- Studies suggest that cannabidiol (CBD) may have an antiviral potential due to its purported effects on immune cell functions(1). However, researchers have not thoroughly evaluated how CBD works specifically for herpes virus diseases.
- The same study suggested that CBD may help against the herpes simplex virus (HSV) and manage inflammation and the immune response caused by HSV outbreaks(2).
- Research on CBD use in virally induced conditions is limited(3). Scientists must conduct more extensive studies to conclude a definite outcome in humans.
How CBD Oil May Work to Help With Herpes
One study mentioned that cannabidiol (CBD), a cannabis plant compound, has received limited scientific attention regarding its potential use as an antiviral remedy(4).
However, researchers have not thoroughly examined how CBD works specifically for diseases caused by the herpes virus.
CBD is a plant-based cannabinoid that works as a chemical messenger for the endocannabinoid system (ECS) in the body(5). The ECS is a system-wide network of receptors and chemical signals that help control and regulate crucial body functions such as inflammatory responses, pain control, and immune responses(6).
The ECS contains cannabinoid receptors, including the CB1 and CB2 receptors(7). CB1 receptors, mainly in the brain and spinal cord, affect pain, emotional processing, and appetite regulation. Meanwhile, CB2 receptors in the peripheral nervous system regulate inflammation.
Researchers stated that CBD’s antiviral potential may be due to how the substance affects immune cell functions(8). Additionally, host inflammatory responses may have a crucial role in the viral disease’s pathogenesis (how an infection leads to disease).
Scientists may consider conducting further extensive studies on how CBD interacts with the ECS’ cannabinoid receptors to help manage viral diseases, including herpes.
Research on CBD for Herpes
There is insufficient clinical evidence that CBD works for the herpes simplex virus (HSV).
Additionally, research on CBD use in virally induced conditions is limited to only one in vivo and two in vitro studies(9). This limitation may not be enough to provide a definite outcome for humans.
One study published in Cannabis and Cannabinoid Research suggested that CBD may be helpful against HSV and help manage inflammation and the immune response caused by HSV outbreaks(10).
However, the study gathered this information from claims found on various commercial websites, whose reliability may be uncertain.
In addition to HSV, which includes oral and genital herpes, the same study also suggested that CBD may help manage other viral diseases, such as acquired immunodeficiency syndrome (HIV/AIDS), shingles (also called herpes zoster), and hepatitis C(11).
Individuals interested in reading this study in detail may access it through PubMed Central’s online database or visit the National Library of Medicine website under the National Institutes of Health (NIH) at https://www.ncbi.nlm.nih.gov/.
Readers may also access the study through its digital object identifier (DOI) link.
In one in vitro study, researchers mentioned that CBD may help inhibit hepatitis C virus (HCV) replication by as much as 86.4% with a single concentration of 10 micrometers (µm)(12).
One of the potential complications of HSV, particularly genital herpes, is inflammation of the cerebrospinal fluid and membranes surrounding the individual’s brain and spinal cord, leading to meningitis(13).
CBD is purported to have anti-inflammatory properties(14). This benefit suggests that the compound, if proven effective, may have the potential to help manage inflammation caused by HSV.
Individuals with herpes may also develop painful blisters(15). Studies showed that CBD may have an analgesic (pain-relieving) effect(16). This effect suggests a possibility for CBD to help alleviate pain caused by blisters.
Usage and Dosage of CBD for Herpes
Individuals considering taking CBD for candidiasis have several methods to administer the substance. These delivery routes include the following:
- Topical application: In this method, an individual applies the CBD product to the skin. CBD topicals typically do not enter the bloodstream. Still, applying these products to the affected area may provide pain relief(17).
CBD brands sell various topical products, such as CBD creams, ointments, lotions, and lip balms, to cater to individual preferences.
- Ingestion: This method involves taking CBD orally or through the mouth. Drugs administered via ingestion pass through the body’s digestive system before entering the bloodstream.
Oral products include CBD capsules and edibles, such as CBD gummies, candies, chews, and cookies.
- Sublingual administration: Sublingual delivery involves administering CBD oil under the tongue. This method lets the drug bypass the digestive tract and directly enter the bloodstream.
Sublingual CBD products include oromucosal sprays, tinctures, and high-potency oils.
Tinctures typically come with a calibrated dropper to help provide accurate dosing.
CBD oil tinctures may have an earthy or grassy natural flavor. One way to take these products is by mixing these products with food or drinks(18).
- Inhalation: In this method, the individual inhales the CBD product, which enters the lungs and gets absorbed by the heart and brain before spreading throughout the body(19). Vaping is one method to inhale CBD.
Consumers should take precautions when using vapes as these products may cause health risks leading to lung disease(20). Individuals must take these risks into consideration and exercise caution before vaping.
Another method to administer CBD is through the use of suppositories. These pill-sized products are usually inserted into the vagina or rectum.
Some CBD brands claim that suppositories provide therapeutic effects, such as reducing anxiety, improving mood, and promoting muscle relaxation. These are unsubstantiated claims, and researchers have not determined the product’s effectiveness, especially for herpes.
Additionally, scientists have not concluded a specific CBD dosage appropriate for oral or genital herpes. Furthermore, the Food and Drug Administration (FDA) has not approved any CBD dosing guidelines specifically for this disease.
However, one recommendation is to take CBD starting with a low dose, then slowly increasing the dosage(21).
For instance, new cannabis users may consider taking an initial dose of 10 milligrams (mg) of CBD per day(22).
Generally, CBD dosage may vary among consumers depending on their diet, exercise, health conditions, and stress levels(23).
Before deciding on a specific CBD dose, individuals should consult a doctor, preferably someone well versed in cannabis use, to know the appropriate CBD dosage for the individual’s needs.
Depending on the individual’s chosen delivery method, CBD’s onset times may vary, such as the following(24):
- Topical application: 15 to 30 minutes
- Oral ingestion: 30 to 90 minutes
- Sublingual administration: 15 to 30 minutes
- Inhalation: 2 to 15 minutes
Meanwhile, how long CBD’s effects will last may also depend on the different administration routes.
For example, orally administered CBD may remain effective for six to eight hours(25). On the other hand, delivering CBD through the topical, sublingual, or inhalation routes may make the drug effective for about two to four hours.
CBD brands often include a disclaimer mentioning that CBD products are not meant to treat diseases. Thus, consumers must first consult a doctor before considering taking CBD.
CBD Oil vs. Alternative Treatments for Herpes
Despite the growing interest in CBD’s potential to help with herpes, individuals may also consider natural alternatives such as essential oils to manage the disease.
Essential oils studied for their potential antiviral effects against HSV include extracts from the eucalyptus plant, oils extracted from the Labiatae and Verbenaceae plant families, and compounds isolated from the Eucalyptus globulus leaves and twigs(26).
One study mentioned that eucalyptus oil may exert a direct antiviral effect on HSV(27). Although the researchers have not determined the oil’s active antiherpes components, results suggested that eucalyptus oil may have a promising application against recurring herpes infection.
In the case of Labiatae and Verbenaceae, one study evaluated the antiviral activity of these plant families against the human herpes virus(28).
Results showed that certain oils derived from these plants, such as Lepechinia salvifolia, Hyptis mutabilis, and Lepechinia vulcanicola, may have an inhibitory effect during the early stages of the infection.
What Is CBD?
Cannabidiol (CBD) is a phytocannabinoid (plant-based cannabinoid) extracted from Cannabis sativa. CBD typically comes from hemp, a cannabis plant variety that is CBD-rich and contains no more than 0.3% tetrahydrocannabinol (THC)(29).
THC is a cannabis compound known to cause psychoactive effects or a feeling of “high” typically linked to marijuana use(30). Marijuana is a cannabis plant variety containing high THC concentrations(31).
Although CBD is usually extracted from hemp, the compound is also one of the essential components of medical marijuana(32).
During the 19th and 20th centuries in the United States, individuals utilized the cannabis plant for medicinal purposes(33). However, cannabis sales and use became federally restricted in 1937 through the Marihuana Tax Act.
In 1996, the Compassionate Use Act became a law in the U.S., and California became the first state that legalized cannabis for medicinal use under physician supervision(34).
In 2018, the U.S. enacted the Farm Bill, which excludes hemp-based CBD products with less than 0.3% THC content from the Controlled Substances Act’s “marijuana” definition(35).
Therefore, CBD products whose THC content exceeds 0.3% are illegal under U.S. federal law(36).
Despite this law, the legal implementation and regulation of sales and use of CBD products vary from one state to another. Hence, consumers must review and understand their state’s laws before buying or using CBD products.
In June 2020, the FDA approved Epidiolex, an oral CBD medication containing pure CBD for treating seizures due to epilepsy and tuberous sclerosis complex (TSC)(37).
As of February 3, 2022, about 37 U.S. states have implemented and regulated medical cannabis programs. These states include New York, Kentucky, Washington, Colorado, and Texas(38).
Effectiveness of CBD
CBD has putative anti-inflammatory properties that may help manage various medical conditions, including inflammatory, cardiovascular, neurodegenerative, and autoimmune diseases(39).
Studies mentioned that CBD may also help alleviate chronic pain, addiction, insomnia, and epilepsy(40).
Still, many of these studies are inconclusive, and researchers must conduct more extensive and well–designed trials to help provide convincing evidence that CBD works effectively for such conditions.
The most scientifically-proven benefit of CBD is its effectiveness in managing childhood epilepsy syndromes, such as Lennox-Gastaut syndrome and Dravet syndrome, which usually do not respond to anti–seizure medicines(41).
Side Effects, Risks, and Considerations
Scientists have not thoroughly examined CBD’s side effects and potential risks to individuals infected with HSV.
However, CBD may cause dry mouth, drowsiness, appetite loss, and fatigue, which may be tolerable among humans(42).
Other commonly reported CBD side effects are diarrhea, tiredness, and appetite or body weight changes(43).
Additionally, CBD may interfere with the cytochrome P450. This class has more than 50 enzymes (proteins). Six of these proteins metabolize around 90% of drugs, with CYP3A4 and CYP2D6 being the two most significant(44).
CBD at high enough doses may inhibit these liver enzymes’ activities, possibly affecting the effectiveness of the metabolized drugs(45).
What Is Herpes?
Herpes is a viral infection brought by the herpes simplex virus (HSV). According to a WHO report in 2022, herpes is a globally known disease, with about 3.7 billion individuals under 50 affected by the HSV type 1 (HSV-1) infection and around 491 million aged 15 to 49 infected with the HSV type 2 (HSV-2) variant(46).
Individuals are likely to contract HSV if they(47):
- Have multiple sex partners
- Engaged in sexual activities at a young age
- Do not use condoms during intercourse
- Have a sexually transmitted infection (STI) history
- Have a weakened immune system
While HSV may be mostly asymptomatic or show no symptoms, the virus can cause ulcers (open sores) or painful blisters, ranging from mild to severe, at the infection site(48). HSV infection can last for a lifetime, and the symptoms can recur for years.
The virus typically infects epithelial cells and may also infect sexual partners(49). Although CD8+ cells, a type of white blood cell, kills these infected cells, there are occasions when the infection overwhelms the body’s immune system and causes a lesion.
Epithelial cells line the surfaces of various body parts, such as the skin, blood vessels, and organs(50).
One complication of the disease, specifically HSV-2 infection, is the risk of getting a human immunodeficiency virus (HIV) infection. Furthermore, individuals with HSV-2 and HIV have a higher likelihood of spreading HIV to others.
HIV is a virus targeting the body’s immune system(51). If left untreated, the virus can cause acquired immunodeficiency syndrome (AIDS).
Additionally, herpes can cause more severe symptoms among immunocompromised individuals, including those infected with advanced HIV.
Types of Herpes
There are two herpes types based on transmission: oral herpes and genital herpes(52).
- Oral herpes (HSV-1): This herpes type causes an infection in or around an individual’s mouth. HSV-1, or herpes simplex 1, can be spread through oral contact. However, the infection can also lead to genital herpes.
HSV-1 is primarily transmitted through contact with the virus in the saliva, sores, or surfaces in or around the mouth. However, this virus can also transfer from one individual to another via oral-genital contact.
Individuals with HSV-1 are less likely to get reinfection. Still, they can be at risk of contracting HSV-2.
- Genital herpes (HSV-2): Genital herpes is a sexually transmitted disease. HSV-2 is typically transmitted during sex or through contact with the genitals, anal surfaces, skin, fluids, or sores of an individual infected with the virus.
HSV-2 can also transfer to other individuals even when the skin appears normal, and the infected individual shows no symptoms.
In rare cases, neonatal herpes can occur, wherein the virus transfers from mother to child during delivery(53).
Doctors or healthcare providers typically diagnose HSV based on the appearance of herpes sores or lesions and take a sample from these sores.
If there are no sores, the doctor can recommend a blood test to check for HSV antibodies, indicating whether or not the individual was exposed to the virus.
Symptoms of Herpes
Individuals with HSV-1 will often have blisters or sores, also called cold sores or fever blisters, in or around the mouth and feel an itching, burning, or tingling sensation around their mouths before the sores appear.
HSV-1 symptoms may appear periodically. However, their frequency varies among individuals.
On the other hand, HSV-2 may have asymptomatic or mild, unrecognized symptoms. Individuals with genital herpes often have one or more genital or anal ulcers or blisters.
Other HSV-2 symptoms include fever, swollen lymph nodes, and body aches. Symptoms may also recur after the initial episode. However, such recurrences are usually less severe and may decrease over time.
While genital herpes caused by HSV-1 does not frequently recur, recurrent HSV-2 symptoms are more common.
Conventional Herpes Treatments
HSV has no cure. However, available medications may help reduce the frequency and severity of the symptoms.
Individuals having a herpes outbreak can use antiviral creams or ointments to help lessen the symptoms. Still, these medications typically work only when applied immediately after an outbreak.
Doctors can prescribe the following topical or oral medications for herpes(54):
- Famciclovir (Famvir)
- Acyclovir (Zovirax, Sitavig)
- Valacyclovir (Valtrex)
Individuals with HSV-1 may manage their symptoms by applying ice to their sores or taking nonsteroidal anti-inflammatory drugs (NSAIDs) or over-the-counter topicals such as benzocaine (Orajel), docosanol (Abreva), or L-lysine(55).
On the other hand, individuals with HSV-2 symptoms may apply an ice pack on their genitals, wear cotton or nonsynthetic underwear, soak in a warm bath, take NSAIDs, or apply analgesic topicals containing 1% or 2% lidocaine(56).
Individuals may prevent contracting HSV-1 by avoiding kissing, having oral sex, touching the skin near the mouth, or sharing utensils or personal care products.
Meanwhile, HSV-2 prevention involves avoiding or limiting multiple partners, getting tested for STIs, using condoms during intercourse, and informing sex partners of the disease so they can get tested.
Additionally, avoiding triggers such as stress or illness may help individuals with the virus reduce the outbreak frequency.
Brief History of Herpes
Researchers from the San Diego School of Medicine at the University of California identified the origins of the herpes virus, tracing the HSV-1 variant to infected hominids six million years ago(57). Meanwhile, HSV-2 jumped from ancient chimpanzees to the ancestors of modern humans 1.6 million years ago.
Genetic examination of human and primate herpes viruses showed that HSV-1 was present in humans longer than HSV-2.
- Cannabidiol for Viral Diseases: Hype or Hope?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347053/ - Ibid.
- Ibid.
- Ibid.
- Cannabidiol Primer for Healthcare Professionals
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/ - The Endocannabinoid System: Essential and Mysterious
https://www.health.harvard.edu/blog/the-endocannabinoid-system-essential-and-mysterious-202108112569 - Cannabidiol Primer for Healthcare Professionals
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/ - Cannabidiol for Viral Diseases: Hype or Hope?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347053/ - Ibid.
- Ibid.
- Ibid.
- Potential of Cannabidiol for the Treatment of Viral Hepatitis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5330095/ - Genital Herpes: Symptoms & Causes
https://www.mayoclinic.org/diseases-conditions/genital-herpes/symptoms-causes/syc-20356161 - Cannabidiol Primer for Healthcare Professionals
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/ - Herpes Simplex Virus
https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus - Cannabidiol Primer for Healthcare Professionals
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/ - Page 210 of Healing With CBD
https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view - Page 208 of Healing With CBD
https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view - Best Way to Take CBD
https://www.projectcbd.org/guidance/best-way-take-cbd - Can Vaping Damage Your Lungs? What We Do (and Don’t) Know
https://www.health.harvard.edu/blog/can-vaping-damage-your-lungs-what-we-do-and-dont-know-2019090417734 - CBD Dosing
https://www.projectcbd.org/guidance/cbd-dosing - Page 218 of Healing With CBD
https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view - CBD Dosing
https://www.projectcbd.org/guidance/cbd-dosing - Page 190-193 of Healing With CBD
https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view - Ibid.
- Current Antivirals and Novel Botanical Molecules Interfering With Herpes Simplex Virus Infection
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026011/ - Antiviral Activity of Australian Tea Tree Oil and Eucalyptus Oil Against Herpes Simplex Virus in Cell Culture
https://pubmed.ncbi.nlm.nih.gov/11338678/ - Antiviral Activity of Colombian Labiatae and Verbenaceae Family Essential Oils and Monoterpenes on Human Herpes Viruses
https://www.tandfonline.com/doi/full/10.1080/10412905.2015.1093556 - Cannabidiol Primer for Healthcare Professionals
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/ - Tetrahydrocannabinol
https://www.sciencedirect.com/topics/neuroscience/tetrahydrocannabinol - Marijuana
https://teens.drugabuse.gov/drug-facts/marijuana - Cannabidiol (CBD)-What We Know and What We Don’t
https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476 - Medicinal Cannabis: History, Pharmacology, And Implications for the Acute Care Setting
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/ - Ibid.
- Hemp Production and the 2018 Farm Bill
https://www.fda.gov/news-events/congressional-testimony/hemp-production-and-2018-farm-bill-07252019 - CBD & THC: Myths and Misconceptions
https://www.projectcbd.org/guidance/cbd-thc-myths-and-misconceptions - FDA Approves New Indication for Drug Containing an Active Ingredient Derived from Cannabis to Treat Seizures in Rare Genetic Disease
https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare# - State Medical Cannabis Laws
https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx - Anti-Biofilm Activity of Cannabidiol against Candida albicans
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924206/ - Cannabidiol (CBD)-What We Know and What We Don’t
https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476 - Ibid.
- What Are the Benefits of CBD — And Is It Safe to Use?
https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700 - Dosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092763/ - The Effect of Cytochrome P450 Metabolism on Drug Response, Interactions, and Adverse Effects
https://www.aafp.org/pubs/afp/issues/2007/0801/p391.html - Page 114-115 of Healing With CBD
https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view - Herpes Simplex Virus
https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus - Herpes Simplex
https://my.clevelandclinic.org/health/diseases/22855-herpes-simplex - Herpes Simplex Virus
https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus - Herpes Never Sleeps
https://www.science.org/content/article/herpes-never-sleeps - Epithelial Cells in Urine
https://medlineplus.gov/lab-tests/epithelial-cells-in-urine/ - About HIV
https://www.cdc.gov/hiv/basics/whatishiv.html - Herpes Simplex Virus
https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus - Ibid.
- Herpes Simplex
https://my.clevelandclinic.org/health/diseases/22855-herpes-simplex - Ibid.
- Ibid.
- Herpes Infected Humans Before They Were Human
https://health.ucsd.edu/news/releases/pages/2014-06-10-herpes-origins-in-chimpanzees.aspx