Herpes refers to a group of disorders which manifest with an eruption of red, painful blisters or sores on the skin, genitals, lips or eyes. The causative culprits are the closely related herpes simplex 1, herpes simplex 2, and varicella-zoster viruses, often combined with a weakening of immune function. The most common manifestations are cold sores (herpes 1), genital sores (herpes 2) and shingles (varicella-zoster).
Traditional Chinese Medicine (TCM) treats these infections with a two pronged strategy. Firstly, herbs which have a proven effect on herpes virus are used, and secondly, herbs which address the patient’s constitution. A detailed discussion will clarify this below.
ORAL AND FACIAL HERPES
Also known as cold sores, oral herpes usually affects the lip, though it can also erupt closer to the nose, or affect the eye (opthalmic herpes). Generally it is caused by herpes simplex 1, which tends to affect the face, whereas the genitals are more often the domain of herpes simplex 2. (In reality, this can be the other way around, but for the purposes of TCM treatment it is not relevant which of the herpes viruses is present.)
Initial infection with the herpes virus is thought to occur in childhood when it may be entirely asymptomatic. Once present, the virus lays dormant in the nerve cells of the face/mouth and erupts occasionally into the acute, cold sore manifestation. This is preceded by tingling, soreness and burning, and followed by a blister, which eventually weeps and crusts over with a yellow scab. There is the possibility of contagion at any stage of this flare-up, especially upon contact with the fluid.
In TCM, this entire process is indicative of Fire Toxin and Damp Heat. These terms are purely descriptive. Any infection, viral or bacterial, is a type of toxin. Sufferers know herpes to be a very hot, fiery condition, of which burning is a feature, and for which heat from sunlight, stress, fever or spicy food is an aggravating factor. And finally, damp-heat is descriptive of any wet, infected, fluid filled blister.
Treatment can be divided into short and long-term aims. For the short-term the obvious aim is to stop or minimize an impending flare-up, and this depends largely on the timing of treatment. If herbs are taken at the first signs of tingling and sensitivity, the sore can be entirely prevented from surfacing.
The long-term aim of TCM treatment is to reduce or entirely eliminate the flare-ups. In order to do this we must assess what is causing the dormant virus to flare so frequently. There are two possibilities: Liver Fire and Deficient Qi.
In this scenario, the person suffers from pre-existing congested Heat and Fire — their body is quite hot at the best of times, and it doesn’t take much for this heat to trigger the hot herpes pathogen. Generally this type of patient is strong, with a robust constitution and a red tongue. This pattern may be caused by longstanding frustration and resentment or consistent consumption of very warming foods, such as barbequed meats. Fire has a natural tendency to flare upwards, which makes it that much easier to trigger any skin eruption on the upper body. Liver Fire is always involved with eye herpes. In order to treat this pattern, Liver Fire and herpes toxin are addressed concurrently with herbal medicine. Additionally, herbs which direct the prescription to the lip or eye, are included.
This means that the body’s energy stores, and hence it’s immunity, is low, allowing the herpes virus free reign. The causes are multiple: constitutional weakness, poor diet over many years, or the vicious circle possibility, which is when repeated flare-ups of herpes toxin tax the body and induce a further deficiency of its qi. Typically this pattern presents with paleness, tiredness, digestive symptoms, and a pale, teethmarked tongue with a greasy yellowish coating. Treatment focuses equally on tonifying the qi, and attacking herpes toxin.
GENITAL/LOWER BODY HERPES
Here the herpes blisters affect the genitals, perineum or buttocks, and they can be sexually transmitted.
TCM diagnosis is quite similar to the oral/facial variety, with one addition: Dampness is a more relevant co-factor which must be treated.
This is because the reproductive and urinary organs are a very moist and warm environment even when perfectly healthy. Moisture easily congeals and thickens under the influence of extra heat from herpes toxin, or hormonal cycles, or emotional stress. This obstructs, stagnates and induces further heat, with a perfect set-up now in place for further flare-ups of herpes.
Treatment continues to assess how much Liver Heat versus Qi Deficiency still plays a part, and addresses all of these factors with a compound herbal combination. As with oral herpes, an outbreak can be prevented with timely treatment.
Commonly known as shingles, this is caused by the chicken pox virus, which can lay dormant for decades, awaiting an opportune moment to flare. It is a condition very much associated with declining immmunity, from other illness or old age. It is much more common in people over 50. Shingles blisters usually follow the path of an intercostal nerve (along the ribs). It is a famously painful condition, preceded and followed by extreme sensitivity of the affected strip of skin long after the blisters have gone. The acute phase is treated as a Liver Fire pattern, (see above), followed by strong tonification of Qi once it is resolved.
Herpes in all its manifestations is very well treated by TCM. As always with herbal medicine, the longer it has been a problem, and the more severe it is, the longer it will take to treat. However, a decrease in the frequency of attacks can be observed relatively quickly.
Patients often ask if TCM can “cure” this condition. TCM cannot eliminate all traces of herpes or varicella virus from the body, but it can make it extremely unlikely to flare.