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Harvard Medical School Guides delivers compact, practical information on important health concerns. These publications are smaller in scope than our Special Health Reports, but they are written in the same clear, easy-to-understand language, and they provide the authoritative health advice you expect from Harvard Health Publishing.
- Where does shingles come from?
- Who gets shingles?
- Causes of immune system suppression
- Symptoms of shingles
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Look For A Lidocaine Patch
Lidocaine is an anesthetic agent that temporarily numbs the area where it’s applied, which can help with PHN pain. With significant postherpetic neuralgia, I find that the topical lidocaine patch is usually the most useful, says Camille Kotton, M.D., clinical director of transplant and immunocompromised host infectious diseases at Massachusetts General Hospital in Boston. Lidocaine is available as a prescription or OTC, though Dr. Kotton notes it can be difficult to get covered by insurance.
Can Shingles Be Prevented Or Avoided
The best way to prevent shingles is through vaccination. Vaccinate your children for chickenpox. This vaccine reduces their risk for getting chickenpox. You cant get shingles unless youve had chickenpox first.
When you are older, get the shingles vaccine. It is recommended for adults 50 years of age and older. It can prevent shingles. People who have had shingles should get the vaccine to help stop the disease from reoccurring. Common side effects of the vaccine are headache, plus redness, swelling, itching, and soreness at the injection site.
The shingles vaccine is not recommended for anyone who:
- Has had an allergic reaction to gelatin or the antibiotic neomycin
- Has an allergy to any component of the shingles vaccine
- Has a weakened immune system due to conditions such as leukemia, HIV, or AIDS
- Is receiving treatment for cancer
- Is being treated with drugs that suppress their immune system, including high-dose steroids
- Is pregnant or might become pregnant within 4 weeks of getting the vaccine
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Can I Prevent Shingles
There are two shingles vaccines. Shingrix 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 youâre 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 Iâve 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.
Donât 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
How Is Postherpetic Neuralgia Treated
If shingles is caught within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir , valacyclovir or famciclovir . These medications help the rash/blisters heal faster, keep new sores from forming, decrease pain and itching and reduce length of pain after sores have healed.
If your shingles outbreak is not caught early, your healthcare providers has many options to manage your postherpetic neuralgia symptoms.
If your pain is mild, your healthcare provider may recommend:
- Acetaminophen or NSAIDs such as ibuprofen .
- Creams and patches include lidocaine and capsaicin .
If your pain is more severe, your healthcare may prescribe:
- Antiseizure drugs gabapentin and pregabalin .
- Antidepressants, such as escitalopram , quetiapine or amitriptyline.
- Botulinum toxin injections in the area where you are having pain.
Theres no clear-cut superior treatment for PHN. Your provider may need to try more than one medication or prescribe the use of several medications at the same time. You and your provider will discuss options and what makes sense to try for you. Contact your provider if your pain is not lessening after taking your medicine. Take all your medications exactly as prescribed.
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Listerine To Ease Shingles Pain:
Q. I have an unemployed friend who has no health insurance. He had an outbreak of shingles on the right side of his face that made his ear and jaw ache. The shingles was developing into a raw area.
I read your newsletter and website. In researching shingles I came across a one-paragraph mention of using Listerine on shingles. We thought this sounded logical and he tried it.
After only 72 hours of applying the Listerine three times daily, the results are pretty remarkable. The sores have dried up and are scabbing over, his pain is almost gone and he is healing nicely. This really worked in his case.
Treatment Of Pain After Shingles
Treatment for people with PHN may include:
- Nerve blocks: Local anesthetic or alcohol injected directly into the nerve affected
- Thoracic epidural injections: Local injection in the space around the spinal cord
- Antidepressant medications: Such as amitriptyline
- Membrane stabilizers: Such as gabapentin
- Capsaicinapplication: Topical cream applied to the affected area
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What Are The Symptoms Of Shingles
Usually, shingles develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline.
Most people with shingles have one or more of the following symptoms:
- Fluid-filled blisters
- Tingling, itching, or numbness of the skin
- Chills, fever, headache, or upset stomach
For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. Its important to talk with your doctor if you notice any shingles symptoms.
If you notice blisters on your face, see your doctor right away because this is an urgent problem. Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain can also occur.
How Is Shingles Treated
Specific treatment for shingles will be determined by your healthcare provider based on:
- Your age, overall health, and medical history
- How long the shingles have been present
- Extent of the condition
- Your tolerance for specific medicines, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
There is no cure for shingles. It simply has to run its course. Treatment focuses on pain relief. Painkillers may help relieve some of the pain. Antiviral drugs may help lessen some of the symptoms and reduce nerve damage. Other treatments may include:
- Creams or lotions to help relieve itching
- Cool compresses applied to affected skin areas
- Antiviral medicines
- Anticonvulsants
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Eutectic Mixture Of Local Anesthetics Cream
EMLA cream is a prescription medication made up of a 1-to-1 ratio of 2.5 percent lidocaine and 2.5 percent prilocaine.
A 2018 case study of one person found that EMLA cream may make an effective alternative to lidocaine cream for treating PHN in people with special situations like kidney failure. However, theres not much available research about its effectiveness. Most existing research is from the 1980s and 90s.
A doctor can give you specific instructions on how to use EMLA cream.
Using Apple Cider Vinegar For Shingles
Several home remedy recipes online for relieving shingles pain using ACV can be found online.
Some popular options include applying ACV directly to the shingles rash, usually in combination with other ingredients like honey, or taking a bath that contains a small amount of ACV in the bathwater.
Reportedly, ACV can help relieve some of the painful stinging and itching of the shingles rash, as well as potentially help cleanse the rash and kill Herpes zoster, the virus that causes it.
Although some evidence suggests that ACV is antiviral, theres no proof that it can help kill Herpes zoster by applying it to your skin .
Additionally, theres no scientific evidence that ACV applied topically helps relieve pain or itching. However, this doesnt mean that it wont work for you.
Summary
ACV is sometimes used as a home remedy for pain caused by the shingles rash. Although it may work for some people, theres no scientific evidence to support its use.
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What Is Shingles And Postherpetic Neuralgia
Shingles is caused by the varicella-zoster virus, the virus that also causes chickenpox. In a person who has been exposed to chickenpox or its vaccine the virus never really goes away. It can lie dormant in the bodys nerves.
In most cases, it stays that way. But in some especially people with immune systems weakened by disease or treatment the virus can reappear. This is likely to happen years or decades after the person had chickenpox.
When it comes back, the virus can cause shingles, a rash that often appears as a band on one side of the body. Early shingles symptoms can include:
- Flu-like symptoms
Itching, tingling, or extreme pain where the rash is developing may come next, and the pain can be moderate to severe.
Are you contagious? Though people who havent had chickenpox can catch that condition from you, the shingles itself isnt contagious.
For reasons that experts dont really understand, the pain of shingles lingers for some. If the pain lasts for at least 3 months after the shingles rash has healed, a person is diagnosed with PHN. In some people, the pain will subside. In others, it wont.
We dont have any idea why the pain goes away in some people and not others, says Dworkin. But the longer you have PHN especially after a year the less likely it is to resolve, he says.
Treatment For Shingles Rash And Pain
Medications and lifestyle changes can provide relief.
Despite the availability of a highly effective vaccine, an estimated 1 million Americans develop shingles each year.1 Early diagnosis and treatment are key to limiting the severity of the outbreak as well as its associated complications, including nerve damage. There are also simple at-home remedies that can help patients stay as comfortable as possible.
Antiviral medications should be started within 72 hours of the first shingles symptoms. The three antivirals most often prescribed are acyclovir, valacyclovir, and famciclovir. They help the shingles rash crust over, dry up, and heal, shortening the course of the infection.
Pain is a major factor with shingles. Patients can consult with their health care provider on over-the-counter and prescription options to manage it. Nonsteroidal anti-inflammatory drugs like ibuprofen, naproxen, and acetaminophen can be effective, while prescription glucocorticoids such as prednisone can help with more aggressive pain. Short-term usage of opioid pain medicationlike oxycodone or hydrocodone/acetaminophen is reserved for the highest levels of pain.
Shingles typically lasts between 2 and 6 weeks patients are usually confined to their home for the duration both for their own comfort and to prevent spreading the virus to others. There are a number of simple steps they can take to promote healing and increase their comfort level.
References
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Apply A Baking Soda Solution To Relieve Irritated Skin
Another common remedy for itching thats easily available at home is baking soda. Add a little baking soda to a glass of water and apply the solution to relieve irritated skin. You can also try adding some baking soda to your bath water.15 Although its not clear how exactly baking soda works, its alkaline nature is supposed to be at work here.
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How To Cure Shingles In 3 Days
If you want to cure your shingles quickly without much so much struggle, you must activate your body to fight the virus varicella Zoster in the below discussed two ways:
- Use anti-itching and anti-inflammatory medications such as lotions and creams outside the skin this will facilitate healing from outside the skin.
- Make regular consumption of essential nutrients such as minerals, vitamins, and enzyme supplements that will help to strengthen your bodys immune system. A strong body immune system will be able to destroy the shingles virus varicella-zoster.
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I Think I Have Shingles What Should I Do
Repeat after me: Call your doctor right away, within 72 hours. The earlier the better.
You should start taking an antiviral medication, preferably valacyclovir or famciclovir, within 72 hours of your symptoms starting to help reduce the severity of the infection, how long your skin rash lasts, and how painful it gets. If its been more than 72 hours, you should still talk to your provider. Treatment can still help, especially if you still see new rashes showing up.
Is There A Cure For Shingles
There is no known vaccine to treat people infected with shingles. However, there is a live zoster vaccine to help prevent shingles. The live zoster vaccine, which is being marketed under the name Zostavax was approved in the year 2006 by the U.S Food and Drug Administration.
The vaccine is recommended for both young adults and elderly people below the age of 60 years and is supposed to be administered whether a person has been infected by shingles before or not.
In several clinical trials and study cases, the vaccine has been found to reduce the chances of shingles infection by half, especially in reducing the risks of postherpetic pain that ceases to go away after shingles has disappeared.
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When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
These Home Remedies Should Provide Relief During A Case Of Shingles
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Anyone who had chickenpox as a kid remembers the red, painfully itchy blister-like rash, and perhaps the fever and fatigue that came along with it. But even though it’s true you’re now inoculated against chickenpox for life, there’s one pox-related complication you may not have considered: Shingles.
Shingles is a reactivation of the chickenpox virus , and causes a painful, itchy rash in one place on the body. Shingles is most common in adults over 50 years of age in fact, about half of people over age 80 may experience it.
Shingles often begin as pain and itching in the skin before a red rash appears one to two days later, with small, water-filled blisters. These blisters soon rupture and scar over, healing and fading over the course of a few weeks. This process can be extremely uncomfortable and painful, making even the littlest actions difficult.
Here’s how to minimize discomfort and pain with stuff you probably already have at home:
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How Can This Pain Be Managed
If your doctor is able to identify an underlying cause for the neuropathic pain, treating it may reduce and even eliminate the pain.
For example, diabetes is a common cause of neuropathic pain. Proper diabetes care which includes a healthy diet and regular exercise may eliminate or reduce neuropathic pain.
Taking care of blood sugar levels can also prevent worsening pain and numbness.
How Long Does Nerve Pain Last After Shingles
Only approximately 9-15% of patients who get shingles develop Postherpetic Neuralgia. For those few patients who develop PHN, the length of time that it lasts usually varies. The majority of PHN patients have discomfort that lasts one to two months. About one-third of Postherpetic Neuralgia patients have symptoms that last around three months, and about one-fifth have symptoms that last a year or longer. Researchers are unsure what triggers the herpes zoster virus to re-emerge even after years of lying dormant. The virus may be obtained during youth, but it does not flare into shingles until years down the line. When the pain of shingles lingers long after the rash heals, it is considered Postherpetic Neuralgia. The bout of shingles damages the nerves. This means that the nerve damage caused by shingles affects a fully functioning nervous system. The damaged nerve will send random pain signals to the brain, which thereby causes a burning, throbbing sensation. Over time, the nerves of the skin calm, but due to the existing nerve damage, the pain can persist for years, even for the rest of the persons lifetime.
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