One of my friends suffers from recurrent cold sores, every time she is a little stressed or her immune system is weakened by a cold she, more often than not, gets a painful cold sore blister on her lip. 

Cold sores are caused by a virus known as Herpes simplex Type I (HSV-I), [...]]]>

One of my friends suffers from recurrent cold sores, every time she is a little stressed or her immune system is weakened by a cold she, more often than not, gets a painful cold sore blister on her lip. 

Cold sores are caused by a virus known as Herpes simplex Type I (HSV-I), this is different form the type II herpes simplex virus responsible for genital herpes (HSV-II).  Once contracted, the cold sore virus remains dormant (inactive and causing no symptoms) in the body, usually within our nerve cells.  In a healthy, strong body the immune system tends to keep the virus under control.  However, the virus can reactivate at any time and lead to blisters forming around the mouth, but also on the gums or inner cheeks.  Recurrences typically occur when the immune system becomes stressed by a fever, cold or other viral infection.  Excessive tiredness, fatigue, stress and menstruation can also lead to a cold sore forming.  Initially the cold sore appears as a painful and/or itchy fluid-filled small blister, this then breaks to form a scab which usually remains for up to 10 days.

In previous posts I have written about how to keep the immune system strong and healthy in order to prevent against infections.  This general advice will help to keep the body generally strong and able to prevent the herpes virus becoming active.  A diet rich in vegetables and fruits, healthy fats (especially the omega 3 fatty acids found in oily fish) and within minimum inclusion of processed foods seems to be the key.  However, if you are prone to cold sores there are a few specific recommendations that may help prevent cold sore recurrences.  There are also things that can be done once a cold sore has erupted in order to minimise the pain and discomfort caused and reduce the number of days that the blister remains.  Much of the evidence was collated in a review paper(1) that I will use as a basis for this post.

The amino acids Lysine and Arginine
The HSV-I virus requires a specific amino acid (the building blocks of proteins), called arginine, in order to multiply in the body.  However, a different amino acid, lysine, appears to inhibit/prevent the replication of the virus.  Lysine seems to block or ‘antagonise’ arginine via several complex mechanisms in the body.  There are many studies(1) which show that a lysine supplement can reduce the frequency, duration and severity of cold sore attacks.  In order to keep the virus at bay it may be useful to take 500mg of lysine daily, this can increase to 500mg twice, or three times daily during a cold sore attack.

Vitamin C and bioflavonoids
In previous posts I have written about the immune boosting properties of the antioxidant vitamin C and flavonoids (bioactive plant compounds).  A diet rich in vegetables and fruits will provide abundant amounts of vitamin C and flavonoids and I would suggest eating at least five portions a day (there are so many associated health benefits!!).  Studies have shown that supplemental vitamin C and flavonoids appear helpful in reducing the duration of a cold sore attack (1) and more recent laboratory studies have shown that various flavonoids appear helpful for inactivating the virus (2,3).  You may want to think about taking extra amounts of these nutrients daily (via a supplement) as a preventative measure to help keep the immune system strong, especially if you frequently struggle to eat at least five portions of vegetables and fruits daily.  During an attack 500mg Vitamin C with 200mg bioflavonoids twice to three times daily may be helpful.  For daily prevention 200mg vitamin C and 100-200mg flavonoids daily could be useful.

Topical treatment/creams
Most people who suffer from cold sores use popular the over-the-counter creams, which contain a pharmaceutical agent called acyclovir and can sometimes cause burning and stinging, but are keen to look for a more natural cream.  There are several studies looking into different agents which can be applied to the cold sore in order to minimise the redness and the length of duration of the blister/scab.  There are studies which indicate that honey (4), Bee propolis (5,6), vitamin E (7,8) and lemon balm, Melissa officinalis, (9,10,11) may all be helpful in minimising the viral blisters, reducing pain, itchiness or duration of attack.

In the study with honey (4) the average duration of cold sore attack, pain, occurrence of crusting and average healing time were all better with the honey treatment than with the acyclovir cream.  The authors of the study remark that:  “Topical honey application is safe and effective in the management of the signs and symptoms of recurrent lesions from labial and genital herpes”

Those wishing to try a more natural cream may be interested in one that I recently came across Comvita Lipclear Cream – Maintain Healthy Lips I have not tested the cream myself but it contains all of the agents mentioned above: honey, propolis, Vitamin E and lemon balm.  It also contains lysine which may be an added bonus.

Please do read my previous posts related to boosting immune health.  Any action which keep the immune system healthy and strong is likely to minimise the chance of recurrent cold sore attacks. 

(1)Gaby AR.  2006.  Natural remedies for Herpes simplex.  Alternative Medicine Review.  11:93-101
(2) Isaacs CE et al.2008.  Epigallocatechin gallate inactivates clinical isolates of herpes simplex virus. Antimicrob Agents Chemother.  52(3):962-70.
(3) Lyu SY, Rhim JY, Park WB.  2005.  Antiherpetic activities of flavonoids against herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in vitro.  Arch Pharm Res.28(11):1293-301.
(4) Al-Waili NS et al.  2005.  Topical honey application vs. acyclovir for the treatment of recurrent herpes simplex lesions.  Med Sci Monit.  10(8):MT94-98.
(5) Huleihel M et al.  2002.  Anti-herpes simplex virus effect of an aqueous extract of propolis.  Isr Med Assoc J.  4(11 Supplement):923-927.
(6) Giurcaneanu F et al.  1988  [Treatment of cutaneous herpes and herpes zoster with Nivcrisol-D].  Virologie.  39(1):21-24, 1988.
(7)Fink M et al.  1980.  Treatment of herpes simplex by alpha-tocopherol (vitamin E).  Br Dent J.  148:246.
(8)Nead DE.  1976.  Effective vitamin E treatment for ulcerative herpetic lesions.  Dental Survey.  52:50-51.
(9)Dimitrova Z et al.  1993.  Antiherpes effect of Melissa officinalis L. extracts.  Acta Microbiol Bulg.  29:65-72.
(10)Wolbling RH et al.  1994.  Local therapy of herpes simplex with dried extract from Melissa officinalis.” Phytomedicine.  1:25-31.
(11)Koytchev R et al.  1999.  Balm mint extract for topical treatment of recurring herpes labialis.  Phytomedicine.  6:225-230

Written by Ani Kowal

Related posts:

1. National Honey Week
2. Study finds that a dietary supplement may help reduce the symptom severity of the common cold
3. Review study finds that zinc supplements may reduce the severity and duration of the common cold