Genital herpes is a common sexually transmitted viral infection characterized by fluid filled blisters or red bumps in the genital area.
Genital herpes is caused by either of two types of the herpes simplex virus (HSV). There is no known cure for herpes. Both conventional and alternative treatments only help in reducing the symptoms and frequency of outbreaks. Treatments effective for cold sores—which are also caused by the herpes virus—may or may not also be effective for genital herpes, because of possible differences in the type of herpes virus causing infections in different body locations.
What are the symptoms of genital herpes?
People with genital herpes may have outbreaks of small, often painful, fluid-filled blisters (vesicles) in the genital or anal region. Fever, general weakness, and painful urination often accompany the initial occurrence. Subsequent outbreaks may appear with colds, fevers, menstrual periods, or during periods of stress,1 and usually disappear within two weeks. Initially there may be tingling or prickling at the site of the blisters even before they are visible, then the blisters often weep a clear fluid and form a scab.
Dietary changes that may be helpful for genital herpes
Many alternative healthcare practitioners recommend that people with herpes simplex infections eat a diet high in the amino acid lysine and low in arginine. Foods high in lysine include red meat, poultry, fish, and dairy products, while foods such as chocolate, nuts, peas, and cereals are high in arginine. This recommendation is based on test tube research indicating that growth of the herpes virus is inhibited by lysine and promoted by arginine.23 However, no research has investigated whether making these dietary changes helps prevent outbreaks of genital herpes. In fact, one preliminary study found that patients with and without genital herpes did not differ from each other in how much dietary arginine and lysine they consumed.
Lifestyle changes that may be helpful for genital herpes
Since genital herpes is highly contagious, people with active herpes infections should avoid direct sexual contact. Also, infected pregnant women should inform their obstetrician if their herpes becomes active around their delivery date, as HSV can be transmitted to the newborn during birth and cause a more serious infection in the child.
Nutritional supplements that may be helpful for genital herpes
Most research on lysine has been done on people with cold sores or on groups that include both cold sores and genital herpes sufferers. However, some evidence exists that supplemental lysine may be effective in the prevention and treatment of genital herpes. In one preliminary survey, 81% of people with HSV infections (including genital herpes) reported lysine was effective for reducing recurrences and shortening healing time in amounts averaging about 1,000 mg per day.4 A small double-blind trial of people with oral and genital herpes examined the effects of 1,248 mg or 624 mg of lysine daily versus placebo.5 The study found that 1,248 mg per day of lysine, but not the lower dose, was effective in reducing the recurrence rate of herpes outbreaks by 57% to 65%, while neither dose helped reduce the healing time. Another small double-blind trial found that using 3,000 mg per day of lysine in divided doses led to a decrease in severity of symptoms and a reduction in healing time of both oral and genital herpes.6 One preliminary report found no benefit of lysine for a group of patients with either oral or genital herpes.7
In a test tube, zinc is capable of inactivating the type of herpes virus responsible for the majority of genital herpes cases.8 Topical zinc may therefore help prevent outbreaks of genital herpes. One preliminary study treated people (four of whom had genital herpes) with a 4% zinc sulfate solution applied to the site of the initial outbreak.9 In all cases, the pain, burning, and tingling stopped within 24 hours of beginning the topical zinc therapy. The use of lower concentrations of zinc (0.025–0.05%) has also been shown effective against oral and genital herpes outbreaks.10 11 While topical zinc has been shown to be helpful, there is no convincing evidence that oral zinc offers the same benefits.12
Lithium is a mineral available in an ointment or in the prescription drug lithium carbonate. In small studies, pharmacological doses of lithium carbonate have helped prevent outbreaks of genital herpes.13 14 However, there is no evidence that smaller amounts of oral lithium in nonprescription supplements would be similarly effective. A controlled study using a topical ointment containing 8% lithium succinate with 0.05% zinc sulphate diminished the pain and discomfort of genital herpes and shortened the healing time.15 In light of the known benefits of topical zinc, it is unclear whether lithium was an important component of this treatment
A test tube study found that flavonoids present in propolis are responsible for the supplement’s antiviral action.16 A controlled study found that an ointment containing propolis, used four times daily, was almost twice as effective as topical antiviral medication or a placebo ointment.17
Are there any side effects or interactions with genital herpes?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful for genital herpes
Licorice root (Glycyrrhiza glabra) contains antiviral substances18 and ointments containing related substances are effective in treating herpes infections.19 20 While the use of topical licorice preparations to prevent or treat genital herpes has not been studied, some alternative healthcare practitioners recommend applying creams or gels containing licorice three to four times a day.
A double-blind trial found that topical application of a cream containing a highly concentrated extract of lemon balm (Melissa officinalis) four to five times a day helped heal oral and genital herpes sores faster than use of a placebo.21
Aloe vera may also benefit those with genital herpes. A double-blind trial using a 0.5% Aloe vera cream found that applying the cream three times a day shortened the healing time of genital herpes outbreaks. All but 3 of 22 persons in the study who showed healing with the aloe cream had no recurrences 15 months after stopping treatment.22
Test tube and animal research suggests that substances found in turmeric, cloves, eucalyptus, and seaweed have potential benefit for topical prevention of genital herpes, but no human research using available herbal products has been performed.23
Are there any side effects or interactions with genital herpes?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful for genital herpes
Stress plays a major role in the recurrence of genital herpes outbreaks. One preliminary study found that persistent stress (stress lasting more than seven days) increased the recurrence rate by about 25%,24 but another preliminary study found no connection between stress and genital herpes outbreaks.25 In addition, short-term stress, mood changes, and menstrual cycles do not appear to affect herpes recurrences.26 Treatments aimed in part at stress reduction may be helpful for treating genital herpes. One controlled trial showed that patients had fewer outbreaks, shorter episode duration, and less episode severity when they were treated with a series of sessions involving education about genital herpes, stress management, deep breathing exercises, and guided imagery.27 A preliminary study suggested that applied relaxation (a technique that guides the participant through a series of muscle relaxation exercises) reduces recurrences of genital herpes outbreaks.28 Two case reports indicate that self-hypnosis, practiced on a daily basis, helps ease the pain and severity of genital herpes lesions.29