Herpes simplex virus (Cold Sores)

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Cold Sores
Causes Infections, Dietary Factors, Stress
See Also Dermatology / Skin Conditions, Viral Infections
Books Books on Skin Diseases
Articles Articles on Dermatology / Skin Conditions

Herpes simplex, also referred to as oral herpes or cold sores, is a very common acute, self-limiting vesicular eruption that is accompanied by the Herpes simplex virus. Herpes is a very common viral infection with most individuals in North America having been exposed by their early 20s.

Naturopathic Assessment

Article Natural Remedies for Herpes simplex , Alt Med; 2006;Vol11(2)

Causal Factors

The focus of naturopathic assessment and treatment is to identify and address your areas of susceptibility. Addressing the causal factors to a herpes outbreak is typically focused on identifying and decreasing those factors that increase susceptibility and subsequent flare-ups.


  • Diets low in lysine and high in arginine from chocolate, peanuts, gelatin, seeds and almonds increase the risk and occurrence of cold sores. [1]


  • Stress can increase the likelihood, severity and frequency of outbreaks.
  • Relationships
  • Sexual contact with an individual with herpes lesions causes a 75% risk of infection. [1]


  • The virus Herpes virus hominis accompanies the eruptions. This virus is highly contagious and is spread by direct contact with infected individuals.[2]
  • Minor infections and sun exposure are other suggested triggers to reactivate a dormant or latent herpes infection. [1]
  • Socioeconomic factors
  • Lower socioeconomic groups have the greatest frequency of HSV infections. [1]


  • Trauma
  • Trauma to the area of the mouth can increase the likelihood of an outbreak.[2]

Medical Interventions

  • Prescription Medications
  • Any medication that weakens the immune system increases the risk of infection and the change of subsequent outbreaks.

Related Symptoms and Conditions

Article Now That's a Cold Sore!, NDNR; 2012 July
  • Herpes outbreaks commonly occur when the immune system is compromised. Prior to or during an outbreak it is common to have other signs of viral infection including fever, malaise and local lymphadenopathy.
  • Erythema multiforme is aggravated by herpes outbreak.
  • Exposure to other Herpetic viruses such as Varicella zoster(VZV), Epstein-Barr(EBV), and cytomegalovirus(CMV).[1]


The symptoms and characteristics of herpes include:[3]

  • Some people experience a break-out when they are first exposed to the virus, others have no symptoms. It all depends on a person's individual susceptibility.
  • Young children commonly have symptoms.
  • Symptoms range from mild to severe. With flare-ups ranging to only once or twice in a life-time to monthly outbreaks.
  • Symptoms typically appear within 1 to 3 weeks, but can be as quickly as 3 to 4 days, after coming in contact with the virus.
  • Vesicular eruption that is highly contagious.
  • Virus may be spread by respiratory droplets, direct contact with an active lesion or contact with virus-containing fluid, such as saliva or cervical secretions.
  • Warning symptoms:
  • An outbreak is typically preceded by tingling, burning or itchiness near the lips or mouth.
  • Associated symptoms may include: sore throat, fever, swollen glands in the neck, painful swallowing, feeling of unwell.
  • Onset of Symptoms
  • The blisters are typically painful or irritating.
  • Blisters typically form on the gums, lips, mouth or throat.
  • Blisters tend to reappear in the same location every time there is an outbreak.
  • Blisters tend to be red, filled with a clear yellowish fluid, blisters often break open and leak.
  • Several smaller blisters may grow together into a larger blister
  • It may take up to 3 weeks for symptoms to resolve.
  • As a blister heals, it gets yellow and crusty, eventually turning back to the normal skin colour.
  • A herpes eruption can occur as a vesicle or pustule on the finger, known as a herpetic whitlow especially in those individual that work as a dentist, nurse or that have close contact with individuals that may be infected. [2]
  • Subsequent Outbreaks
  • After the initial infection, the virus becomes dormant in the nerve tissues in the face.
  • The virus can be reactivated which causes another, often milder outbreak, of the eruptions typically in a similar site each time.
  • Subsequent outbreaks depend on a person's overall susceptibility and their exposure to known triggers.

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. Herpes simplex is considered a chronic disease. A key aim of naturopathic medicine in the treatment of herpes simplex is to decrease a person's susceptibility by addressing those factors that are weakening the immune system and, in acute situations, to provide symptomatic relief.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

  • Apply ice or warm washcloth to the sores to ease the pain.
  • Gargle with cool water
  • Rinse with salt water
  • Wash towels and linens in boiling hot water after each use
  • Do not share utensils, straws, glasses or other items if someone has oral herpes.


  • Avoid touching the area with the hands to prevent spreading the infection
  • Avoid direct contact, like kissing, when you have an outbreak
  • Do not have oral sex if you have oral herpes, especially during an outbreak. You can spread the virus to the genitals, causing herpes simplex virus 2, or genital herpes.

Personal Care Products

  • Avoid the use of lipstick or other personal care products that may have chemicals or irritants.
  • If using a lip balm choose one where you apply the cream to your lips versus one that is solid and you rub over the lips as this may increase the risk of spread.
  • Lip balms assist in keeping the lips moist, which decreases the risk of outbreak.
  • Lip balms that have L-Lysine may have an added benefit


Lifestyle recommendations include:

  • Get regular exercise.[4]
  • Adequate sleep is important to support and strengthen immune health.
  • Perform a relaxation exercise (deep breathing, meditation, prayer, visualization, etc,) 10 to 15 minutes each day.[4]

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for herpes simplex virus include:


It is always advised to seek naturopathic treatment or other medical care if the outbreaks:

  • appear to be getting worse or more frequent.
  • are near the eye
  • don't resolve within two weeks.


Reviewed by Iva Lloyd, BScH, RPE, ND [1]

  1. 1.0 1.1 1.2 1.3 1.4 Murray Michael, Pizzorno Joseph. Encyclopedia of Natural Medicine. 2nd ed. 1998 Three Rivers Press, New York
  2. 2.0 2.1 2.2 Gawkrodger David 1997 An Illustrated Colur Text, Dermatology Second Edition Churchill Livingstone
  3. Campbell James, Chapman Shane, Dinulos James, Zug Kathryn (2005) Skin Disease, Diagnosis and Treatment, Second Edition Elsevier Mosby
  4. 4.0 4.1 4.2 4.3 4.4 Murray Michael (1996) Encyclopedia of Nutritional Supplements, The Essential Guide for Improving Your Health Naturally Prima Publishing
  5. Godfrey Anthony, Saunders Paul Richard, Barlow Kerry, Gilbert Cyndi, Gowan Matthew, Smith Fraser 2010 Principles and Practices of Naturopathic Botanical Medicine, Vol 1: Botanical Medicine Monographs, CCNM Press, Toronto
  6. Boon Heather, Smith Michael 2004 The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs, Robert Rose, Toronto
  7. Yarnell E, Abascal K (2005) Herbs for treating herpes simplex infections. Altern Complement Ther.83-88.
  8. Hershoff Asa 2000 Homeopathic Remedies, A Quick and Easy Guide to Common Disorders and their Homeopathic Treatments, Avery Publishing Group, New York
  9. Ullman Robert, Reichenberg-Ullman Judyth 1997, Homeopathic Self-Care, the quick and easy guide for the whole family. Prima Publishing