Conditions

Herpes

Herpes viruses are a family of viruses that cause skin eruptions. The herpes simplex virus 1 (HSV1) usually causes cold sores (fever blisters). Herpes simplex virus 2 (HSV2) involves genitals and is usually, although not always, passed through sexual contact. The varicella-zoster virus causes chickenpox and shingles. Zoster oticus involves facial nerves. The Epstein-Barr virus causes mononucleosis.

This writing concentrates on HSV1 and HSV2.

Once these viruses enter the body, they can remain dormant in the nervous system for varying amounts of time. They can then be reactivated by fever, physical or emotional stress, excessive exposure to sunlight, and some foods or drugs. Herpes outbreaks can recur for life, but they generally taper off after age fifty.

Both HSV1 and HSV2 infections are extremely common. For those that have had herpes before, the early burning and tingling sensation signals an imminent outbreak. Once the blisters form into sores, healing usually occurs within seven to ten days.

An HSV2 infection in a pregnant woman poses a serious danger to the fetus. The herpes virus can attack the baby's nervous system, leading to seizures, mental retardation, or developmental disabilities. To avoid infecting the baby, it is recommended that infants be delivered by cesarean section if the mother has a herpes outbreak within three weeks of delivery.

Signs and Symptoms:
Symptoms of HSV (1 & 2) generally make themselves known within one or two weeks after contraction of the virus.

HSV1:

• Burning, tingling or itching sensation around the edges of the lips or nose
• Small red pimples develop within a few hours
• Formation of small fever blisters filled with fluid
• Blisters itch and hurt
• Mild fever
• Lymph nodes in your neck may become enlarged
• Blisters form thin yellow crusts (after 7 days) ­ virus has run its course and healing has begun.

HSV2:

• Burning, tingling, or itching sensation in the genital area
• Painful blisters on the skin and moist linings of the sex organs
• Fluid-filled blisters
• Red and painful surface sores that itch and burn (also easily infected)
• Fever
• Swelling of the lymph nodes in the groin
• Pain when urinating

In addition to the sores, herpes simplex affects the nervous system.

Diagnosis:
After a physical examination and review of the symptoms your doctor may order any of the following diagnostic procedures:

• Tissue cultures-to show characteristic multinucleated giant cells
• Antigen detection - for group and type discrimination
• Polymerase chain reaction (PCR) - especially for CNS infections
• Serologic assays, especially tissue-specific assays (e.g., complement fixation, passive hemagglutination, indirect immunofluorescence, radioimmunoassay, complement-mediated cytolysis, antibody-dependent cellular cytolysis)-to type isolates.
• Magnetic resonance imaging (MRI) and computed tomography (CT) - to locate involved areas of HSV encephalitis
• Electroencephalography (EEG) to locate involved areas of HSV encephalitis.
• Staining of scrapings with Wright, Giemsa, or Papanicolaou stains - to diagnose skin lesions and to view intranuclear inclusions
• Immunoblotting techniques
• Cell-mediated immunity assay

Treatment Options:

Treatment helps reduce the discomfort of outbreaks and tries to lessen the reoccurrences.

Traditional Treatments:

• The treatment of cold sores caused by HSV is aimed at relieving symptoms. To reduce the risk of secondary infection, you can gently wash the sores with soap and water.
• A viscous solution of lidocaine is a topical anesthetic that can be prescribed to decrease the pain of a herpes sore in the mouth.
  Warning: It is extremely important not to exceed the recommended dosage of this drug because of its potential toxicity.
• To ease discomfort, you can take acetaminophen or ibuprofen.
  Warning: In excessive amounts, acetaminophen can cause liver damage. Do not exceed the recommended dosage.
• An astringent such as Campho-Phenique can help relieve symptoms and speed healing, although it may sting when first applied.
• The antiviral acyclovir (Zovirax) is a common treatment for genital and oral herpes. It is a relatively safe and well-tolerated drug. The course of treatment requires that the drug be taken every four hours for up to ten days. If you take acyclovir on a regular basis as a preventative measure, exercise caution. When the drug is stopped, outbreaks sometimes become more severe.

Complementary and Alternative Therapies:

Enhancing the immune system and inhibiting the herpes virus may be achieved through nutritional and herbal support.

Nutritional Supplementation:

• Take a good multivitamin and mineral supplement.
• Folic acid and vitamin B12 help to heal mucous membranes and are helpful for oral herpes. Chew a 400 or 800 mcg tablet of folic acid three times a day for one week or until the outbreak subsides. Also take 250 mcg of vitamin B12 each day for one week. If you take any of the B vitamins individually, you should also take a B-complex supplement at a different time of day.
• Lactobacillus acidophilus helps to balance the acidity of the body and thus speed healing. Take an acidophilus supplement for two weeks, following the label directions.
• The amino acid lysine fights the herpes virus. Take 250 mg of L-lysine four times a day (on an empty stomach) for one to two weeks. Then take the same dose twice a week for three months. L-lysine is also available in a cream form. The application of this over-the-counter cream can help minimize an outbreak.
• Selenium and vitamin E have antioxidant properties and activate the immune system. Take 200 mcg of selenium and 400 IU of vitamin E (in mixed-tocopherol form) once or twice daily for the duration of the outbreak.
  Warning: If you are taking blood thinners contact your doctor before taking supplemental vitamin E.
• Mineral ascorbate vitamin C and bioflavonoids have anti-inflammatory properties. Take 500 to 1,000 mg of each three times daily for three days. Then take one dose a day for four days, followed by one-half dose a day for one week.
• Beta 1,3-D-glucan is useful for treating any bacterial, viral, or fungal disease. Follow label directions.
• Vitamin A with mixed carotenoids is important for healing and helps prevent spreading of infections. Use emulsion form for easier assimilation and greater safety at higher doses. Take 25,000 IU daily.
  Warning: If you are pregnant, intend to get pregnant, or have liver disease consult your doctor before taking supplemental vitamin A.

Alternative Therapies:

• Astragalus, or huang lu, enhances the immune system.
• Applying black walnut or goldenseal extract to the affected area may help.
• Cat's claw has immune-enhancing properties and acts against viral infection.
• Larreastat is a trademarked herbal remedy derived from chaparral that is said to have antioxidant, antiviral, and anti-inflammatory properties.
• Licorice root inhibits both the growth and cell-damaging effects of herpes simplex. If you are using licorice, increase your potassium intake.
  Warning: Do not use licorice root on a daily basis for more than seven days in a row. Avoid licorice root completely if you have high blood pressure.
• Olive leaf extract appears to help curb the growth of viral diseases such as herpes.
• Red marine algae contains antiviral carbohydrates that are effective, both topically and orally, for the treatment of herpes.
• Spirulina contains phytonutrients that appear to boost the immune system.
• Tea tree oil is a powerful natural antiseptic. During a herpes outbreak, dab it lightly on the affected area several times a day, either full strength, or if that is too strong, diluted with distilled water or cold-pressed vegetable oil. Do not get tea tree oil close to the eye area.
• Topical melissa is an excellent healing salve for herpes. Follow the label directions.
• Other herbs useful for herpes treatment include cayenne, echinacea, myrrh, red clover, and St. John's wort.

General Recommendations:

• Stress can add to the possibility and severity of an outbreak. Learn stress management techniques.
• Get plenty of rest
• Practice scrupulous hygiene.
• Encourage air circulation. If you have genital herpes, wear loose-fitting cotton underwear.
• Avoid alcohol, processed foods, colas, white flour products, sugar, refined carbohydrates, coffee, and drugs to lessen the chance of an outbreak. Herbal teas are beneficial, but all other teas should be avoided.
• Eat the following in moderation during outbreaks: almonds, barley, cashews, cereals (grains), chicken, chocolate, corn, dairy products, meat, nuts and seeds, oats and peanuts. These contain L-arginine, an amino acid that suppresses L-lysine, the amino acid that retards virus growth.
• Do not consume citrus fruits and juices while the virus is active.
• To ease swelling and pain in the genital area, use ice packs.
• Warm Epsom salts or baking soda baths help itching and pain. After the bath, pat dry gently and keep the lesions dry.

Warnings:

• If you are pregnant and know you have genital herpes, tell your health care provider. If an attack occurs late in the pregnancy, your baby may have to be delivered by cesarean section to protect against exposure at birth.
• Do not use licorice root on a daily basis for more than seven days in a row.
• Avoid licorice root completely if you have high blood pressure.
• If you are pregnant, intend to get pregnant, or have liver disease consult your doctor before taking supplemental vitamin A.
• If you are taking blood thinners contact your doctor before taking supplemental vitamin E.