It is estimated that as many as 70% of people in the UK carry the herpes virus. Herpes simplex virus (HSV) is a recurrent viral infection that remains dormant in the nervous system. The virus is either HSV-1 which manifests as cold sores, or HSV-2 which manifests as sores around genital areas. Triggers to reactivation can include stress, depression, anxiety, trauma to skin (shaving, wounds, waxing) immune-deficiency and exposure to sun light. For many there is a stigma around herpes and outbreaks are frequent and distressing. Although there is no ‘cure’ for herpes, the frequency and severity of outbreaks can be managed by changes to diet and management of stress and herbal medicine. Herbal medicine can help manage the herpes virus in a number of ways. Some herbs, such as Melissa officinalis, or Lemon balm, Hypericum perforatum or St John’s Wort and Astralagus stop the virus from replicating, thus limiting severity of outbreaks. Lemon balm can also help reduce stress and anxiety which can trigger an outbreak. Applied topically, Lemon balm, Glycrizzha galbra or Licourice, Thujia and Sage (Salvia) can reduce the severity of sores. I have blended an oil to apply topically when the signs of an outbreak are experienced and to sores when they appear. The oil combines hypericum and Calendula (Marigold) oils and drops of Lemon balm essential oils. Calendula is a great wound healer as well as having anti-bacterial and anti-viral activity. This can help prevent infection in the most severe outbreaks. Applying this oil when the first signs of an outbreak appear, can reduce the severity and length of outbreaks. Indeed, one patient wrote, ’Catherine you are a star. Longest I’ve been in years without an outbreak. I missed a tingle and a sore started but your oil saw it off better than any medication I’ve ever had. Wonderful stuff’. Herbs such as Eleutherococcus senticosus or Siberian ginseng, Astragalus membranaceus, Glycyrrhiza glabra or Liquorice, Echinacea and Calendula officinalis, can be given to boost immunity, preventing the outbreak of the virus. Herbs to manage stress and anxiety like Lemon balm, (Melissa), Skullcap (Scutellaria lateriflora) or Passionflower (Passiflora incarnata) can also help as stress lowers immunity, thus allowing the virus to outbreak and multiply. For primary outbreaks accompanied by fever and aching, Black cohosh (Cimicfuga racesmosa) or Cramp bark (Viburnum opulus) can be taken. Diet can help reduce outbreaks. Increasing foods containing lysine and reducing foods containing arginine can reduce the frequency and severity of outbreaks. Evidence suggests that arginine is required for the replication of HSV and may stimulate replication. Arginine is found in nuts, chocolate, wheat, raisons, oatmeal and coconut. L-lysine on the other hand may block arginine activity. Increasing consumption of foods rich in lysine, such as fish, eggs, turkey and cheese and taking L – Lysine supplements can help. Zinc supplements (25mg daily) inhibit HSV replication and reduces frequency and severity of outbreaks. Vitamin C at a dose of 1000mg daily during symptoms of an outbreak (tingling, heat) then reduce to 5000mg with the onset of symptoms. If you are experiencing frequent outbreaks then herbal medicine and a consultation with a Medical Herbalist may help you reduce the frequency and severity of outbreaks.