Understanding Shingles - Treatment

What Are the Treatments for Shingles?

Although you can take steps to shorten the duration of a shingles outbreak, the virus must often simply run its course. Postherpetic neuralgia is difficult to manage and can last months or even years, in rare cases. So the best approach is early and immediate treatment. Also, early medical attention may prevent or reduce the scarring that shingles can cause.

Conventional Medicine

Your doctor may suggest medications to reduce inflammation, ease pain, and control the infection. These are examples of medications you may use:

• Painkillers, such as aspirin or acetaminophen, can relieve mild pain.
• Anti-inflammatory drugs, such as ibuprofen (Motrin) or naproxen (Aleve), are also often helpful for pain.
• Antiviral drugs, such as Acyclovir, may help stop progression of the rash, especially if used early in the course of the blister breakout. Similar drugs, such as Valtrex or Famvir, can also be used. These drugs may also help stave off the painful after-effects of shingles known as postherpetic neuralgia.
• Benzoin, available over the counter, may protect irritated skin when applied to unbroken lesions.
• Antibiotics can keep the infection under control if the area becomes infected by bacteria.
• Tricyclic antidepressants or seizure medication may be prescribed for the pain that lingers after lesions have healed. Antidepressants may also help with depression that can occur with the onset of shingles or as a result of the lingering pain.

Steroids to reduce inflammation and postherpetic neuralgia are considered controversial.

At-Home Remedies

• Keep the affected area clean, dry, and exposed to air (without clothes covering it) as much as possible. Don't scratch or burst the blisters. If the pain keeps you from sleeping, try snugly binding the area with an elastic sports bandage.
• For the first 3 or 4 days, try ice for 10 minutes on, 5 minutes off, every few hours. Later, apply cool, wet compresses soaked in aluminum acetate, available over the counter in the form of astringent solution, powder packets, or effervescent tablets.
• To desensitize nerve endings, crush 2 aspirin, mix them with 2 tablespoons rubbing alcohol, and apply the paste to the blisters 3 times a day.
• To cut down on itching, ask your pharmacist to mix 78% calamine lotion with 20% rubbing alcohol, 1% phenol, and 1% menthol. You can apply this mixture continuously until your blisters scab over.
• Other remedies for itching include frequent applications of vitamin E oil or gel from the aloe vera plant. Dusting colloidal oatmeal powder where clothes rub against your skin or taking a warm (not hot) bath with colloidal oatmeal may reduce pain.

How Can I Prevent It?

In 2006, the FDA approved a shingles vaccine called Zostavax. The shingles vaccine is now recommended for everyone age 60 and older. For this age group, the vaccine cuts the occurrence of shingles by about half. Even in those who are vaccinated and still develop shingles, the painful period is reduced. This is a great development because one out of five people who have had chickenpox will eventually get shingles.

You and your doctor may also be able to avert some of the pain that follows a shingles outbreak by using a nerve block during the acute phase of the disease. A nerve block may act as a preemptive strike against later development of postherpetic neuralgia. Administered on an outpatient basis in a hospital, it deadens pain and shrinks inflammation at the nerve root.