Herpes Simplex

Description

Alternative Names

Home Remedies and Prevention

Most herpes simplex infections that develop on the skin can be managed at home with over-the-counter painkillers and symptomatic relief.

Symptomatic Relief

A number of simple steps can produce some relief:

• Hygiene is important. Avoid touching the sores. Wash hands frequently during the day. Fingernails should be scrubbed daily. Keep the body clean.
• Drink plenty of water.
• Blisters or sores should be kept clean and dry with an agent such as cornstarch. (Talcum powder should never be used because it is associated with an increased risk for ovarian cancer.)
• Some people report that drying the genital area with a blow dryer on the cool setting offers relief.
• Avoid tight-fitting clothing, which restricts air circulation and slows healing of the sores.
• Choose cotton underwear, rather than synthetic materials.
• Local application of ice packs may alleviate the pain and help reduce recurrences by suppressing the virus.
• Lukewarm baths may be helpful. (For people who have pain on urination, some experts recommend urinating in the bath water at the end of the bathing time. This dilutes the urine and prevents burning the sores. Urinating in a cool shower is also helpful and is less offensive to many people. )
• Wearing sun block helps prevent sun-triggered recurrence of HSV-1.
• Sex should be avoided both during the outbreaks and the prodromes (the early symptoms of herpes), which include tingling, itching, or tenderness in the infected areas.
• Over-the-counter medications such as aspirin, acetaminophen (Datril, Panadol, Tylenol), or ibuprofen (Advil, Medipren, Motrin, Nuprin), can be used to reduce fever and local tenderness. Children should take acetaminophen; they should never be given aspirin.

Stress Management

In one study, stress management techniques developed using cognitive-behavioral methods were not only effective in reducing depression in those with HSV-2, but blood test results also revealed lower levels of HSV-2 antibodies, a possible sign of decreased viral activity. In any case, reducing stress using relaxation techniques does no harm.

Herbal and Other Alternative Remedies

There are many unproven claims for numerous alternatives and unconventional remedies for herpes simplex. Among those that have shown no additional advantages are various vitamins and minerals.

There are anecdotal reports of relief from other herbal or over-the-counter remedies, including the following:

• Cream made from Melissa, an herb from the mint family.
• Aloe vera ointments for genital herpes.
• A dropper-full of an extract of echinacea applied to the sores every few hours. A 2002 laboratory study reported that certain echinacea extracts (E. pallida, C. purpurea root extract, and others) had activity against HSV. A previous study, however, reported no benefits from echinacea purpura (Echinoforce) compared to a placebo, however, although the study had limitations. (It should be noted that echinacea may worsen allergies or even trigger one. People with autoimmune diseases or who have plant allergies should particularly avoid it.)
• Tea tree and eucalyptus oils. Such oils exhibit anti-viral activity against HSV. Warning: such oils are for topical use only since they can be very toxic if ingested. They should not be used in children.
• An ointment for genital herpes made from propolis, a substance made by bees from tree resin.

A number of these and other herbal or natural substances have anti-HSV properties in laboratory studies. Few human studies have been conducted. In any case, none can be recommended for treatment, since product quality and long-term effects are unknown. It should be noted that many herbal treatments are not harmless. And none are government regulated.

Preventing Transmission

There are a number of steps that infected people should take to avoid transmitting the virus to others. It should be noted that it is almost impossible to defend against the transmission of oral HSV-1 since it can be transmitted by very casual contact.

Preventing Transmission During an Outbreak. When an outbreak of herpes occurs the following precautions are useful:

• Persons carrying any herpes virus should carefully wash their hands and nails after contact with the infected area so as not to transmit the virus to other sites on the body.
• Although transmission from objects such as toilet seats and towels is unlikely, keeping personal items separate during an active infection may help to reduce transmission to other household members. The virus can live for up to two hours on cloth and for four hours on plastic.
• If genital lesions are present, infected persons should abstain from sexual intercourse.

Preventing Sexually Transmitted Disease. Any infected man or a partner of an infected woman should wear a condom during any sexual activity, even when symptoms are not present. Condoms are also important during oral sex, as an increasing number of new genital herpes cases are due to HSV-1, particularly among younger people.

The use of condoms for preventing the transmission of HSV-2 is not foolproof, however. Even a small tear can permit passage of the virus. Condoms made of latex are less likely to slip or break than those made of synthetic materials, such as polyurethane (Avanti or eZ). Condoms made from animal membrane do not protect against HSV infection because herpes viruses can pass through them.

Women appear to be better protected than men are by male condoms. The reason may be that men shed HSV-2 from the skin of the penis, which is covered by the condom. However, in women the virus is often shed from skin areas around the genital area, which can have contact to skin areas in the male outside the condom.

The female condom (Reality) may be the best option for infected women or partners of infected men. The female condom covers a large area and is an effective barrier to viruses. There are virtually no obstacles against its use except a negative psychologic perception and the fact that it is not completely fail-proof against pregnancy.

Note on Lubricants and Spermicides. Only water-based lubricants (e.g., K-Y Jelly, Astroglide, AquaLube, glycerin) should be used. Oil-based lubricants (e.g., petroleum jelly, body lotions, cooking oil) can weaken latex.

Some condoms come prelubricated with sperm-killing substances called spermicides, which are no longer recommended. The standard active ingredient in spermicides in the US is nonoxynol-9, which attacks the surface of the sperm cell. Its use, however, may promote yeast and urinary tract infections in women. Worse, evidence now strongly suggests that nonoxynol-9 does not provide any additional protection against sexually-transmitted diseases. In fact, research now suggests that it actually increases the risk for HIV in women, possibly by causing injury in the vaginal area.

A unique synthetic polymer gel (PRO 2000 Gel) interferes with viral infection itself--not the sperm--and is undergoing trials. Early studies suggest it is well tolerated although it does have some adverse effects, including vaginal discharge and bleeding.