What You Need to Know About Shingles Treatment

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Shingles, also known as herpes zoster, is a viral infection that causes a painful, itchy, blistering rash as well as other symptoms such as fever, headache, and stomach upset.

Shingles is caused by the varicella-zoster virus (VZV), which is also responsible for chickenpox. You may develop shingles if you have had chickenpox or received the chickenpox vaccine. After you recover from chickenpox, the virus travels to nerves in your body, where it remains dormant. Shingles are caused when VZV reactivates.

There is no treatment for shingles. There are, however, medications that can help prevent shingles, alleviate symptoms, shorten the duration of the disease, and reduce the risk of complications.

Why Early Treatment Is Important

Because shingles can spread to various parts of the body, they can occasionally cause serious health complications if left untreated.

Postherpetic neuralgia (PHN), a type of long-term nerve pain that lasts more than three months, is the most common complication of shingles. PHN affects about one in every five people who have shingles, and it is most common in people over the age of 50.

Other less common shingles complications include vision or hearing loss, pneumonia, and brain inflammation.

Medications for Treating Shingles

Treatments for shingles aim to alleviate symptoms and prevent the rash from spreading further. Antivirals, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids are among the treatments available.

Antivirals

Antiviral medications work by preventing the virus from multiplying in your body. This speeds up the healing process and reduces the severity and duration of pain. If you suspect you have shingles, it's critical to get diagnosed as soon as possible because antiviral medications work best if started within 72 hours of the rash appearing.

Antiviral treatment, in addition to shortening the duration of shingles, can cut your risk of developing PHN in half.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Over-the-counter NSAIDs such as Advil (ibuprofen), Aleve (naproxen), and Tylenol may be recommended by your healthcare provider for mild shingles pain (acetaminophen). Stomach ulcers and high blood pressure are common side effects. Consult your doctor before taking an NSAID if you have a kidney condition.

Opioids 

Opioids may be prescribed by your healthcare provider for severe shingles pain and PHN. Over 25% of people with shingles received opioid prescriptions, according to a 2022 study of U.S. health insurance data. Opioids were more likely to be prescribed to people with immunocompromised status, PHN, or multiple health comorbidities.

At-Home Remedies 

Along with shingles medication, common at-home treatments for shingles include wet compresses and calamine lotion.

Wet Compresses

Applying a cool, damp washcloth as a compress to your shingles rash may help relieve pain. You can use a cool compress for five to ten minutes at a time throughout the day. Always use a clean washcloth each time.

Calamine Lotion

Calamine lotion has traditionally been used to relieve itchy skin caused by insect bites, poison ivy, and eczema. This lotion may also help with shingles itching. To begin using this product, wait until the blisters on your rash have scabbed over. To avoid infection, wash your hands before and after applying calamine lotion.

Medications for Postherpetic Neuralgia (PHN) –

The primary goal of PHN treatment is to alleviate pain. However, because the symptoms of PHN are caused by nerve pain, the medications used to treat it may differ from those you are used to.

Anti-seizure Medications

Pain management for PHN frequently begins with a prescription for an anticonvulsant, also known as an anti-seizure medication. Gabapentin, sold under the brand names Neurontin and Gralise, and Horizant are two examples of anticonvulsants used to treat PHN-related nerve pain (gabapentin enacarbil). Lyrica (pregabalin) is another anticonvulsant that is commonly used to treat PHN.

Tricyclic Antidepressants

Tricyclic antidepressants (TCAs) are a type of medication used to treat depression that can also be used to treat PHN pain. TCAs are typically prescribed at lower doses for PHN than they are for treating depression.

It may take three weeks or longer to notice a difference in your pain if you are taking a TCA. This is because these drugs are frequently started at a very low dose and gradually increased.

Topicals

There are topical medications that can be applied to the skin to help relieve the pain associated with PHN. Capsaicin, a chemical compound found in chili peppers, for example, can be used to treat pain; however, approximately one-third of people may be unable to tolerate the burning and stinging side effects of capsaicin application to the skin.