What is the treatment for shingles?
There are several effective treatments for shingles. Drugs that fight viruses (antivirals), such as acyclovir (Zovirax) or famciclovir (Famvir) can reduce the duration of the rash if started early (within 48 hours of the appearance of the rash). The addition of steroids may also limit the length of time that a patient has pain with shingles. However, the benefit of both of
these drugs is limited.
In most people, shingles goes away on its own after it has run its course, and requires no treatment. However, your doctor may prescribe antiviral drugs to shorten the length of the infection, especially if you have a weakened immune system. Antiviral drugs are also used to prevent post-herpetic neuralgia, especially in people older than 50. Most people will find pain relief with acetaminophen or other over-the-counter pain medicines, as well as cool compresses on the affected area. More severe pain may be relieved by prescription pain medications. It's important to keep your skin clean so you don't develop any other types of infections in the blistered area. Your doctor might also prescribe some type of antibacterial ointment to help prevent infection. Severe infections, such as those involving the eyes, may be treated with corticosteroids drugs as well as antiviral therapy. Post-herpetic neuralgia is treated with tranquilizers, sedatives, or antidepressants that are taken at night. During an outbreak of shingles, as with any illness, it's important to get plenty of rest, follow a health diet, and reduce stress levels. Some people believe it's beneficial to boost the immune system with additional supplements of vitamins B12 and B complex, and C, as well as calcium. It's important to follow your doctor's recommendations for safe levels of vitamin supplements.
Pain medications can also offer relief. For mild to moderate pain, acetaminophen (Tylenol) or over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil), naproxen (Aleve), and ketoprofen (Orudis KT) can be effective. For moderate to severe pain, more powerful pain killers may be needed, such as prescription NSAIDs or narcotic analgesics. Corticosteroids (for example, prednisone, methylprednisolone, cortisone, and hydrocortisone) are also sometimes prescribed to reduce the pain, discomfort, inflammation, redness, and itching associated with the rash and blisters.
For postherpetic neuralgia (PHN), medications for nerve pain may be needed. These include anti-seizure drugs such as gabapentin (Neurontin), carbamazepine (Tegretol), and phenytoin (Dilantin); antidepressants such as amitriptyline (Elavil), nortriptyline (Pamelor), desipramine (Norpramine), and doxepin (Adapine); a lidocaine patch 5% (Lidoderm); or capsaicin cream (Dolorac, Trixaicin, Zostrix, Zostrix-HP).
In addition to antiviral medication, pain medications may be needed for symptom control. The affected area should be kept covered and dry. However, bathing is permitted and the area can be cleansed with soap and water. An aluminum acetate solution (Burows or Domeboro's solution, available at your pharmacy) can be used to help dry up the blisters and oozing.
Post-herpetic neuralgia may be difficult to treat successfully. It may respond to tricyclic antidepressant medications such as amitriptyline or anti-epileptic medication such as carbamazepine or sodium valproate. For ophthalmic herpes zoster, antivirals are used to fight the varicella zoster virus and prevent it from spreading to a larger area of the face and the eye. Other treatments include pain medicines, corticosteroids, and cool compresses. If you think you might have ophthalmic shingles, it is extremely important that you consult your primary doctor or an ophthalmologist immediately for treatment and advice to prevent permanent eye damage.