Combined herbal preparation for topical treatment of Herpes labialis

Forsch Komplementarmed Klass Naturheilkd. 2001 Dec;8(6):373-82. doi: 10.1159/000057255.


Background: The efficacy of many preparations for topical use in herpes infections have remained rather disappointing. The development of new antiviral drugs, especially herbal preparations, thus remains desirable. In a screening study with plant extracts, a rhubarb root extract and a sage extract showed a promising activity.

Objective: The efficacy of a combined topical preparation with rhubarb and sage extracts, of a single-agent preparation with sage extract and of a reference treatment was investigated in a double-blind, comparative, randomised trial.

Patients and methods: A total of 149 patients participated, and 145 patients (111 female, 34 male) of whom 64 received the rhubarb-sage cream, 40 the sage cream and 41 Zovirax cream could be evaluated by intention-to-treat analysis. The dried rhubarb extract (23 mg/g) is a standardised aqueous- ethanolic extract according to the German Pharmacopoeia (DAB) with 4.0-6.0% hydroxyanthracene derivatives. The dried sage extract (23 mg/g) is an aqueous extract. The reference product was Zovirax cream (Zovirax(R) Creme) with the active ingredient aciclovir (50 mg/g).

Results: The mean time to healing in all cured patients was 7.6 days with the sage cream, 6.7 days with the rhubarb-sage cream and 6.5 days with Zovirax cream. There were statistically significant differences in the course of the symptoms. For the parameter 'swelling', at the 1st followup visit there was a significant advantage for Zovirax cream compared to sage cream, and for the parameter 'pain', at the 2nd follow-up visit there was a significant difference in favour of the rhubarb-sage cream compared to the sage cream.

Conclusion: The combined topical sage-rhubarb preparation proved to be as effective as topical aciclovir cream and tended to be more active than the sage cream.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Acyclovir / administration & dosage
  • Acyclovir / therapeutic use
  • Administration, Topical
  • Adult
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use
  • Double-Blind Method
  • Drug Combinations
  • Female
  • Herpes Labialis / drug therapy*
  • Humans
  • Male
  • Phytotherapy*
  • Plant Extracts / administration & dosage
  • Plant Extracts / therapeutic use*
  • Rheum* / chemistry
  • Salvia officinalis* / chemistry
  • Treatment Outcome


  • Antiviral Agents
  • Drug Combinations
  • Plant Extracts
  • Acyclovir