Genital Herpes
Also indexed as: Herpes Simplex Virus Type 2
A variety of treatments offer relief from this common
STD—find out what works best for your symptoms. According to research or other evidence,
the following self-care steps may be helpful:
- Talk to your doctor
- Ask about antiviral agents that may reduce the duration of lesions
and help prevent spread, such as acyclovir (Zovirax), valacyclovir (Valtrex), and famcyclovir
(Famvir)
- Test topical alternatives
- For symptom relief and faster healing, try ointments containing
zinc, lithium succinate, propolis, lemon balm, or aloe
- Try lysine
- Taking 1,000 mg a day of this nutritional supplement may speed
healing and help prevent outbreaks
- Use condoms
- Gain added protection by using latex condoms when having sex
- Guard your partner
- Avoid sexual contact during active infections to prevent infecting
others
- Protect your unborn child
- Let your obstetrician know if your infection becomes active near
your delivery date to prevent passing the infection to your baby
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full genital herpes article for
more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About genital herpes
Genital herpes is a common sexually transmitted viral infection characterized by fluid
filled blisters or red bumps in the genital area.
Genital herpes is caused by either of two types of the herpes simplex virus (HSV). There is
no known cure for herpes. Both conventional and alternative treatments only help in reducing
the symptoms and frequency of outbreaks. Treatments effective for cold sores—which are also caused by the herpes
virus—may or may not also be effective for genital herpes, because of possible
differences in the type of herpes virus causing infections in different body locations.
Product ratings for genital
herpes
What are the symptoms?
People with genital herpes may have outbreaks of small, often painful, fluid-filled
blisters (vesicles) in the genital or anal region. Fever, general weakness, and painful
urination often accompany the initial occurrence. Subsequent outbreaks may appear with colds,
fevers, menstrual periods, or during periods of stress,1 and usually disappear
within two weeks. Initially there may be tingling or prickling at the site of the blisters
even before they are visible, then the blisters often weep a clear fluid and form a scab.
Dietary changes that may be helpful
Many alternative healthcare practitioners recommend that people with herpes simplex
infections eat a diet high in the amino acid
lysine and low in arginine. Foods high in
lysine include red meat, poultry, fish, and dairy products, while foods such as chocolate,
nuts, peas, and cereals are high in arginine. This recommendation is based on test tube
research indicating that growth of the herpes virus is inhibited by lysine and promoted by
arginine.2 However, no research has investigated whether making these dietary
changes helps prevent outbreaks of genital herpes. In fact, one preliminary study found that
patients with and without genital herpes did not differ from each other in how much dietary
arginine and lysine they consumed.3
Lifestyle changes that may be helpful
Since genital herpes is highly contagious, people with active herpes infections should
avoid direct sexual contact. Also, infected pregnant women should inform their obstetrician if
their herpes becomes active around their delivery date, as HSV can be transmitted to the
newborn during birth and cause a more serious infection in the child.
Vitamins that may be helpful
Most research on lysine has been done on
people with cold sores or on groups that
include both cold sores and genital herpes sufferers. However, some evidence exists that
supplemental lysine may be effective in the prevention and treatment of genital herpes. In one
preliminary survey, 81% of people with HSV infections (including genital herpes) reported
lysine was effective for reducing recurrences and shortening healing time in amounts averaging
about 1,000 mg per day.4 A small double-blind trial of people with oral and genital
herpes examined the effects of 1,248 mg or 624 mg of lysine daily versus placebo.5
The study found that 1,248 mg per day of lysine, but not the lower dose, was effective in
reducing the recurrence rate of herpes outbreaks by 57% to 65%, while neither dose helped
reduce the healing time. Another small double-blind trial found that using 3,000 mg per day of
lysine in divided doses led to a decrease in severity of symptoms and a reduction in healing
time of both oral and genital herpes.6 One preliminary report found no benefit of
lysine for a group of patients with either oral or genital herpes.7
In a test tube, zinc is capable of
inactivating the type of herpes virus responsible for the majority of genital herpes
cases.8 Topical zinc may therefore help prevent outbreaks of genital herpes. One
preliminary study treated people (four of whom had genital herpes) with a 4% zinc sulfate
solution applied to the site of the initial outbreak.9 In all cases, the pain,
burning, and tingling stopped within 24 hours of beginning the topical zinc therapy. The use
of lower concentrations of zinc (0.025–0.05%) has also been shown effective against oral
and genital herpes outbreaks.10 11 While topical zinc has been shown to
be helpful, there is no convincing evidence that oral zinc offers the same
benefits.12
Lithium is a mineral available in an ointment or in the prescription drug lithium carbonate. In small studies, pharmacological
doses of lithium carbonate have helped prevent outbreaks of genital herpes.13
14 However, there is no evidence that smaller amounts of oral lithium in nonprescription
supplements would be similarly effective. A controlled study using a topical ointment
containing 8% lithium succinate with 0.05% zinc sulphate diminished the pain and discomfort of
genital herpes and shortened the healing time.15 In light of the known benefits of
topical zinc, it is unclear whether lithium was an important component of this treatment
A test tube study found that flavonoids
present in propolis are responsible for the
supplement’s antiviral action.16 A controlled study found that an ointment
containing propolis, used four times daily, was almost twice as effective as topical antiviral medication or a placebo
ointment.17
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Licorice root (Glycyrrhiza
glabra) contains antiviral substances18 and ointments containing related
substances are effective in treating herpes infections.19 20 While the
use of topical licorice preparations to prevent or treat genital herpes has not been studied,
some alternative healthcare practitioners recommend applying creams or gels containing
licorice three to four times a day.
A double-blind trial found that topical application of a cream containing a highly
concentrated extract of lemon balm
(Melissa officinalis) four to five times a day helped heal oral and genital herpes sores
faster than use of a placebo.21
Aloe vera may also benefit those
with genital herpes. A double-blind trial using a 0.5% Aloe vera cream found that
applying the cream three times a day shortened the healing time of genital herpes outbreaks.
All but 3 of 22 persons in the study who showed healing with the aloe cream had no recurrences
15 months after stopping treatment.22
Test tube and animal research suggests that substances found in turmeric, cloves, eucalyptus, and seaweed have potential benefit for
topical prevention of genital herpes, but no human research using available herbal products
has been performed.23
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful
Stress plays a major role in the recurrence of genital herpes outbreaks. One preliminary
study found that persistent stress (stress lasting more than seven days) increased the
recurrence rate by about 25%,24 but another preliminary study found no connection
between stress and genital herpes outbreaks.25 In addition, short-term stress, mood
changes, and menstrual cycles do not appear to affect herpes recurrences.26
Treatments aimed in part at stress reduction may be helpful for treating genital herpes. One
controlled trial showed that patients had fewer outbreaks, shorter episode duration, and less
episode severity when they were treated with a series of sessions involving education about
genital herpes, stress management, deep breathing exercises, and guided imagery.27
A preliminary study suggested that applied relaxation (a technique that guides the participant
through a series of muscle relaxation exercises) reduces recurrences of genital herpes
outbreaks.28 Two case reports indicate that self-hypnosis, practiced on a daily basis, helps ease
the pain and severity of genital herpes lesions.29
References
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1. Cohen F, Kemeny ME, Kearney KA, et al. Persistent stress as a
predictor of genital herpes recurrence. Arch Intern Med 1999;159:2430–6.
2. Tankersley RW. Amino acid requirements of herpes simplex virus in
human cells. J Bacteriol 1964;87:609–13.
3. Algert SJ, Algert SJ, Stubblefield NE, et al. Assessment of dietary
intake of lysine and arginine in patients with herpes simplex. J Am Diet Assoc
1987;87:1560–1.
4. Walsh DE, Griffith RS, Behforooz A. Subjective response to lysine in
the therapy of herpes simplex. J Antimicrob Chemother 1983;12:489–96.
5. McCune MA, Perry HO, Muller SA, O’Fallon WM. Treatment of
recurrent herpes simplex infections with L-lysine monohydrochloride. Cutis
1984;34:366–73.
6. Griffith RS, Walsh DE, Myrmel KH, et al. Success of L-lysine therapy
in frequently recurrent herpes simplex infection. Dermatologica
1987;175:183–90.
7. Simon CA, Van Melle GD, Ramelet AA. Failure of lysine in frequently
recurrent herpes simplex infection. Arch Dermatol 1985;121:1678 [letter].
8. Arens M, Travis S. Zinc salts inactivate clinical isolates of herpes
simplex virus in-vitro. J Clin Microbiol 2000;38:1758–62.
9. Wahba A. Topical application of zinc solutions: A new treatment for
herpes simplex infections of the skin? Acta Derm Venereol 1980;60:175–7.
10. Finnerty EF. Topical zinc in the treatment of herpes simplex.
Cutis 1986;37:130–1.
11. Brody I. Topical treatment of recurrent herpes simplex and
post-herpetic erythema multiforme with low concentrations of zinc sulphate solution. Br J
Derm 1981;104:191–4.
12. Eby GA, Halcomb WW. Use of topical zinc to prevent recurrent herpes
simplex infection: review of literature and suggested protocols. Med Hypotheses
1985;17:157–65.
13. Amsterdam JD, Maislin G, Hooper MB. Suppression of herpes simplex
virus infections with oral lithium carbonate—a possible antiviral activity.
Pharmacotherapy 1996;16:1070–5.
14. Amsterdam JD, Maislin G, Potter L, Giuntoli R. Reduced rate of
recurrent genital herpes infections with lithium carbonate. Psychopharmacol Bull
1990;26:343–7.
15. Skinner GRB. Lithium ointment for genital herpes. Lancet
1983;2:288 [letter].
16. Debiaggi M, Tateo F, Pagani L, et al. Effects of propolis flavonoids
on virus infectivity and replication. Microbiologica 1990;13:207–13.
17. Vynograd N, Vynograd I, Sosnowski Z. A comparative multi-centre study
of the efficacy of propolis, acyclovir and placebo in the treatment of genital herpes (HSV).
Phytomedicine 2000;7:1–6.
18. Pompei R, Flore O, Marccialis MA, et al. Glycyrrhizic acid inhibits
virus growth and inactivates virus particles. Nature 1979;281:689–90.
19. Csonka GW, Tyrrell DA. Treatment of herpes genitalis with
carbenoxolone and cicloxolone creams: a double blind placebo controlled clinical trial. Br
J Vener Dis 1984;60:178–81.
20. Partridge M, Poswillo D. Topical carbenoxolone sodium in the
management of herpes simplex infection. Br J Oral Maxillfac Surg
1984;22:138–45.
21. Wolbling RH, Leonhardt K. Local therapy of herpes simplex with dried
extract of Melissa officinalis. Phytomedicine 1994;1:25–31.
22. Syed TA, Afzal M, Ahmad SA, et al. Management of genital herpes in
men with 0.5% Aloe vera extract in a hydrophylic cream: a placebo-controlled,
double-blind study. J Dermatol Treat 1997;8:99–102.
23. Bourne KZ, Bourne N, Reising SF, Stanberry LR. Plant products as
topical microbicide candidates: assessment of in vitro and in vivo activity against herpes
simplex virus type 2. Antiviral Research 1999;42:219–26.
24. Cohen F, Kemeny ME, Kearney KA, et al. Persistent stress as a
predictor of genital herpes recurrence. Arch Intern Med 1999;159:2430–6.
25. Rand KH, Hoon EF, Massey JK, Johnson JH. Daily stress and recurrence
of genital herpes simplex. Arch Int Med 1990;150:1889–93.
26. Cohen F, Kemeny ME, Kearney KA, et al. Persistent stress as a
predictor of genital herpes recurrence. Arch Intern Med 1999;159:2430–6.
27. Longo DJ, Clum GA, Yaeger NJ. Psychosocial treatment for recurrent
genital herpes. J Consult Clin Psychol 1988;56:61–6.
28. Koehn KA, Burnette MM, Stark C. Applied relaxation training in the
treatment of genital herpes. J Behav Ther Exp Psychiatry 1993;24:331–41.
29. Gould SS, Tissler DM. The use of hypnosis in the treatment of herpes
simplex II. Am J Clin Hypn 1984;26:171–4.
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