vitro, while enhancing cell immunity in vivo. Oral Zinc is a common addition in many treatment protocols of hsv-1 clinical trials. [11] Combined with vitamin C, Zinc may be effective in reducing the frequency, severity, and duration of genital herpes. In several case studies, it has suppressed the eruption completely. [12] In a study using topical zinc oxide, patients reported shorter duration of lesions and reduction in symptoms. [13] A solution of zinc sulphate has also been proven effective at reducing symptoms and healing time of oral herpes. Zinc is also thought to prevent the recurrence of oral herpes. [14]

Melissa officinalis

Lemon balm possesses some anti-viral activity. Its components work at preventing infection of healthy cells by the virus. It has been equally effective at reducing herpes reoccurrence, and may reduce healing time by as much as half. In one study using balm mint extract from Melissa officinalis applied topically to the outbreak area, the healing period was shortened, there was decrease in symptom, and the vesicles were contained to initial lesions. Also, the outbreak did not spread. [15]

Glycyrrhiza glabra

A primary constituent of licorice root, glycyrrhizin, has potent anti-viral activity. In a study comparing the efficacy of idoxuridine gel combined with glycyrrhizin or idoxuridine gel alone, patients had decreased healing time and instantaneous pain relief with the combination compared to the idoxuridine alone. The glycyrrhizin was also shown to increase the absorption of idoxuridine. [16] Another component of licorice, glycyrrhizic acid, taken internally inhibits growth of the herpes simplex virus and can inactivate the virus. [17] Long-term oral use of licorice is not recommended due to the effects on the cardiovascular system. Topical treatment is considered safe and effective for long term use without side effects.

References

[1] Beers M and Berkow R. Herpesvirus Infections. The Merck Manual 17th Ed. Pp: 1293-1294.

[2] Pizzorno J, Murray M, and Joiner-Bey H. Herpes Simplex. The Clinicians Handbook of Natural Medicine. 2002 Churchill Livingstone New York. Pp: 220-223.

[3] Beers M and Berkow R. Herpesvirus Infections. The Merck Manual 17th Ed. Pp: 1293-1294.

[4] Beers M and Berkow R. Herpesvirus Infections. The Merck Manual 17th Ed. Pp: 1293-1294.

[5] Vynograd N et al. A comparative multicenter study of the efficacy of propolis, acyclovir, and placebo in the treatment of genital herpes (HSV). Phytomedicine 2000 Mar; 7(1): 1-6.

[6] Kaul TN, Middleton EJ, and Ogra PL. Anti-viral effect of flavonoids on human viruses. J Med Virol. 1985 Jan; 15(1): 71-79.

[7] Ohnishi E and Bannai H. Quercitin potentiates TNF-induced antiviral activity. Antiviral Res. 1993 Dec; 22(4): 327-331.

[8] Terezhalmy GT et al. The use of water-soluble bioflavonoid-ascorbic acid complex in the treatment of herpes labialis. Oral Surg Oral Med Oral Path. 1978 Jan; 45(1): 56-62.

[9] Hovi T et al. Topical treatment of recurrent mucocutaneous herpes with ascorbic acid containing solution. Antiviral Res. 1995; 27(3): 263-270.

[10] Griffith RS et al. Success of L-lysine therapy in frequent recurrent herpes simplex infection: Treatment and prophylaxis. Dermatologica 1987; 175(4): 183-190.

[11]Pizzorno J, Murray M, and Joiner-Bey H. Herpes Simplex. The Clinicians Handbook of Natural Medicine. 2002 Churchill Livingstone New York. Pp: 220-223.

[12] Fitzherbert J. Genital herpes and zinc. Med J Austr. 1979; 1:399.

[13] Godfey HR et al. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med. 2001 May-June; 7(3): 49-56.

[14] Brody I et al. Topical treatment of recurrent herpes simplex and post-herpetic erythema multiforme with low concentration of zinc sulphate solution. Br J Dermatol. 1981 Feb; 104(2): 191-194.

[15] Koytchev RA, Iren RG, Dundarov S. Balm mint extract (LO-701) for topical treatment of recurring herpes labialis. Phytomedicine 1999 Oct; 6(4): 225-230.

[16] Segal R and Pisanty S. Glycyrrhizin gel as a vehicle for idoxuridine. J Clin Pharm Ther. 1987 June; 12(3): 165-171.

[17] Pompie R et al. Anti-viral activity of glycyrrhizic acid. Experientia. 1980 Mar 15; 36(3): 304.