Many of us are infected with herpes simplex virus, which can be transmitted sexually to cause genital herpes. Although herpes is incurable, there are antivirals that can help reduce symptoms. But, because not everyone wants to take pharmaceuticals, a lot of us might seek alternatives in an attempt to treat or even cure our herpes infections.

“Natural” doesn’t necessarily mean safe or effective, so be critical.

For centuries, we have treated herpes in many ways — though not necessarily successfully! In the early 1800s, a British treatment involved placing lint between the tip of the penis and the foreskin. It was claimed that this would cause herpes lesions to heal within 14 days — not coincidentally, this is about how long it takes for them to heal on their own, untreated. Later that century, a London surgeon promoted an arsenic-based solution as a cure for recurrent herpes outbreaks. He presented the cases of a couple of patients. One had been suffering from outbreaks for six years, and after a course of this treatment he allegedly never experienced them again. Another patient had been experiencing recurring outbreaks for four years, and after taking this treatment for a year, his outbreaks “became less and finally cleared altogether.”

We now know that, even without treatment, herpes outbreaks generally become less severe over time, and often stop flaring up completely. When outbreaks do occur, they clear on their own, without treatment. This phenomenon is called “regression to the mean,” and many promoters of bogus remedies rely on it for the appearance that their products work. Because we often think that two things that happen at the same time are related, and that one causes the other, we might attribute the clearing of our herpes lesions to whatever “treatment” we were taking, regardless of whether or not it actually benefited us.

The only way we can know if treatments actually work is to compare them with standard medications or placebos (such as identical-looking sugar pills) in well-designed clinical trials. In such studies, patients are assigned to either medication or placebo at random, which is called “randomization” and is like flipping a coin. And, to protect against introducing bias into the study’s outcomes, trials should be “double-blinded,” meaning that neither researchers nor patients know whether the placebo or the medication under study is being administered. The “miracle cures” you hear about usually haven’t been subjected to such scientific rigor — if they have, the results usually aren’t promising.

It can also be difficult to find a study of an alternative treatment that wasn’t funded by supplement manufacturers. Dietary supplements, like pharmaceuticals, represent a multibillion dollar industry, but compared to pharmaceuticals they are subjected to very little regulation and are more likely to be marketed with misleading health claims. Claims that genital herpes is “reversible,” or that certain herbs can control the herpes virus by “boosting” immunity, aren’t supported by reliable evidence.

Despite all the reasons to be skeptical, some people seek “natural” treatments, believing they are safe, effective, or free of side effects. However, a natural product can range from safe to dangerous, and from effective to ineffective, and could very well have side effects. Let’s look at some of the proposed “natural” treatments for herpes.

Propolis: Propolis is made by bees to seal hives. Focus on Alternative and Complementary Therapies (FACT) is a medical journal that evaluates alternative treatments using the best available evidence. Its authors often examine studies published in the alternative medical literature and assess their scientific rigor, often reevaluating the evidence to reach a less biased conclusion. A FACT author examined a study of a propolis ointment that was marketed as a treatment for genital herpes. Despite some promising results, the study design was flawed — most notably, the researchers knew which treatment each patient received, which could heavily bias the results in favor of the treatment being studied. The author cautions that it is difficult to apply the results of this study to other circumstances because the chemical makeup of propolis varies wildly from region to region, as bees manufacture it using resins from local plants. A more recent study, conducted in Ukraine, also found promising results for propolis, but it suffered from the same methodological weaknesses.

Summary: Despite some promising preliminary results, we need to gather higher quality evidence from well-designed studies. Additionally, not all propolis products are created equal, as it is a natural product whose chemical makeup varies regionally.

L-lysine: Before the development of herpes drugs like acyclovir, many studies were conducted on L-lysine, an essential amino acid, in the 1970s and ’80s. Unfortunately, no real consensus was reached. In test tube studies, L-lysine appeared to inhibit virus replication, but in cell cultures it didn’t have any effect at all. Because L-lysine can be obtained from the foods we eat, some people suggest that herpes sufferers eat a diet high in lysine. Human trials using L-lysine supplements or examining the effect of high-lysine diets had mixed results. If L-lysine is effective, there are still not enough data to determine what an effective dose might be.

Summary: Results have been mixed, and we need to gather higher quality evidence from well-designed studies.

Aloe vera cream: One study examined a first genital herpes outbreak in men, and investigated the topical use of a 0.5 percent aloe vera cream in comparison with aloe vera gel and a topical placebo medication. The group treated with aloe vera cream healed faster than the other two groups — though, without a group using an antiviral medication, we can’t know how aloe vera cream performs in comparison to conventional medicine. Another study compared aloe vera cream to a placebo and reached similar conclusions. More rigorous clinical trials are clearly needed.

Summary: We need to gather higher quality evidence from well-designed studies, and all genders need to be studied.

Echinacea: Much attention has been given to this herb for its alleged “immunity-boosting” properties. Unfortunately, echinacea extracts have not been found to be effective in treating genital herpes outbreaks — in a well-designed clinical trial, it performed no better than placebo in controlling the rate of outbreaks.

Summary: No evidence of efficacy.

Homeopathy: Many people think that “homeopathy” is another word for “herbal medicine,” but they are actually two different things. Homeopathy’s development in the 1800s was guided by the belief that the lower a medicine’s dose, the more effective it was. Homeopathic preparations are often so diluted that they don’t contain a single molecule of the “active” ingredient. Many studies have examined homeopathic treatments, which haven’t been found to be more effective than placebo (in fact, some homeopathic preparations are literally sugar pills). Studies of homeopathy’s effect on herpes have not been impressive — for instance, one study claimed homeopathy could control herpes outbreaks, but it didn’t compare homeopathy to placebo, and some patients were using antiviral herpes medications in addition to homeopathy. Remember, herpes outbreaks decline over time, so it is not surprising that the patients being studied experienced fewer outbreaks. Thanks to “regression to the mean,” the 19th century doctors using lint and arsenic achieved similar results!

Summary: Ineffective.

Colloidal silver: While silver does have antimicrobial properties, there is no basis for using colloidal silver, marketed as a cure-all that can treat STDs like AIDS and herpes — as well as other serious conditions, including cancer and diabetes. Its use as a legitimate medical treatment was debunked back in the 1950s, but that doesn’t stop companies from manufacturing, marketing, and making money off of it. Not only does it have no beneficial health effects, it also has the side effect of turning your skin a dull gray as particles of silver become embedded in your skin and other tissues — permanently. This condition is called argyria, and you’re stuck with it for life (though one woman mitigated her appearance somewhat with dermabrasion). Furthermore, since silver is photo-reactive, sunlight will make the silver darken.

Summary: STAY AWAY!

If you have herpes, you can make an appointment at a Planned Parenthood health center to talk to us about whether herpes medications are right for you, as well other methods of self-care and ways to decrease risk of transmitting the virus to a partner.