Lemon Balm

Other Common Names: Balm, bee balm, Melissa balm
Latin Name: Melissa officinalis L. [Lamiaceae]
Plant Part: Leaf


The genesis of the lemon balm product Herpilyn®, indicated for
the topical treatment of herpes infections, was the discovery of antiviral
properties of the herb in a cell culture assay. The traditional use
for lemon balm is reflected in the German Commission E’s approval
of oral preparations for nervous sleeping disorders and gastrointestinal
complaints (Schulz, Hänsel, and Tyler, 2001).
A standardized preparation of lemon balm leaves is manufactured
by Lomapharm, Rudolf Lohmann GmbH KG, Emmerthal, Germany.
Lomaherpan® cream contains 1 percent of a dried aqueous extract
called Lo-701 (ratio of leaf to extract 70:1). The product in the United
States, distributed by Enzymatic Therapy under the name of
Herpilyn®, contains the same lemon balm extract, Lo-701. In addition,
it contains 1 percent allantoin, which is a monographed ingredient
for over-the-counter (OTC) fever blister medications. The product
tested in the two clinical trials reviewed here did not contain
allantoin.

We reviewed two controlled clinical studies that examined the
ability of Lomaherpan to reduce the symptoms of herpes simplex, a
viral lesion that can occur on the lips of the mouths (cold sores), on
the genitals (genital herpes), or on the skin. Herpes infections are
characterized by local outbreaks with itching followed by blisters and
inflammation, which usually heal in a few days, sometimes producing
scabs in the process. Herpes is often treated with antiviral agents
such as acyclovir, which, when given orally, can reduce virus shedding,
symptoms, and time to healing. Such agents appear to have less
benefit when given topically (Hardman et al., 1996).

Herpes simplex


Arecent study included 66 adults with a history of recurrent herpes
of the lips (orolabial herpes). The subjects were administered Lomaherpan
or placebo cream (2 mm) four times daily at the first sign of an
outbreak. Participants were monitored for five days following an outbreak,
with symptoms on day 2 being the primary end point. The
Lomaherpan cream produced a significant reduction in the symptom
score compared with placebo on day 2. However, overall symptom
scores for the five-day periods were not different for the two groups
(Koytchev, Alken, and Dundarov, 1999). Our reviewer, Dr. Richard
O’Connor, considered that the small improvement observed after two
days might not be clinically relevant.
The second placebo-controlled, double-blind study examined a total
of 116 outpatients, both children and adults, with herpes lesions on
multiple sites, including the lips, skin, and genitals. Patients were instructed
to apply cream two to four times daily to the affected site
over a maximum of ten days (on average five) until the lesion was
healed. A significant reduction in redness (rubor) and swelling was
observed on day two, but no significant difference in symptoms of
blisters, scabbing, erosion, pain, or course and extent of the lesions.
However, a significant increase in healing time compared with placebowas
seen in a subgroup of patients (67) with herpes on the lips of
the mouth (Wolbling and Leonhardt, 1994). The evidence for benefit
in this trial was weakened by poor methodological descriptions in the
report.