Friday, October 2, 2009

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 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.

At the first sign of an outbreak
During an outbreak

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:
Time spent in nature
Deep breathing
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)

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.

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

Foods high in arginine include:
Brown rice

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.

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.

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.


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.