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What Meds Treat and Prevent Shingles?

Medically Reviewed by Neha Pathak, MD on August 11, 2021

The virus that causes chickenpox is also what causes shingles. It’s called varicella zoster. It can lie quietly in your nerves for decades after causing chickenpox but suddenly wake up and become active.

The main symptom of shingles is a painful rash that comes up on one side of your body or face. See your doctor as soon as you can if you think you might have this condition.

Your doctor may want to put you on medications to control your infection and speed up healing, cut inflammation, and ease your pain. They include:

Antiviral Medications

These medicines may slow down the progress of the shingles rash, especially if you take them within the first 72 hours of having symptoms.

They can also lower your chance of having complications. Your doctor may prescribe:

Talk with your doctor or pharmacist about side effects to watch for if you’re put on one of these drugs.

Painkillers

Shingles causes inflammation and pain. Your doctor can suggest over-the-counter medicines to relieve milder discomfort. They include:

These may also help you stave off postherpetic neuralgia, which is a burning pain that some people get after the rash and blisters of shingles go away.

Other Medications

If you have severe pain after the rash clears or an infection during your shingles outbreak, your doctor might prescribe:

Capsaicin cream: Be careful not to get it in your eyes.

A numbing medicine: You might get lidocaine (Lidoderm, Xylocaine) for pain. It can come in a variety of forms, such as creams, lotions, patches, powders, and sprays, among others.

Antibiotics: You might need these medicines if bacteria infect your skin and rashes. But if bacteria aren’t involved, then antibiotics won’t help.

Tricyclic antidepressants: There are many of these medications that might help ease the pain that lingers after your skin has healed, such as amitriptyline, desipramine (Norpramin), and nortriptyline (Pamelor). They may also help you with depression, if you have that in addition to shingles. Your doctor can tell you what the risks and benefits are.

Are There Alternative Treatments?

Some studies show that various alternative treatments, from acupuncture to supplements, can offer relief. The research isn’t complete, but some shows promise. Check with your doctor before you try any of these: 

TENS (transcutaneous electrical nerve stimulation). This therapy uses tiny electrical pulses to relieve pain. A TENS unit is about the size of a smartphone and comes with small patches called electrodes. You put them over the painful area and turn the unit on and off as your pain comes and goes. 

Traditional Chinese medicine: These treatments aim to restore balance in your body. They include acupuncture, the ancient practice of inserting very thin needles into your skin at specific points. Also, moxibustion and cupping, two types of heat therapy, are supposed to draw out toxins. These treatments may be done in combination.

Creams and other skin treatments: A mixture of liquid dimethyl sulfoxide (DMSO) and idoxuridine, an antiviral drug, may reduce swelling and the number of blisters you have when you put it on your rash. And chlorophyll, the chemical that gives plants their green color, is also used directly on the rash as a cream or saline solution. 

Supplements: You’ll find a long list of herbs, pills, and oils that claim to relieve shingles. Most have no research to back them up, but there are a couple of exceptions. Papain, a protein found in papayas, is sold in capsules. And manuka and clover honeys can be put directly on your skin. Very early studies on both show they may be helpful. 

Home Care

There aren’t home remedies for shingles. But there are things you can do to help your skin heal.

Keep the affected area clean, dry, and exposed to air as much as possible.

The itching can be maddening at times, but try not to scratch or burst the blisters.

Can I Prevent Shingles?

There are two shingles vaccines. Shingrix (RZV) is recommended over the older vaccine, Zostavax, because it is more than 90% effective in preventing a shingles outbreak

Who should get it: The CDC recommends that you get this vaccine if you’re a healthy adult age 50 or older, whether or not you remember having had chickenpox, because most people have been exposed to the virus. If you have had the Zostavax vaccine, you can also have Shingrix.

How many shots do you need? You would need two shots for Shingrix: One at first, with a follow-up in 2 to 6 months.

What it does:Shingrix reduces your chance of getting shingles by more than 90%. Even if you still get shingles, the vaccine may help it be less painful.

I never had chickenpox. Do I still need the shingles vaccine? Yes, you do. Shingrix is recommended for everyone age 50 or older, whether or not you remember having had chickenpox.

If I’ve had shingles, can I still get the vaccine? Yes. It may help prevent you having another bout of shingles later on. If you have shingles right now, you should wait until the rash is gone before you get vaccinated.

What are the side effects? The most common side effects with Shingrix include pain and swelling where you got the shot, muscle pain, tiredness, headache, chills, fever, and stomach troubles. With any vaccine, there is a chance of a severe allergic reaction. Also, since Zostavax is a live virus vaccine, it is also possible to get a small chickenpox-like rash around the spot where you got the shot.

Don’t get the Shingrix vaccine if you:

  • Are allergic to any of the ingredients
  • Are pregnant or nursing
  • Have tested negative for immunity to the chickenpox virus. Ask your doctor about the chickenpox vaccine instead.
  • Have shingles now

 

Who Shouldn’t Get the Shingles Vaccine?

Don’t get the Shingrix vaccine if:

  • You’re allergic to any of the ingredients.
  • You’re pregnant or nursing.
  • You have tested negative for immunity to the chickenpox virus. Ask your doctor about the chickenpox vaccine instead.
  • You have shingles now.
WebMD Medical Reference

Sources

SOURCES:

National Institute of Neurological Disorders and Stroke: "Shingles. Seek Early Treatment," “Shingles: Hope Through Research.”

Mayo Clinic Health Letter, June 2002.

The New England Journal of Medicine: “A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults.”

Drug Safety: “Tolerability of Treatments for Postherpetic Neuralgia.”

WebMD Health News: "Shingles Vaccine to Be Routine at 60."

FDA: "FDA Licenses New Vaccine to Reduce Older Americans' Risk of Shingles."

Vaccines.Gov: “Shingles (Herpes Zoster).”

CDC: “What Everyone Should Know About Shingles Vaccine.”

Mayo Clinic: “Acupuncture," “Fibromyalgia,” “Shingles.”

National Health Service (NHS): “Shingles.”

PubMed: “In vitro antiviral activity of honey against varicella zoster virus (VZV): A translational medicine study for potential remedy for shingles,” “Medical use of dimethyl sulfoxide (DMSO),” “TENS -- an alternative to antiviral drugs for acute herpes zoster treatment and postherpetic neuralgia prevention,” “Wet cupping therapy for treatment of herpes zoster: a systematic review of randomized controlled trials.”

Columbia Neurosurgeons: “Postherpetic Neuralgia.”

University of Minnesota, Center for Spirituality and Healing: “Moxibustion,” "What is Qi? (and Other Concepts).”

Beth Israel University Hospital and Manhattan Campus for the Albert Einstein College of Medicine: “Post-Herpetic Neuralgia.”

Natural Medicines Comprehensive Database: “Chlorophyll,” “Cupping,” “DMSO (Dimethylsulfoxide),” “Light Therapy,” “Moxibustion,” “Papain.”

National Eczema Association: “Phototherapy.”

Encyclopedia Britannica: “Papain.”

Oxford Journals: “Rheumatology: A brief history of acupuncture.”

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