The topical gold standard treatment for the 30% of Kiwis who suffer recurrent cold sore attacks for the last three decades has been over-the-counter aciclovir creams such as Zovirax and Viraban. However, there has been a growing call for natural alternatives.
Now a trial, led by researchers at the Medical Research Institute of New Zealand (MRINZ) shows that a medical-grade honey formulation derived from the native kānuka is just as effective as aciclovir cream.
A natural option
The results show that the Honevo kanuka honey formulation presents patients with an evidence-based, alternative option. The study was funded by Tauranga-based HoneyLab, which manufactures Honevo.
“This means that patients with a preference for natural and alternative medicines, as well as pharmacists who sell these treatments, can have confidence in the effectiveness of this kanuka honey formulation,” said lead MRINZ researcher Dr Alex Semprini.
Semprini says it was unusual for a company selling an alternative medicine to undertake a randomised trial comparing its product with traditional pharmaceutical medicine.
“There are significant barriers relating to both cost and quality assurance in order to meet strict New Zealand regulatory requirements for clinical trials and, of course, there’s always the risk the results may prove negative,” he says.
In another novel element to the study, all 952 subjects were enrolled in the 2015-17 trial through 76 community pharmacies across the country.
Patients presenting to participating pharmacies within the first 72 hours of a cold sore episode were asked if they wished to take part. They were then randomly assigned either the 5% aciclovir cream Viraban or medical-grade Honevo and asked to apply it five times daily.
Patients self-recorded their pain levels and cold sore progression in diaries, comparing their recovery rate. Their entries were monitored for 14 days or until the cold sore fully healed. Results showed the median time for a return to normal skin was 8-9 days for both aciclovir and honey creams. No serious adverse effects were reported.
“This was an ideal opportunity for community pharmacies to be directly involved in a research initiative, and they can now use the results in future patient consultations,” said Pharmacy Guild of NZ chief executive Andrew Gaudin.
“Pharmacists are highly trained health professionals and can be seen without the need to book an appointment, so they are well-placed to consult patients on minor conditions such as cold sores”.
Solving everyday problems
Dr Semprini says community pharmacy involvement for this trial was pivotal.
The Health Research Council, which provides funding to MRINZ, said studies on everyday health problems can be seen as “less exciting", but the findings are still important.
“Some dismiss cold sores as minor but they can be quite distressing,” said chief executive Professor Kathryn McPherson.
“Finding new remedies by drawing on some of New Zealand’s great natural products will be positive for patients, and should have significant commercial potential.”
