Any condition that keeps you from smiling and kissing is inherently dislikable. Cold sores (also called fever blisters) are generally a harmless condition I’d classify as a medical “annoyance,” like dandruff or hemorrhoids–not a danger to life or limb. Nevertheless, no one wants to go through the day with a large, unsightly sore on the lip, especially since they seem to appear on days you’re set for an interview or an important photograph. Actually, good news is here. At WholeHealth Chicago, we’ve found some safe and effective natural therapies that can either prevent the eruption of a cold sore or inhibit the virus that causes it, heal the inflamed skin, and shorten its unsightly life. (One such remedy is an herb with the lovely name of melissa.)
Let’s see what we can do to help.
What are Cold Sores?
These small, unsightly and often painful lesions, also called fever blisters, usually appear on the lips, but can also develop on the gums, inner cheeks, soft palate, and around the nostrils. The fluid-filled blisters normally rupture within hours, crust over to form a scab on the skin, and disappear within a week to 10 days. In the mouth they turn into small ulcers with a red or whitish base after the blister stage. The initial outbreak may be accompanied by flulike symptoms and enlarged lymph nodes. Cold sores do recur, but subsequent flare-ups tend to be milder. A recurrence is often signaled by a tingling, itchy sensation or discomfort on the lips a day or two before blisters appear. The virus that causes cold sores can also be spread by touch from lip sores to other parts of the body, primarily the mucous membranes of the eyes, nose, and genitals. Open cuts or abrasions can also be affected.
Infection usually occurs through close contact with someone who has active sores. Once infected, a person has the virus for life, although it remains dormant in the body between outbreaks. By early adulthood, a large part of the population has contracted the cold sore virus, but actually many people go through life carrying the virus while not remembering ever having had a cold sore. However, if you are prone to cold sores, both supplements and antiviral drugs can help relieve symptoms, speed healing, and inhibit future flare-ups.
Key Symptoms
Small, often painful, fluid-filled sores on the lips or inside the mouth
Rupture and scabbing of the skin blisters within hours of their appearance
Flulike symptoms and enlarged lymph nodes may accompany an initial outbreak
A tingling, itchy sensation or discomfort on the lips a day or two before an outbreak
What Causes Cold Sores?
The herpes simplex type 1 virus (HSV-1) is the most common cause of cold sores. This is a different virus from the sexually transmitted herpes simplex type 2 virus (HSV-2) that causes genital herpes (and less commonly cold sores as well). After an initial outbreak, the cold sore virus lies dormant in nerve cells until the next outbreak, which usually occurs when the immune system is weakened by a cold or fever. New outbreaks can recur as frequently as every few weeks or as rarely as every few years.
Other factors that can reactivate the cold sore virus include fatigue, stress, menstruation, and exposure to sun and wind. High blood levels of the amino acid arginine allows the cold sore virus to thrive; arginine is present in large amounts in chocolate, nuts, whole-grain cereals, and gelatin. On the other hand, eating foods high in another amino acid, lysine, (corn, kidney beans, split peas) may drive down levels of arginine.
Treatment and Prevention
Cold sores usually clear up on their own within about a week, but supplements can be very helpful in shortening outbreaks and relieving symptoms. Cold sore recurrences can be prevented (or at least their frequency reduced) with supplements, as well as by avoiding or protecting yourself from known triggers, such as sun exposure and foods rich in arginine.
To prevent the transmission of cold sores in the first place, try to avoid close contact with anyone who has active sores. Someone with an active sore should take precautions to avoid spreading the virus through touch or close contact with another person. (Kissing is a major transmitter of cold sores.)
To combat persistent cold sores, prescription antiviral drugs and creams, such as acyclovir and penciclovir, are available. It’s safe and even useful to take supplements with these medications.
Just a reminder: If you have a serious medical condition, be sure to talk to you doctor before taking supplements.
How Supplements Can Help
The amino acid lysine is one of the two leading anti-cold sore supplements. Taken orally during a flare-up, lysine inhibits the growth of the cold sore virus. Applied directly to a sore, lysine cream promotes healing, and a low-maintenance dose may prevent recurrences. (If you use lysine long-term, be sure to take it with an amino acid complex to ensure a balanced mix of amino acids.) At the first sign of a cold sore, start taking lysine in combination with the other anti-cold sore supplements listed here. You should begin to see effects in two or three days or even sooner.
The second leading supplement is an herbal cream. When you first feel the tingling that announces a cold sore, apply melissa to the affected area. Made from the powerful antiviral herb Melissa officinalis, or lemon balm, melissa cream helps sores heal more quickly and may also prevent recurrences. As an alternative you can prepare a melissa tea, by steeping 2 to 3 tablespoons of the herb in a cup of very hot water for 15 minutes. Once the liquid has cooled, apply it externally to the cold sore using a cotton ball.
The antioxidant combination of vitamin C plus flavonoids promotes healing and boosts viral-fighting immune system cells. Or, consider a short course of a high dose of vitamin A, well known for its antiviral properties. In liquid form, it can either be taken orally or applied directly to the cold sore.
If you believe a weakened immune system is contributing to your frequent outbreaks of cold sores, consider regular use of echinacea. Herbalists also recommend applying liquid extract of echinacea directly to cold sores to speed healing.
In cases of severe or recurrent cold sores not responding well to a simple drug or supplement regimen, you should be evaluated by a doctor for an underlying problem with your immune system.
Other herbal agents are sometimes helpful as well. In addition to taking low doses of lysine to prevent cold sore recurrences, try alternating some of the well-known immune stimulating herbs. Use the herbs in three-week rotations: Take echinacea the first week; astragalus the second week; and a mixture of reishi, shiitake and maitake mushrooms the third week. And then restart the cycle.
Self-Care Remedies
Applying ice to a cold sore for a few minutes several times a day eases pain and helps dry out the sore. Wrap the ice in a moist washcloth before applying it.
Compresses made with the herb hyssop can be directly applied to the cold sores. Make an infusion solution by using one ounce of dried herb per pint of boiling water. Steep for 15 minutes and allow to cool before using.
To avoid spreading the virus, don’t touch active blisters and don’t share personal items such as drinking glasses, toothbrushes, razors, or towels.
If you are prone to cold sore outbreaks, always apply sunscreen (SPF 15 or higher) to your lips before going out into the sun.
The amino acid arginine is thought to play a role in reactivating the cold sore virus. To prevent recurrences, avoid chocolate, nuts, whole-grain cereals, and gelatin, which are all rich in arginine. Eat more kidney beans, split peas, and corn, which are rich in lysine.
Yoga, meditation, and other mind-body techniques help relieve stress, a possible cold sore trigger.
Do not pick or squeeze a cold sore blister or scab. This can cause it to spread and impede the healing process.
Keep lips moisturized at all times by using a lip balm. Dry, chapped, or cracked lips can be more susceptible to an outbreak.
When to Call a Doctor
If cold sores last longer than two weeks
If you develop a fever during a cold sore outbreak
If cold sores recur frequently
If your eyes hurt or become sensitive to light during or after an outbreak. (This could mean that the cold sore virus has spread to your eyes, where it can harm vision.)
Supplement Recommendations
From David Edelberg, M.D.at WholeHealth Chicago: To be on your guard against cold sores, it helps to know what triggers flare-ups of the herpes simplex type 1 virus that causes them. An immune system weakened by a cold, fatigue, or stress is one culprit, as are menstruation and exposure to sun and wind. Pay attention to possible personal triggering events, as you may want to provide some treatment for these as well.
All the supplements listed here are perfectly compatible with conventional antiviral medications.
How to Take the Supplements
If you’re prone to cold sores: You might reduce your chances of a flare-up if you use lysine on a regular basis along with your daily multivitamins. This amino acid inhibits the growth of the type 1 herpes virus.
Also consider building up your own natural defenses. This can be beneficial especially if you’ve have other signs of an underfunctioning immune system, such as frequent colds or infections. If this is your situation, try the preventive measure of rotating echinacea, medicinal mushrooms (reishi, shiitake, and/or maitake) and astragalus. Use one herb for a couple of weeks, then shift to the next and then the next and then start again.
If you feel a tingle of a cold sore beginning: Increase the lysine to three times a day (once healing occurs, return to your maintenance dose). In addition, be sure to have some melissa cream handy. Start applying this herbal cream directly to the tingly area at least four times a day.
If you already have a cold sore: Increase the preventive lysine dosage to three times a day, apply the melissa cream, and temporarily add echinacea, vitamin C (with flavonoids), and vitamin A. Although smaller amounts of both of these vitamins are already present in your daily vitamins, we recommend these increased amounts, along with the echinacea, because of their antiviral and immune-stimulating properties.
Special Considerations
If you are aware of an increased susceptibility to cold sores during the week before your menstrual period, consider a PMS herbal combination (follow label instructions) or chasteberry (200-225 mg standardized extract twice a day or 40 drops liquid extract once a day) during the 10 days before your period.
If you are aware that stress seems to trigger a cold sore flare-up, think of adding kava (250-500 mg 2 or 3 times a day as needed). This herb can be particularly beneficial if you sense you’re entering an especially stressful period in your life.
If exposure to wind and sun routinely brings forth a cold sore, be sure to moisturize your lips with lip balm and protect them with sunscreen. Important:
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
Be well,
David Edelberg, MD