Cold sores may be harmless but they are the bane of any sufferer’s life. They’re itchy, red and painful; they make the sufferer feel acutely self-conscious; and they can last for weeks. In the most severe cases, a first infection is accompanied by a temperature and swollen lymph glands.
The standard treatment is anti-viral cream such as acyclovir, which is also available in tablet form for more severe cases. However, a new device that zaps cold sores with infra-red light claims to heal cold sores in half the time.
The treatment was created by Gordon Dougal, a Durham GP who has researched cold sores for several years. He first became aware of the misery they can cause when his daughter Shanna, now 18, started to suffer from them when she was 8. In his spare time he drew on skills that he had developed through taking a part-time degree in electronic engineering while working as a GP in his native South Africa to come up with a treatment.
“I wouldn’t have thought about cold sores if my daughter hadn’t suffered quite badly. When she was younger she was plagued by them, to the point where her lips became terribly scarred. People always stared, which had a bad effect on her morale, and it was especially hard at that age. She used anti-viral cream but it was little help and the cold sores kept returning.”
Left untreated, a cold sore still heals, but it can take two or three weeks. Once you’ve caught the virus (by kissing someone who carries it), herpes simplex stays in the body for life. Between attacks the virus lies dormant in nerve cells and it is normally kept in check by the immune system. It resurfaces in response to triggers that are generally linked to a weakening of the immune system. These include tiredness, stress and being run-down, as well as menstruation, alcohol and UV light.
Dr Dougal’s desire to help his daughter coincided with an interest in the effects of light on human tissue, inspired by his electronic engineering degree. His initial research investigated claims by doctors in Eastern Europe that red light could help to heal cold sores. The research was supervised by a consultant eye surgeon in Darlington who funded it through a company they set up together. The research revealed that red light had no effect, but Dr Dougal refused to give up.
After several years of trial and error on more than 400 patients he hit on one particular wavelength of infra-red light (1072 nanometre narrow waveband) which could reduce healing time significantly. Fortunately, his daughter, who was then 11, was willing to be one of the first guinea pigs to test her father’s findings. After one five-minute exposure to the light, the outbreak of cold sores that she was suffering from not only cleared up more quickly than they had with anti-viral cream, but she has not had a recurrence since.
“Once I started believing that it worked I asked friends and anyone we knew who suffered from cold sores to come into my surgery to try it. People were willing because they’d tried everything else with limited success, so they were desperate. It’s a totally benign treatment because the power you need for the light to be effective is less than you would get from a standard 60-watt light bulb at 30cm (12in) distance.”
Dr Dougal then carried out a pilot study of 60 patients, at North Tees Hospital, published in Clinical and Experimental Dermatology in 2001. “I was absolutely ecstatic when the results came through, which confirmed that after working on the project for so many years I really had found something that made a difference. The study showed that a single five-minute exposure to 1072 nanometre narrow waveband light reduced the healing time of cold sores by 30 per cent, while anti-viral cream reduced it by 10 per cent.” The treatment appears to work by enhancing the immunity in the area around the cold sore, not by attacking the virus itself.
He went on to develop a battery-powered electronic device, called the Virulite CS, to administer doses of the light. It has the C E (Conformité Européene) mark of approval for sale as a medical product and Dougal is submitting the device for approval by the NHS.
No side-effects have been reported, although a small number of people are allergic to the plastic holder and some patients feel a tingling during the treatment. Many of his patients, such as his daughter, have not suffered from cold sores since the treatment.
Although it could still be some time before the Virulite CS hits the pharmacy shelves, if and when it does, sufferers could be chucking away their creams, and making light work of their cold sores.
The Virulite CS costs £45 and is available by mail order from www.vcs.eu.com
What is it?
For more information on cold sores, contact the Herpes Viruses Association www.hva.org.uk; 0845 1232305 WHAT’S THE EVIDENCE? DR TOBY MURCOTT
Does it work? The evidence from the one published clinical trial suggests that it does. The study was double blind and randomised — the gold standard for this type of research — and the results were statistically significant. But this is only one study and Dr Michael Clark, a scientist specialising in radiation at the Health Protection Agency, says that it’s too much to claim that the treatment is medically proven on this basis. Typically, many studies involving thousands of patients are needed to establish a treatment’s effectiveness.
Is there other evidence that it might work? A German study published in 1989 suggests that shining infra-red lasers on herpes-infected cells in a test tube did reduce the amount of virus. A separate clinical trial of 50 patients, conducted in 1999 at the University of Vienna, found that low-intensity infra-red laser treatment reduced significantly the recurrence of cold sores. Once again, though, they were small studies and cannot be considered conclusive. However, the Virulite is not an infra-red laser and the two may not be related.
How can infra-red light do this? That’s not clear yet, but the idea is that it stimulates the immune system. There is also some evidence that infra-red lasers encourage wound healing. At least one NHS registered trial is under way looking at this effect.
Is it safe? The amount of infra-red it produces is extremely small. Dr Clark thinks that it is unlikely that infra-red radiation at these levels could do any harm, but people should seek advice from their doctors before embarking on new treatments.
Will it be available on the NHS? Once a medical device has its CE mark (as this does) it is approved for sale within Europe. For it to be available on the NHS it needs to be approved by the Prescriptions Pricing Authority. The PPA is not concerned with whether something works but only with details of supply and pricing. Virulite could be available on prescription if the PPA approves it.
Dr Toby Murcott is a former BBC science correspondent
