Bioidentical Hormones 101 
The Book, by Jeffrey Dach MD

Herpes Simplex

Herpes Simplex Labialis Lower Lip Natural Treatments Jeffrey Dach MDHerpes Simplex Natural Treatments

by Jeffrey Dach MD

Herpes is a common problem I see in the office. Many of these patients are on long term acyclovir, the standard anti-viral medication which is quite effective at suppressing recurrence. However, this drug is not without adverse side effects. Many would like to know about safer natural remedies. This article discusses Lysine, Olive Leaf, Lithium and low level laser natural treatments for Herpes which are also quite effective at eradicating infection and suppressing outbreaks.

Two Types of Herpes

Herpes Simplex Type I (HSV-1) is transmitted through kissing, sharing drinking utensils, and other oral contact. (see image at left).  Herpes Type II (HSV2) is the main cause of genital Herpes, transmitted via sexual contact.  Link to this article,

Anti-Herpes Drugs - Acyclovir and Valcyclovir

Despite an inability to eradicate latent virus, Acyclovir is considered the standard antiviral therapy for herpes simplex virus infection,  Acyclovir (Zovirax) and Valacyclovir (Valtrex)  are prescribed for labial herpes, genital herpes, cold sores, shingles, and chicken pox.  They can be used short term for acute infection, or long term for suppression of outbreaks.


Long term safety studies on these drugs are comforting and show a high safety profile.  The drugs are DNA polymerase inhibitors, with preferential activity for viral DNA polymerase.  However, the drugs can have an effect on human DNA polymerase as well, and therefore may not be totally free of adverse side effects.  The most common adverse effects are headache, nausea and vomiting.

Natural Treatments for Herpes  – Lysine

Lysine, a commonly available amino acid with no adverse side effects has been shown in numerous studies to reduce frequency of Herpes outbreaks.  Usual Dosage is 750 mg -1000 mg two to three times a day.(1)

Dr. Kathleen Regan’s article summarizes the medical research on Lysine for Herpes citing  seven randomized, double-blind, placebo-controlled studies on the effectiveness of lysine in preventing and reducing severity of outbreaks of herpes.(2)

Buy Lysine Pure Encapsulations

Reduce Arginine Containing Foods

Lysine inhibits viral replication, while Arginine is a requirement for viral replication.  Dr Regan mentions the importance of the Lysine to Arginine ratio in the diet.  Reducing Arginine containing foods such as cashews, nuts and seeds, etc. while taking the lysine is important for maximal benefit.(2)

Dr Alan Gaby’s article, Natural Remedies for Herpes simplex, also discusses the use of Lysine for Herpes and the importance of reducing Arginine containing foods.(3)

Lithium for Herpes

Lithium is a naturally occurring mineral found in our water supply and is available as a drug called Lithium Carbonate, or as a nutritional supplement called Lithium Orotate.  The drug form of Lithium Carbonate comes in 300 mg tablets is used to treat bipolar syndrome, and requires blood levels to avoid toxicity.  The Lithium Orotate is low dose 5 mg capsules and regarded as safe, as no blood testing is required,

Over the years, Dr. Amsterdam at the University of Pennsylvania noticed a benefit for recurrent herpes infections in his Bi-Polar patients treated with Lithium Carbonate. (4-15)

Further studies show that not only does lithium inhibit herpes virus replication, it also restores host cellular functions which were hijacked by the virus. (4-15)

Dr Jonathan Wright created a formulation called HPX which combines lithium with selenium, lysine, vitamin C, and olive leaf extract as a natural remedy for Herpes.  Credit and Thanks goes to the Jonathan Wright MD Newsletter for bringing the benefits of Lithium to my attention.

Buy Lithium Orotate on Amazon.

Buy Lithium Orotate Pure Encapsulations.

olea_europaea_olive leaf Olive Leaf- antiviral properties

As discussed in my previous article, Olive leaf has anti-viral properties and may be useful against Herpes outbreaks.(16)  Buy Olive Leaf Pure Encapsulations.

Lithium for Alcoholism (17-18)

While we are on the topic of Lithium, there may be additional benefits as a treatment for chronic alcoholism as noted by Dr. Jonathon Wright in his newsletter. (17-18)  He will try 10 mg of Lithium Orotate Three times a day to wean off the chronic alcoholic.

Low level Laser for Herpes

My previous article on low level laser discussed this device as a useful treatment for Herpes.  Considerable research, much of it from Brazil, has been published on the benefits of low level laser to hasten healing and prevent breakouts of herpes.(19-20)  Battery operated Low Level Lasers are inexpensive and available for home use.  (see above image)

BHT (Butylated hydroxytoluene) for Herpes

A food preservative called BHT (Butylated hydroxytoluene)  has anti-viral activity in various medical studies, and has been mentioned anecdotally as beneficial for Herpes.  (21-24)

However, the lack of controlled human trials, and possibility of toxicity at high doses makes BHT somewhat questionable, and should probably be a last resort after all the above remedies have failed.

Jeffrey Dach MD
7450 Griffin Road Suite 190
Davie, Florida 33314

Links and References

Header image: Herpes Labialis (arrow) courtesy of wikimedia.

Herpes General information

Herpes simplex virus – University of Maryland

Anti-Herpes Drugs

Acyclovir- Acyclovir is used to treat infections caused by herpes viruses. Illnesses caused by herpes viruses include genital herpes, cold sores, shingles, and chicken pox.
Valacyclovir (Valtrex) suppressive therapy  500 mg of Valtrex daily


Lysine for Herpes

Dermatologica. 1987;175(4):183-90.
Success of L-lysine therapy in frequently recurrent herpes simplex infection. Treatment and prophylaxis.  Griffith RS1, Walsh DE, Myrmel KH, Thompson RW, Behforooz A.

A double-blind, placebo-controlled, multicenter trial of oral L-lysine monohydrochloride for the prevention and treatment of recurrent herpes simplex (HSV) infection was conducted. The treatment group was given L-Lysine monohydrochloride tablets (1,000 mg L-lysine per dose) 3 times a day for 6 months. A total of 27 (6 male and 21 female) subjects on L-lysine and 25 (6 male and 19 female) subjects on placebo completed the trial. The L-lysine treatment group had an average of 2.4 (p less than 0.05) less HSV infections, symptoms were significantly (p less than 0.05) diminished in severity and healing time was significantly reduced (p less than 0.05). L-Lysine appears to be an effective agent for reduction of occurrence, severity and healing time for recurrent HSV infection.


The Truth About Arginine, Lysine and Herpes Simplex Virus by Dr. Kathleen Regan, ND on April 17, 2013

3) Natural Remedies for Herpes simplex Alan Gaby
Natural Remedies for Herpes simplex by Alan R. Gaby, MD  full pdf avaiable


Lithium for herpes

4) Natural Remedies for Herpes simplex Alan Gaby
Natural Remedies for Herpes simplex by Alan R. Gaby, MD  full pdf avaiable

Amsterdam JD, Maislin G, Hooper MB.
Suppression of herpes simplex virus infections with oral lithium carbonatea possible antiviral activity.  Pharmacotherapy 1996; 16(6): 1,070-1,075 – 1Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia 19104, USA.

In vitro studies have shown an inhibitory effect of lithium salts on herpes simplex virus (HSV) replication by mechanisms that interfere with viral DNA synthesis. Moreover, clinical studies have shown that oral lithium carbonate and topical lithium succinate can suppress genital HSV infections in humans. We conducted a randomized, double-blind, placebo-controlled trial of oral lithium carbonate in 11 healthy subjects age 28-65 years (mean +/- SD age 38 +/- 11 years) who had at least four recurrent HSV infections in the year preceding the study. Six patients completed at least 5 months of lithium therapy at a mean (+/-SD) average daily lithium dose of 437 +/- 185 mg (range, 150-900 mg) and an average serum lithium level of 0.56 +/- 0.20 mmol/L. Overall, lithium treatment resulted in a consistent reduction in the mean number of episodes/month, the average duration of each episode, the total number of infection days/month, and the maximum symptom severity. In contrast, treatment with placebo resulted in an increase in three out of the four severity measures. Although the comparisons between the treatment groups did not achieve statistical significance due to the limited sample size, there was a clear “trend” for a reduction in the total monthly duration of all HSV infections with lithium (p = 0.08). Lithium treatment was well tolerated and produced no deleterious effects on renal or thyroid function. These observations lend support to prior observations of an antiviral activity of lithium, and suggest the possibility that oral lithium may represent a safe prophylactic agent in patients with recurrent HSV infections.

Psychopharmacol Bull. 1990;26(3):343-7.
Reduced rate of recurrent genital herpes infections with lithium carbonate.  Amsterdam JD1, Maislin G, Potter L, Giuntoli R.
Preliminary observations indicate that lithium carbonate may have an anti-herpes simplex virus activity. We conducted a randomized, double-blind, placebo-controlled trial of oral lithium therapy in 10 healthy women with chronic, recurrent genital herpes infections. During one year of lithium treatment at a mean (+/- SD) daily dose of 587 +/- 49 mg and an average plasma lithium level of 0.51 mEq/L, we observed a significant reduction in the total monthly duration of all herpes episodes (p less than .01), the average duration of each herpes infection (p less than .01), the maximum symptom severity (p less than .01), and a clinical severity index score (p less than .004). The onset of prophylaxis was gradual, with the duration of each episode declining by an average of 0.5 days per month. The present data indicate that chronic lithium therapy may be effective in preventing recurrent genital herpes infections.

Biol Psychiatry. 1990 Feb 15;27(4):447-53.
A possible antiviral action of lithium carbonate in herpes simplex virus infections.  Amsterdam JD1, Maislin G, Rybakowski J.
1Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia.

There has been considerable interest in the possibility that some psychotropic medications may possess antiviral activity. Several clinical observations suggest that lithium may inhibit the reactivation of latent herpes simplex virus, thereby reducing the number of recurrent infections. We performed a retrospective study examining the putative antiviral activity of various psychotropic agents in 177 subjects receiving lithium prophylaxis and a comparison group of 59 subjects receiving other antidepressant drugs for affective illness. Chronic lithium administration resulted in a significant reduction in the mean rate of recurrent labial herpes infections when compared to the pretreatment period (p less than 0.001). In contrast, the mean rate of herpes infections was unchanged in patients taking other antidepressants (p = 0.53). Although the overall reduction in herpes infections was not significantly different between groups, the proportion of subjects reporting a reduction in infection rate was greater in the lithium group (71%) compared with those receiving other antidepressants (52%) (p = 0.07). These data compliment prior in vitro and clinical studies demonstrating a potential antiviral activity for lithium carbonate.

Med Microbiol Immunol. 1980;168(2):139-48.
The effect of lithium chloride on the replication of herpes simplex virus.  Skinner GR, Hartley C, Buchan A, Harper L, Gallimore P.
Lithium chloride inhibited the replication of type 1 and type 2 Herpes simplex virus at concentrations which permitted host cell replication. Virus polypeptide and antigen synthesis were unaffected while viral DNA synthesis was inhibited. The replication of two other DNA viruses, pseudorabies and vaccinia virus, was inhibited but there was no inhibition of two RNA viruses, namely, EMC and influenze virus.

Biochem Biophys Res Commun. 1989 May 15;160(3):1073-8.
Lithium chloride restores host protein synthesis in herpes simplex virus-infected endothelial cells.  Ziaie Z1, Kefalides NA.
1Connective Tissue Research Institute, University of Pennsylvania, Philadelphia.
In previous studies we have shown that herpes simplex virus type 1 (HSV-1) infection suppresses host-cell protein synthesis in human endothelial cells (EC). It has been demonstrated that lithium salts prevent viral replication in HSV-1 infected cells. In the present study, we have measured host-cell protein synthesis in HSV-1 infected EC in the presence or absence of 20 and 30 mM LiCl. Although LiCl restored synthesis of almost all host-cell proteins, [35S]methionine incorporation was most pronounced in thrombospondin and plasminogen activator inhibitor 1 and least in fibronectin and type IV collagen. LiCl was more effective at the higher concentration (30 mM) and when the compound was added to the EC culture at the time of infection rather than after adsorption of HSV-1. Synthesis of virus proteins continued in LiCl-treated EC but at a reduced rate. The data suggest that LiCl not only interferes with virus replication, but may also, to some extent, interfere with the virion-associated inhibition of host protein synthesis.

Lab Invest. 1994 Jan;70(1):29-38.
Lithium chloride suppresses the synthesis of messenger RNA for infected cell protein-4 and viral deoxyribonucleic acid polymerase in herpes simplex virus-1 infected endothelial cells.  Ziaie Z1, Brinker JM, Kefalides NA. 1Connective Tissue Research Institute, University of Pennsylvania, Philadelphia.

Patients treated with lithium salts for manic depression had a lower incidence of herpes simplex infections. Initial studies in our laboratory demonstrated that addition of LiCl in cultures of human endothelial cells infected with herpes simplex virus suppressed viral replication and allowed synthesis of host proteins.
EXPERIMENTAL DESIGN:Based on the above observations, we decided to study the optimal condition for the lithium effect and determine the process of inhibition of viral replication. Endothelial cell cultures infected with herpes simplex virus-1 were exposed to LiCl at various times postinfection. The levels of host and viral mRNAs were measured by Northern and slot blot hybridization. The pattern of protein synthesis was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblot and replication was assessed by plaque assay.
RESULTS:LiCl inhibited virus replication in a dose- and time-dependent manner as was reflected in the sharp decrease or absence of infectious virus production. The condition for optimal effects of LiCl were the addition of the salt between 0-3 hours postinfection, and at a concentration of 30 mM. LiCl suppressed the synthesis of viral polypeptides, whereas the synthesis of host proteins was maintained. Similar results were observed with phosphonoacetic acid, an inhibitor of viral DNA polymerase. NaCl, at the same concentration as LiCl, did not prevent the virus-induced inhibition of host cell protein synthesis. The level of host mRNA for fibronectin, thrombospondin, collagen type IV, actin, and plasminogen activator inhibitor-1 were maintained in the presence of LiCl. mRNAs for viral proteins, ICP-4 and DNA polymerase were nearly undetectable when LiCl was added with the virus (0 time postinfection).
CONCLUSIONS:The data indicate that LiCl treatment results in suppression of herpes virus mRNAs, i.e., mRNAs for ICP-4 and DNA polymerase, thereby inhibiting replication. On the other hand, the levels of host mRNAs are maintained to varying degrees depending on the message. The data suggest that a very early step in the process of viral replication is affected by LiCl, since the drug is maximally effective when added with the virus.

11) Mechanisms of Lithium Chloride on Cell Infection by Transmissible Gastroenteritis Coronavirus
Ren X, Meng F, Yin J, Li G, Li X, et al. (2011)
Action Mechanisms of Lithium Chloride on Cell Infection by Transmissible Gastroenteritis Coronavirus. PLoS ONE 6(5):

Transmissible gastroenteritis virus (TGEV) is a porcine coronavirus. Lithium chloride (LiCl) has been found to be effective against several DNA viruses, such as Herpes simplex virus and vaccinia virus. Recently, we and others have reported the inhibitory effect of LiCl on avian infectious bronchitis coronavirus (IBV) infection, an RNA virus. In the current study, the action mechanism of LiCl on cell infection by TGEV was investigated. Plaque assays and 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-​phenyltetrazoliumbromide (MTT) assays showed that the cell infection by TGEV was inhibited in a dose-dependent manner, when LiCl was added to virus-infected cells; the cell infection was not affected when either cells or viruses were pretreated with the drug. The inhibition of TGEV infection in vitro by LiCl was observed at different virus doses and with different cell lines. The inhibitory effect of LiCl against TGEV infection and transcription was confirmed by RT-PCR and real-time PCR targeting viral S and 3CL-protease genes. The time-of-addition effect of the drug on TGEV infection indicated that LiCl acted on the initial and late stage of TGEV infection. The production of virus was not detected at 36 h post-infection due to the drug treatment. Moreover, immunofluorescence (IF) and flow cytometry analyses based on staining of Annexin V and propidium iodide staining of nuclei indicated that early and late cell apoptosis induced by TGEV was inhibited efficiently. The ability of LiCl to inhibit apoptosis was investigated by IF analysis of caspase-3 expression. Our data indicate that LiCl inhibits TGEV infection by exerting an anti-apoptotic effect. The inhibitory effect of LiCl was also observed with porcine epidemic diarrhea coronavirus. Together with other reports concerning the inhibitory effect of lithium salts on IBV in cell culture, our results indicate that LiCl may be a potent agent against porcine and avian coronaviruses.


free full  Br J Pharmacol. Mar 2011; 162(6): 1410–1423.
Inhibition of inositol monophosphatase by lithium chloride induces selective macrophage apoptosis in atherosclerotic plaques
Inge De Meyer,1 Wim Martinet,1 Cor E Van Hove,1 Dorien M Schrijvers,1 Vicky Y Hoymans,3 Luc Van Vaeck,2 Paul Fransen,1 Hidde Bult,1 and Guido RY De Meyer1  1Division of Pharmacology, University of Antwerp, Antwerp, Belgium
2Division of Chemistry, University of Antwerp, Antwerp, Belgium
3Laboratory for Cellular and Molecular Cardiology, Antwerp University Hospital, and Division of Cardiology, University of Antwerp, Antwerp, Belgium
Miss Inge De Meyer, Pharmacology, University of Antwerp, Wilrijk, Antwerp 2610, Belgium.


Mol Vis. 2013 Jul 19;19:1502-14. Print 2013.
Lithium chloride promotes host resistance against Pseudomonas aeruginosa keratitis.
Chen K1, Wu Y, Zhu M, Deng Q, Nie X, Li M, Wu M, Huang X.
To explore the role of lithium chloride (LiCl) in Pseudomonas aeruginosa (PA) keratitis.
METHODS:B6 mice were subconjunctivally injected with LiCl in contrast to appropriate control sodium chloride (NaCl), and then routinely infected with PA. Clinical score, slit-lamp photography, hematoxylin and eosin (H&E) staining, and bacterial plate counts were used to determine the role of LiCl in PA keratitis. Messenger ribonucleic acid and protein levels of inflammatory cytokines in PA-challenged mouse corneas and in vitro cultured macrophages and neutrophils were measured with real-time PCR and enzyme-linked immunosorbent assay (ELISA), respectively. Apoptosis of the infiltrating inflammatory cells in the PA-infected murine corneas was assessed using terminal deoxynucleotidyl transferase-mediated uridine 5′-triphosphate-biotin nick end labeling staining and propidium iodide staining associated with flow cytometry. In cultured murine macrophages and neutrophils, cell apoptosis was determined with annexin V/propidium iodide double staining associated with flow cytometry and western blot analysis for cleaved caspase-3 and cleaved poly(ADP-ribose) polymerase.
RESULTS:Treatment with LiCl reduced the severity of corneal disease by reducing corneal inflammatory response and bacterial burden. Moreover, LiCl increased anti-inflammatory cytokine interleukin-10 levels, decreased proinflammatory cytokine tumor necrosis factor-α levels, and enhanced apoptosis of infiltrating macrophages and neutrophils in the PA-infected mouse corneas. In vitro studies further confirmed that LiCl elevated anti-inflammatory cytokine expression but reduced proinflammatory cytokine production, as well as promoted cell apoptosis in murine macrophages and neutrophils.
CONCLUSIONS:This study demonstrates a protective role of LiCl in PA keratitis. LiCl promotes host resistance against PA infection by suppressing inflammatory responses, enhancing inflammatory cell apoptosis, and promoting bacterial clearance.


Medical Hypotheses  Volume 7, Issue 7, Pages 885–890, July 1981  Immunopotentiation and inhibition of herpes virus activation during therapy with lithium carbonate
J. Lieb   41 Village Lane, Bethany, CT. 06525 USA
Recurrent respiratory tract infections and other recurrent manifestations of defective immunity remitted in nine patients taking lithium. Remission of viral activation in four patients with recurrent herpes labialis also appeared to be due to lithium therapy.


The immunostimulating and antimicrobial properties of lithium and antidepressants   Julian Lieb, M.D is a retired Yale medical school professor,

Remission of such manifestations of viral infections assinusitis, sinobronchitis, frequent colds, sorethroats, cold sores and genital herpes in patientstaking lithium carbonate has been reported.[61 – 65]
In a retrospective study of the antiviral activity of various psychotropic agents, chronic lithium administration reduced the mean rate of recurrent labial herpes infections. Lithium and antidepressants reduced the mean yearly rates of common, ‘flu-like’colds.[63,64] In a randomised, double blind, placebo [64] controlled study lithium reduced the frequency andduration of recurrences of genital herpes.[64]
The polymorphonuclear leukocytes (PMN) of a 29-year-old woman with eczema and recurrent staphylococcal and streptococcal skin infections were unresponsive to standard chemotactic stimuli.
In vitro addition of lithium to her PMN preparations restored their chemotactic response. After receiving lithium carbonate, 1 g per day for 5 weeks she became free of infection and relapsed when lithium was withdrawn.[66]
Lithium chloride prevents replication of type 1 and 2 herpes virus in baby hamster kidney cells. Virus particle production, polypeptide and antigen synthesis were unaffected while viral DNA synthesis was inhibited. The replication of two other DNA viruses, pseudo rabies and vaccinia virus was inhibited but two RNA viruses, EMC and influenza virus were not inhibited.[67]


Olive Leaf

16) olive leaf extract exhibits antiviral activity
Antiviral Research 66 (2005) 129–136
The olive leaf extract exhibits antiviral activity against viral
haemorrhagic septicaemia rhabdovirus (VHSV)
Vicente Micol 1, Nuria Caturla 1, Laura P´erez-Fons,
Vicente M´as, Luis P´erez, Amparo Estepa ∗
Instituto de Biolog´ıa Molecular y Celular, Universidad Miguel Hern´andez, E-03202-Elche, Alicante, Spain
Received 10 November 2004; accepted 11 February 2005

Lithium Orotate for alcoholism

Alcohol. 1986 Mar-Apr;3(2):97-100.
Lithium orotate in the treatment of alcoholism and related conditions.
Sartori HE.
The subjects were 42 alcoholic patients (33 males and 9 females) who were treated with lithium orotate during an alcohol rehabilitation program in a private clinical setting for at least six months. They derive from a total number of 105 patients who received this treatment initially, while the remainder discontinued the treatment within six months. The data were collected from a private practice record and the follow-up varied between six months and 10 years. The 42 patients studied displayed a multitude of complaints in addition to chronic alcoholism. These included liver dysfunction, seizure disorders, headaches, hyperthyroidism, affective disorders. Meniere’s syndrome, liver and lung cancers. Thirty-six of the 42 patients studied had been hospitalized at least once for the management of their alcoholism. Lithium orotate was given, 150 mg daily, with a diet low in simple carbohydrates and containing moderate amounts of protein and fat. In addition, calcium orotate (for hepatic involvement), magnesium orotate, bromelaine, and essential phospholipids (for cardiac problems), and supportive measures were instituted, if required. Lithium orotate proved useful as the main pharmacologic agent for the treatment of alcoholism. Ten of the patients had no relapse for over three and up to 10 years, 13 patients remained without relapse for 1 to 3 years, and the remaining 12 had relapses between 6 to 12 months. Lithium orotate therapy was safe and the adverse side effects noted were minor, i.e., eight patients developed muscle weakness, loss of appetite or mild apathy. For these patients, the symptoms subsided when the daily dose was given 4 to 5 times weekly.(ABSTRACT TRUNCATED AT 250 WORDS)

Lithium for treatment of alcoholism

18) For “practicing” alcoholics, I recommend a trial of lithium orotate,
10 milligrams three times daily (along with diet advice, niacin,
glutamine, and other supplements). I ask recovering alcoholics to
try 5 milligrams, three times daily (occasionally more). The
majority of these patients report improved mood and decreased
desire for alcohol after about six weeks using lithium therapy.

McMillan TM. Lithium and the treatment of alcoholism: a critical review. British Journal of Addiction 1981; 76: 245-258


Low intensity Laser for Herpes

Lasers Med Sci. 2013 Apr 13. [Epub ahead of print]
Laser treatment of recurrent herpes labialis: a literature review.
de Paula Eduardo C1, Aranha AC, Simões A, Bello-Silva MS, Ramalho KM, Esteves-Oliveira M, de Freitas PM, Marotti J, Tunér J.  Author information      1Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry of the University of São Paulo (USP), Av. Prof. Lineu Prestes, 2227, 05508-000, São Paulo, SP, Brazil,

Recurrent herpes labialis is a worldwide life-long oral health problem that remains unsolved. It affects approximately one third of the world population and causes frequent pain and discomfort episodes, as well as social restriction due to its compromise of esthetic features. In addition, the available antiviral drugs have not been successful in completely eliminating the virus and its recurrence. Currently, different kinds of laser treatment and different protocols have been proposed for the management of recurrent herpes labialis. Therefore, the aim of the present article was to review the literature regarding the effects of laser irradiation on recurrent herpes labialis and to identify the indications and most successful clinical protocols. The literature was searched with the aim of identifying the effects on healing time, pain relief, duration of viral shedding, viral inactivation, and interval of recurrence. According to the literature, none of the laser treatment modalities is able to completely eliminate the virus and its recurrence. However, laser phototherapy appears to strongly decrease pain and the interval of recurrences without causing any side effects. Photodynamic therapy can be helpful in reducing viral titer in the vesicle phase, and high-power lasers may be useful to drain vesicles. The main advantages of the laser treatment appear to be the absence of side effects and drug interactions, which are especially helpful for older and immunocompromised patients. Although these results indicate a potential beneficial use for lasers in the management of recurrent herpes labialis, they are based on limited published clinical trials and case reports. The literature still lacks double-blind controlled clinical trials verifying these effects and such trials should be the focus of future research.

J Invest Dermatol. 1999 Aug;113(2):221-3.
Low-intensity laser therapy is an effective treatment for recurrent herpes simplex infection. Results from a randomized double-blind placebo-controlled study.  Schindl A1, Neumann R.

Recurrent infection with herpes simplex virus is a common disease. Recently, alternative therapies have been introduced. Among those, low-intensity laser therapy mainly used for the acceleration of wound healing and in pain therapy has previously been shown to be of benefit in herpes zoster infections. In this study we evaluated the influence of low-intensity laser therapy (wavelength 690 nm, intensity: 80 mW per cm2, dose: 48 J per cm2) in 50 patients with recurrent perioral herpes simplex infection (at least once per month for more than 6 mo) in a randomized, double-blind placebo-controlled trial design. Patients in the laser group received daily irradiations for 2 wk, whereas patients in the placebo group were sham-irradiated. After completion of the laser/sham treatment, patients were asked to return to the Department of Dermatology, University of Vienna Medical School at the time of recurrence. All except two patients completed the study and were monitored for 52 wk. The median recurrence-free interval in the laser-treated group was 37.5 wk (range: 2-52 wk) and in the placebo group 3 wk (range: 1-20 wk). This difference was found to be statistically significant (p < 0.0001; Wilcoxon’s Rank Sum Test). In conclusion, we demonstrated that a total of 10 irradiations with low-intensity laser therapy significantly lowers the incidence of local recurrence of herpes simplex infection. Since this athermic phototherapeutic modality represents a safe, noninvasive treatment, it might be considered as an alternative to established therapeutic regimens in this indication.


Herpes  BHT

BHT for herpes

Science. 1975 Apr 4;188(4183):64-6.
Butylated hydroxytoluene inactivated lipid-containing viruses.
Snipes W, Person S, Keith A, Cupp J.
Butylated hydroxytoluene (BHT) is widely used as a food preservative for its antioxidizing property. This small, hydrophobic molecule has been found to be a potent inactivator of lipid-containing mammalian and bacterial viruses.

Poult Sci. 1978 Nov;57(6):1526-9.
Studies on the effect of butylated hydroxytoluene on Mycoplasma synoviae.
Vardaman TH, May JD, Drott JH.
Butylated hydroxytoluene (BHT) is one of the antioxidants added to human and animal feed products in concentrations ranging from 50 to 200 ppm to delay degradation of the labile lipid components. BHT is known to be an inactivator of mammalian and bacterial viruses that contain lipid. Results of in vitro studies showed that 10 ppm of BHT in Mycoplasma medium prevented growth of each of the six Mycoplasma synoviae (Ms) isolates. BHT added at 100, 200, and 400 ppm in the feed did not have any significant in vivo effect on the Ms serological responses or show any chemoprophylactic effect on birds infected with Ms.

24) More references BHT:

Brugh M Jr. Butylated hydroxytoluene protects chickens exposed to Newcastle disease virus. Science. 1977;197(4310):1291-2.

Kim KS, Moon HM, Sapienza V, Carp RI, Pullarkat R. Inactivation of cytomegalovirus and Semliki Forest virus by butylated hydroxytoluene. J Infect Dis 1978;138(1):91-4.

Pirtle EC, Sacks JM, Nachman RJ. Antiviral effectiveness of butylated hydroxytoluene against pseudorabies (Aujeszky’s disease) virus in cell culture, mice, and swine. Am J Vet Res. 1986;47(9):1892-5.

Richards JT, Katz ME, Kern ER. Topical butylated hydroxytoluene treatment of genital herpes simplex virus infections of guinea pigs. Antiviral Res 1985;5(5):281-90.

Mann JA, Fowkes SW. Wipe Out Herpes with BHT. Manhattan Beach, Calif: MegaHealth Society; 1983.

Lanigan RS, Yamarik TA, Final report on the safety assessment of BHT, Int. J. Toxicol., 2002:21 Suppl 2:19-94

Shlian DM, Goldstone J, Toxicity of butylated hydroxytoluene, N Engl J Med, 1986; 34; 648-649


Jeffrey Dach MD
7450 Griffin Road Suite 190
Davie, Florida 33314

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