The herpes simplex virus (HSV) affects more than a third of the world's population. HSV infections are among the most common. The aim of this study was to compare the effectiveness of local applications of honey and topical application of acyclovir cream in the event of recurrent herpes infection.

The study involved 8 patients with genital recurrence and 8 patients with recurrent cold sores. The average age of the patients was 42 years. The average number of exacerbations in the past year with genital herpes was 6, with labial herpes - 5. The duration of exacerbations before inclusion in the study ranged from 7 to 12 days. Patients who had previously received acyclovir therapy were not included in the study. A blood test was done for anti-HSV antibodies, antibodies were found in all patients.

After signing the informed consent, the patients were observed for 2 consecutive exacerbations. With an exacerbation, honey was used and with another 5% acyclovir cream (the order was determined by the patient). A placebo was not used for ethical reasons. Patients were advised to start treatment within 1 hour of the first symptoms of exacerbation and to inform the doctor about starting treatment within 24 hours. The honey treatment consisted in applying closely gauze soaked in honey to the lesion for 15 minutes 4 times a day until complete healing. Acyclovir cream was applied 6 times a day.

The herpes outbreak was examined daily by a doctor. In the two groups, the following indicators were assessed:

In the treatment of cold sores with acyclovir, the average duration of exacerbation was 5.28 ± 1.2 days, and in the treatment with honey, it was 35% lower (p less than 0, 05). For lip herpes, the average duration of pain, the time before the appearance of a crust, the duration of an episode of exacerbation were respectively 39%, 28%, 43% shorter than the group. acyclovir. In genital herpes, the average duration of pain, the time before the onset of crust, the duration of the episode of exacerbation were respectively 50%, 49% and 59% shorter than in the acyclovir group. Honey applications led to an exacerbation abortion in 2 cases with cold sores and in 1 with genital. There were no abortions of exacerbations in the acyclovir group. In the treatment of honey, a scab at the site of the lesion formed in 3 patients with labial herpes and in 4 patients with genital herpes, while in the acyclovir group, the scab formed in all the patients. In 5 patients with cold sores and 5 patients with genital herpes, mild or moderate pain was observed within 24 hours of starting treatment with honey. In the honey-treated group, the pain, tingling and burning sensations subsided and disappeared within 24 hours in 3 patients with cold sores and 2 patients with genital herpes. When using acyclovir in any patient, the pain went away within the first 24 hours. In the group that used acyclovir for cold sores, in three patients the pain disappeared in 48 hours, in the rest - in 72 hours.The same picture was observed in the group of patients who used l 'acyclovir for genital herpes.

During the honey treatment, no adverse event was observed. During treatment with acyclovir, 1 patient with cold sores and 2 patients with genital herpes developed itching.

The antibacterial activity of honey is due to its acidity, its osmotic pressure and its hydrogen peroxide. The effect of honey on viruses has not been fully understood. Honey contains flavonoids, vitamin E, vitamin C, zinc, copper, amino acids and B vitamins. Copper inactivates HSV, this effect is enhanced by ascorbic acid and peroxide. hydrogen, also found in honey. Honey contains nitric oxide, which plays an important role in protecting the body against bacteria, protozoa, tumor cells and certain viruses.

Prostaglandins, which suppress the function of T cells, participate in the start of an exacerbation of herpes infection. Prostaglandins are also mediators of pain and inflammation. Honey causes a decrease in the content of prostaglandins in various biological fluids. Relief of exacerbation symptoms with honey applications may be due to inhibition of prostaglandin synthesis. Honey stimulates the immune system by inhibiting the synthesis of prostaglandins and stimulating the synthesis of nitric oxide.

Honey accelerates recovery from the exacerbation of labial and genital herpes and significantly relieves symptoms. The effect can be explained by the antimicrobial properties of honey, the inhibition of prostaglandin synthesis and the stimulation of nitric oxide synthesis in the lesion. The limits of the study are the lack of blindness and the small number of patients. More research is needed on the effect of local use of honey and its ingestion on the frequency and course of exacerbations of herpes. Another important factor is that honey is cheaper and more affordable than acyclovir.