Herbal Considerations for Cold Sores ~ an excerpt

Cold sores are a painful condition that is caused by the herpes simplex-1 virus (HSV1). Genital herpes, shingles, and the Epstein Barr virus involve a closely related virus. This article focuses mainly on HSV1.


Once contracted, the herpes virus lives in nerve cells. It can be dormant for long periods of time and then become reactivated through a variety of causes including stress, depression, anxiety, an overabundance of sun exposure, reliance on stimulating nervines such as coffee or tea, fevers, menstruation, possibly food allergies/intolerance and more.


Once activated painful sores erupt most commonly on the lips, but can also affect the skin and other mucosal membranes. Most often an itch or tingle will be the first sensation of a cold sore outbreak. A red bump will shortly appear. This bump will grow and form a blister. These ulcerations can be itchy, painful and swell uncomfortably.


The herpes virus is most contagious during an outbreak, but can be transmitted through viral shedding even when the virus is dormant. Once active it is very contagious and pro-active steps can be taken to avoid transmitting it to others as well as spreading it further on your own body. To reduce chances of spreading the virus it’s important to avoid contact with the ulcerations through direct contact such as kissing or indirect contact such as touching the sores to a towel and then re-using that towel. When you have a current outbreak wash your hands frequently and especially after touching the cold sores themselves.


It is estimated that 75% of the population has the herpes virus, although many of these people are asymptomatic or otherwise do not know they are carriers of the virus.


Herbal remedies for cold sores can be thought of in four different stages.


Prevention
At the first sign of an outbreak
During an outbreak
Recovery


Prevention
Anyone who has had a herpes outbreak will understand the benefits of prevention. Cold sores are often very painful and unsightly.


The first steps of prevention can be avoiding known causes of outbreaks. If you notice that sun exposure results in cold sores take care to wear lip balm with sunscreen in it and/or a sun hat if you are unavoidably going to be in the sun for long periods of time.


Stress is a common cause of cold sores. Minimizing stress through self-nourishment such as taking time to do the things you enjoy, meditation, yoga, spending time in nature, getting restful sleep or whatever you need to do to maintain a stress resistant life can all go a long way in preventing herpes outbreaks.


However, many of us experience stress in our lives, and the reality is that stress is not going to go away. Adaptogen herbs can help strengthen our body’s response to stress and combined with the lifestyle suggestions above can be a powerful way to being more balanced health to our lives.


Adaptogens can be taken as single herbs or formulated by an herbal practitioner for an individual person.


Stimulating nervines such as coffee and tea may trigger cold sore outbreaks. If you suspect this may be causing your outbreaks, adaptogen herbs, along with slowly reducing the frequency of stimulating nervines may help to reduce the dependency on these “pick-me-ups” and reduce the number of outbreaks.


Examples of herbal adaptogens:


Licorice (Glycyrrhiza glabra) is usually added in small amounts to formulas, this sweet herb is commonly used in Chinese medicine especially and has been scientifically proven to be effective against the herpes virus.)
Holy Basil: (Ocimum sanctum) A highly revered herb from India it also has anti-viral capabilties
Ashwagandah (Withania somnifera)
Shatavari (Asparagus racemosus)
Eluethero (Eleutherococcus senticosus)
Codonopsis (Codonopsis pilosula)
Schizandra (Schizandra chinensis)

Holy Basil

Examples of lifestyle adaptogens:
Yoga
Meditation
Time spent in nature
Deep breathing
Exercise
Joyful activities


Relaxing nervines can calm the nerves during acute situations of anxiety or stress.


Chamomile (Matricaria recutita)
California poppy (Eschscholzia californica)
Passionflower (Passiflora incarnata)
Lavender (Lavendula officinalis)
Skullcap (Scutellaria lateriflora)

Passionflower

Building a strong immune system can also prevent outbreaks. This includes all those things we know we should do for ourselves such as whole fresh foods, a good balance of proteins and healthy oils, plenty of restful sleep, exercise, and joy. Certain nutrients support our immune system and are a beneficial part of the diet. Vitamin C can be found abundantly in rose hips, pine needle leaves and dandelion leaves. In fact, a good amount is found in most leafy green vegetables. Building the immune system may also include optimal vitamin D levels and the support of immunomodulating herbs.


Examples of immunomodulating herbs


Astragalus root (Astragalus membranaceous): One of my most relied upon herbs for maintaining health. We add several handfuls of the roots to large pots of simmering bone broth or small handfuls to herbal chai mixes.

Astragalus roots

Elderberry (Sambucas nigra. S. canadensis) This delicious berry can be prepared as a syrup, elixir, jelly, or tincture and can be taken daily to support the immune system.


Reishi mushroom (Ganoderma lucidum) is an adaptogen as well as immunomodulator that has demonstrated activity against HSV.

Reishi mushroom

Dietary suggestions: Eating lysine rich foods and avoiding foods high in arginine.
The amino acid arginine has been implicated in herpes outbreaks. The virus actually needs arginine to replicate and may even stimulate the virus. Lysine blocks arginine and can help prevent outbreaks.


Lysine rich foods include:
Meat (turkey, beef, chicken, turkey)
Milk and cheese
Eggs,
Fish


Foods high in arginine include:
Nuts
Brown rice
Wheat
Oatmeal
Chocolate
Beer


Anti-viral herbs

St. John's Wort

Taken preventively as well as during an outbreak anti-viral herbs can help to minimize the virus from replicating and stop it from attaching to cells.


Garlic (Allium sativum.)
St. John’s Wort (Hypericum perforatum)
Lemon balm (Melissa officinalis)
Cedar (Thuja occidentalis)
Licorice (Glycyrrhiza glabra)
Aloe (Aloe vera)
Elderberry (Sambucus spp.)
Echinacea (Echinacea spp.)


Reishi (Ganoderma lucidum)

Echinacea purpurea

At the first sign of an outbreak:
If preventive steps fail and you feel the onset of an outbreak there are several things you can do to help either stop the outbreak or lessen the symptoms.


Internal Treatments:
Take regular teas and tinctures of anti-viral and immunomodulating herbs as listed above.


Large doses of lysine supplements at the first sign have been helpful for me in stopping an impending outbreak. I may take as much as 4,000 mg every half hour until the outbreak has abated. This can make one nauseas on an empty stomach. If you take too much lysine loose stools will develop. 

St. John's Wort Oil

Topical Treatments:
St. John’s Wort oil or tincture can be applied liberally and frequently. If applied often enough one can stop an outbreak entirely. 




A freshly sliced clove of garlic apply directly to the sore can stop it from growing, but beware garlic is spicy even when used topically and can cause burning and moderate discomfort.


Essential oils:
Many people successfully stop cold sore outbreaks by applying essential oils to the sores themselves. They may be diluted in a carrier oil to avoid irritation. Essential oils often used include tea tree oil, lavender, lemon balm, and thuja. Please keep in mind that essential oils are not for internal use and can cause irritation when applied externally.


Through all this remember to rest. Your body is not fighting a viral infection and can use rest and support of immune system functions.


Herbal options for a cold sore outbreak


If the above suggestions still result in an outbreak there are multiple herbs and other resources to lessen the pain and speed healing.


St. John’s Wort continues to be helpful during an outbreak. It can be taken internally and used externally. 
Calendula is an effective wound healer. It can be applied as an oil or tincture.
Aloe Vera is anti-viral and a fabulous vulnerary. The gel from the inside of the leaves can provide instant cooling relief to the pain and discomfort of cold sores.
Plantain (Plantago major) can be applied as a poultice, salve, or tincture to speed healing time.



Swelling
If there is significant swelling ice can be applied to the wounds. You can also make tea and freeze the tea in ice cube trays for an added kick. I especially like to do this with licorice root, but many anti-viral and vulnerary herbs could be used such as lemon balm, calendula, St. John’s Wort, etc.


Weeping
If there is pus weeping from the wound you can make a clay poultice and apply that to the sores.


Clay poultice for cold sores:
1 tsp French green clay
½ tsp powdered licorice root
½ tsp powdered rose petals


To this add enough St. John’s Wort tincture to create a clay plaster. You can add a little St. John’s Wort oil to this mix to avoid the mixture from drying too quickly. (Water can also be substituted) Once it reaches a good consistency it can be slathered over the sores. I’ll warn you that this clay poultice is not a pretty sight but is a good option when sores are weeping especially at night in order to sleep more comfortably.


Astringent herbs can also be helpful topically for weeping sores. A simple remedy for this is to briefly wet a black tea bag with hot warm, let cool slightly and then apply that topically to the sore.


Again, during an outbreak remember to rest. Your immune system can use the help.




Recovery
Cold sore outbreaks can last anywhere from a couple of days to a full week. As the sores heal and new skin is formed take the time to fully recover. Review the recommendations for prevention and adopt them into your life as you can.

Milky oats tincture

A fresh milky oats (Avena sativa A. fatua) tincture can be taken three times a day following a cold sore outbreak to help nourish and heal the nerves. A strong infusion of the milky oats can be taken over long periods as a nourishing relaxing nervine.

Everything I know about the dreaded Cold Sore

Cold sores are an outbreak of the herpes virus. The sore begins with a hint of a tingle or itchiness and, if not treated, will turn into a painful blister that usually takes about a week to heal. This virus strikes after prolonged exposure to the sun, or a dip in the immune system at times of stress or sickness. I used to get cold sores more often, and now, only seem to get them when sick. They are the first thing that I started treating herbally years ago and I have found several effective ways of dealing with them. If you are hoping to stop a cold sore from erupting, the trick is to treat it aggressively, both liberally and frequently at the very first tingling. Once the cold sore breaks the surface, the best you can do is treat the pain, although steadily taking anti-viral and immune supporting herbs may shorten the duration of the outbreak.

I contacted cold sores when I was 16 and was so horrified I didn't go to school for a week until my lips were back to normal. At that time I really struggled emotionally with having the herpes virus. Although I certainly don't relish getting cold sores now, I have come to recognize them as a teacher of sorts. If I am getting too stressed, run down, anxious, etc., then my teacher the cold sore will pop up to remind me to take better care of myself. So besides the herbs listed below, proper rest, nutritious food, and calm state of mind can all be helpful in preventing cold sores and helping them to heal more quickly.

Because of their highly contagious nature, proper hygiene is crucial when dealing with an outbreak. Washing your hands after touching the cold sore is important as is refraining from wiping the area with any towel or cloth that will be re-used. A friend of mine told me she chewed on her thumb cuticle while she had an outbreak and her thumb started having outbreaks as well. Another friend contracted the virus into her eye. Obviously not kissing anyone, or placing the cold sore on any other place of the body is good practice as well.

St. John’s Wort Oil or Tincture (Hypericum perforatum)
I apply this oil or tincture topically and take the tincture internally at the first sign of a cold sore. St. John’s Wort has strong anti-viral properties that go straight to where the virus hangs out, in the nerve endings. This is probably my most tried and tested way of preventing outbreaks. St. John’s Wort has the potential to interfere with prescription medications and may cause photosensitivity in some individuals, so this is an herb that you should know well before ingesting.

Tea Tree Oil
This potent oil can be a little too much on the lips, so I like to dilute it in olive oil (or some other carrier oil), or I add tree tea oil to the St. John’s Wort Oil and apply them together with a Q-tip.

Lemon Balm (Melissa officinalis)
Herbalist Jill Stansbury says the tannins in lemon balm are what make it effective against the virus, so a water extract as a tea or infusion is best for use against cold sores. Herbalist Heather Nic an Fleishdier reports having completely gotten rid of the herpes virus from her body by taking daily infusions of lemon balm and St. John’s Wort.

Amino Acids:
Although not an herbal remedy, taking lysine pills at the beginning of a cold sore can stop the outbreak altogether. I take as many as 4,000 mcg at the first tingle of a cold sore, and continue with 2,000 mcg every hour. Trust me, you'll get nauseas if you take too much. Conversely avoiding foods high in arginine can be helpful during an outbreak or to prevent an outbreak. (A listing of foods with a lysine arginine ration can be found here.)

Tulsi (or Holy Basil):
Highly regarded in India, this potent plant related to basil is considered by many as a cure all wonder. Among its many attributes, are anti-viral properties. A warm cup of tea or a dropperful of tincture made from the fresh plant can stop or shorten the duration of a cold sore. Taken over time Tulsi also has the ability to help your body deal with stress better (adaptogenic). Large amounts of Tulsi should not be taken when pregnant.

Hyssop (Hyssop officinalis)
I used to think of hyssop as a “coughing” remedy and have only recently begun using the tea or tincture for cold sores. It tastes great and is very effective.

Elderberry (Sambucus spp. - blue berried varieties)
In the past year I have used elderberry tincture for cold sores a couple of times with mixed results. One thing is for sure it's easy to get this medicine down the trap.

Garlic (Allium sativum)
I haven't tried this myself but have heard from several people that place a raw slice of garlic on the site of the cold sore (again at the first sign of tingling), will help keep it from erupting.



Once the cold sore has erupted there are a few things that can help it to heal more quickly and reduce pain.

Ice
Sometimes I get monster cold sore outbreaks where my lip swells enormously and is so painful I can barely eat. Ice is certainly my friend. It dulls the pain and decreases the swelling.

Herbal bandaid
One time I had such an oozy outbreak that I wanted some kind of bandaid on the sore. I started experimenting with different herbal powders.

Mix together some variation of:
Powdered rose petals, powdered licorice root, powdered hyssop, and powdered lemon balm with kaolin clay. Mix it with a little water and a little St. John's Wort oil. You can also add tea tree oil or lavender EO to the mix. It should form a sticky clay like mixture that will stick to the desired area.

This is especially nice for night time application.

Lip Balm
For applications on the go I've made several variation of a cold sore care lip balm. My favorite herbs to use are St. John's Wort, Lemon Balm, and Hyssop with tea tree oil in an olive oil, coconut oil, and beeswax base.

Herbal Lip Balm for Cold Sores

This has been one of those months for me - just insanely busy and a little stressful. Luckily my body lets me know when it starts to get run down by this little tingly red spot on my bottom lip - the dreaded cold sore.

I am currently assistant teaching at the Institute of Structural Medicine. Trainings here run 16 days and each day is a 12 hour day. I've got four more days to go and I'd rather do it without this big blob on my lip. When I was younger I had no problem taking prescription medication to control cold sore outbreaks. (Oh the power of Acyclovir.) I have a few problems with acyclovir - namely the side effects which include:

nausea, vomiting, diarrhea, or headache, hair loss, dizziness, fatigue, skin rash, anorexia, leg pain, medication taste and sore throat

I'll take a cold sore over hair loss thank you very much!

I've experimented with several more herbal remedies, but lately my favorite is a Cold Sore Care Herbal Lip Balm I made up this summer. To make it I infused St. John's Wort flowers in coconut oil, lemon balm in olive oil, and added alcohol extracts of both of these and some drops of tea tree oil for good measure.

As reported I started getting a cold sore two days ago and at the first sign I repeatedly applied the lip balm. My cold sore didn't entirely go away, but it never came "out" of my lip. It's been very little trouble to me and isn't visible unless I get right up to the mirror.

Besides being unsightly, cold sores can be incredibly painful. A couple of months ago I got a cold sore and didn't get too it soon enough, so it did become quite big, but the Cold Sore Care Herbal Lip Balm relieved the pain. I love being an herbalist!

Some herbalists have reported a photo-sensitivity when using St. John's Wort. This isn't something I've had a problem with.

I used to be ashamed of getting cold sores. Now I just realize it's one way my body lets me know I've gone too far. Besides applying Cold Sore Care Herbal Lip Balm, I've been taking more breaks, deeper breaths, and drinking some nourishing bone broth soup and infusions. It's nice to get this little warning sign before a cold or flu makes it's way in.

I sell my lip balms (Cold Sore Care, Soothing Lip Balm, and Cottonwood 'N Coconut) at the Saturday Market in Twisp - $3 for one or two for $5. If you are interested in trying some out, drop me an email and I'd love to send some your way.

I've also written about cold sores here.