Herpes Simplex or Cold Sores
Cold sores are a secondary manifestation of an initial infection with the herpes virus, usually caught early on in life. Following this primary infection, the virus settles in sensory nerves near the spinal cord and may be triggered again. When this happens, the virus travels from the spinal cord down the nerve fibres to reach the terminals of the nerve endings in the skin. This produces the classic blisters, which then weep and form a scab, and a secondary bacterial infection may worsen the lesion.Some people feel a tingling or itching in the area to be affected just before an outbreak occurs; other may feel neuralgic pain, irritable or under the weather, and many people have no prior warning at all. The usual sites of outbreaks include the lips and nose although other areas of skin and mucous membrane can be affected, such as the eyes, genitals and nails bed. The virus that usually causes genital herpes is slightly different to the cold sore virus affecting the lips etc, but there can be interchange of these viruses.
Hygiene during outbreaks is of utmost importance as the virus is easily spread and the open lesions are very vulnerable to secondary bacterial infection. During outbreaks, take care not to spread herpes infection to the genitals, eyes or nail beds, or areas of eczema, by avoiding touching the lesions and thoroughly washing the hands if the lesions are touched. Do not share towels or cups etc, during outbreaks.
The majority of the population carry the cold sore virus, but only some of us seem to suffer outbreaks. There are a number of factors which may provoke attacks. These include:
- The common cold. As the name suggest, cold sores may appear during or after a cold. This could be due to altered immunity, and the fact that the nose and lips may be dry and irritated from nose blowing does not help matters.
- Sunlight. Many people find they may suffer an outbreak whilst on a holiday abroad. Keep the lips moisturised, use sunscreen and a hat and avoid prolonged exposure to the sun or wind and sunburn to the face/lips.
- Stress. We are beginning to realise just how much stress can suppress the immune system. Maintaining a healthy diet and taking time to relax during times of stress is very important.
- Menstruation/hormonal changes as in pregnancy. Many women find that their outbreaks are confined to the period leading up to menstruation and some pregnant women may notice an outbreak of cold sores, particularly in early pregnancy when oestrogen and progesterone levels start to rise rapidly.
- A diet high in the amino acid arginine (found in nuts, hazelnuts and peanuts especially), and low in lysine (found in fish, meat and yeast in high levels) has been implicated as a trigger in some people. In this case, a nutritional therapist may be helpful.
In herbal medicine, people are treated individually and the unique triggers and factors for each person should be identified. So if dietary factors seem to be involved, attention to diet is required. Where stress is a major factor, then supporting the nervous system with herbal nervines and adaptogens such as lemon balm, oats, liquorice and skullcap may be the best approach. Simple premenstrual outbreaks may be helped by attention to diet and hormone-balancing herbs such as Vitex agnus-castus. However, pregnant women should not self-treat with herbs but should seek help from a qualified herbalist. Click on to the National Institute of Medical Herbalists website to find a qualified practitioner in your area. Repeated colds with associated cold sores are best approached by supporting the immune system with diet, and using herbs, such as Echinacea and lemon balm.
In general, Echinacea and lemon balm may be taken internally to boost immunity and retard viral activity. Research on liquorice has also shown anti-viral activity for herpes. These herbs can also be applied externally onto the lesions. In Addition, Golden seal and myrrh can be helpful external applications. All of these herbs are often used in the form of a tincture for convenience, potency, and the alcohol content, which can help to keep lesions dry and clean when applied externally. However, alcohol can sting and some people with sensitive skin may find alcohol irritating, in which case, an infusion of the herb or its aromatic water (hydrosol) if available, is an excellent alternative. These latter preparations are particularly suitable for application on genital herpes where a tincture would not be advisable for external use.
If outbreaks are very severe or repeated, you should seek medical advice. Lesions around or in the eye should not be self-treated and medical assistance should be sought immediately. Finally, if this is a new phenomena, seek a correct diagnosis from your GP, as other skin infections and diseases may produce similar lesions
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