Herpes simplex virus (HSV) infections are very common worldwide. HSV-1 (oral-facial herpes) is transmitted through kissing or sharing drinking utensils, and HSV-2 (genital herpes) through sexual contact. Both HSV-1 and HSV-2 can cause infections around the face, mouth, and genitals. The infection may not show symptoms for a long time, and then become activated by ultraviolet light, fever, menstruation, emotional stress, a weakened immune system, and trauma to the skin or nerves. Herpes infections in infants and in people who have weak immune systems or herpes infections that affect the eyes are serious and potentially life-threatening.

You may experience swelling and redness in your face and mouth areas, including your gums and throat. You may feel tired, have a fever, and feel pain in your face and muscles. Blisters may appear on your lips, face, gums, tongue, inside your mouth, and on your genitals. You may also have vaginal (in women) or urethral (in men) discharge.

You can get herpes simplex if you come in close contact with an individual infected with HSV-1 or HSV-2, such as a family member or sexual partner. Herpes simplex can also be transmitted through certain occupations (such as dentistry) or sports (such as wrestling). You can get herpes simplex from an infected person even if he or she does not have active symptoms. A mother can also pass the infection to her baby during vaginal birth.

Your provider will explain that there is no cure for herpes simplex but that you can treat the symptoms.

Antiviral medicines treat initial herpes infections and recurrences.

• Intravenous acyclovir—for herpes in newborns and for HSV encephalitis
• Oral acyclovir—for oral-facial herpes
• Oral acyclovir, oral valacyclovir, and oral famciclovir—for genital lesions
• Oral famciclovir and acyclovir—to reduce frequency and severity
• Idoxuridine, trifluridine, topical vidarabine, acyclovir, and interferon—for herpetic keratitis
• Intravenous foscarnet—for acyclovir-resistant HSV

Nutritional and herbal support can help you fight the herpes infection and strengthen your immune system.

• Avoid alcohol, caffeine, refined foods, sugars, saturated fats, and arginine-containing foods (seeds, grains, nuts, nut butters, chocolate).
• Increase intake of high lysine-containing foods (fish, chicken, eggs, potatoes, and dairy products) during active herpes infection.
• Vitamin C (250 to 500 mg twice per day) and acidophilus (one capsule with meals) may reduce the length of outbreaks.
• Beta-carotene (50,000 to 100,000 IU per day) slows viral activity.
• Zinc (30 mg per day) slows viral reproduction.
• L-lysine (500 to 1,000 mg per day for prevention, 2,000 mg two to four times per day during an outbreak)
• Thymus extract can help strengthen the immune system.
• Selenium (250 mcg per day) may reduce length and frequency.
• Vitamin A (200,000 IU per day for 3 days at onset of outbreak) can help decrease length and severity of symptoms. Pregnant women and those with liver disease should not take these doses of vitamin A.

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.

Topical cream applications of concentrated extracts of lemon balm (Melissa officinalis) or glycyrrhizic acid (from licorice root) can provide relief of symptoms and reduce severity and length of outbreak. They may be applied to both oral and genital lesions.

Internal treatment supports antiviral activity and immune function. For acute infection, combine equal parts of the following herbs in a tincture (30 to 60 drops three to four times per day) or a tea (3 to 4 cups per day). Coneflower (Echinacea purpura), licorice root (Glycyrrhiza glabra), lemon balm, yarrow (Achillea millefolium), chamomile (Matricaria recutita), and St. John's wort (Hypericum perforatum). Do not use licorice if you have high blood pressure. For recurrent infections, substitute lomatium (Lomatium dissectum) and astragalus (Astragalus membranaceus) for yarrow and chamomile, and use the new formula in tincture form, 30 drops three times per day. Lemon balm can be used internally for prevention and treatment.

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of HSV based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for each individual.

For lesions around the lips and mouth:

• Natrum Muriaticum -- for eruptions at the corners of the mouth that occur during periods of emotional stress and tend to worsen in the daytime
• Rhus toxicodendron -- for eruptions consisting of many small blisters that itch intensely at night
• Mercurius -- for children who drool and may have a fever
• Sepia -- for outbreaks that do not improve with other homeopathic remedies; this remedy is most appropriate for individuals who tend to have a lack of energy and are intolerant of cold weather

For genital lesions:

• Graphites -- for large, itchy lesions in individuals who are overweight
• Natrum Muriaticum -- for eruptions that occur during periods of emotional stress and symptoms that tend to worsen in the daytime
• Petroleum -- for lesions that spread to anus and thighs; symptoms tend to worsen in winter and improve in summer
• Sepia -- for outbreaks that do not improve with other homeopathic remedies; this remedy is most appropriate for individuals who tend to have a lack of energy and are intolerant of cold weather

Ice packs applied to oral lesions or to the sacral (lower back) area for genital lesions may help reduce pain and inflammation.

To boost the immune system and relieve pain.

Massage helps reduce the effects of stress, which may make HSV worse.

Identifying and avoiding triggers (such as using sunscreen if ultraviolet light activates your symptoms) can help reduce recurrences.

Getting herpes in the third trimester of pregnancy can be dangerous for both mother and baby. Your health care provider should know that you have had herpes.

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