Best Treatments For Lasting Shingles Pain
Postherpetic Neuralgia Pain: What Works, What Doesn’t
Doctors call it postherpetic neuralgia or PHN. It’s caused by nerve damage left behind by a case of shingles. Shingles itself comes from reactivation of a chickenpox virus, varicella zoster. The virus travels down nerve fibers to cause a painful skin rash.
When the rash goes away, the pain usually goes with it. But for 12% to 15% of people the pain remains. If your shingles pain lasts eight to 12 weeks after the rash goes away, you’re part of an “unfortunate minority,” says pain researcher Andrew S.C. Rice, MD, of Imperial College, London.
“Among people with PHN, some have their pain resolve in the first year to 18 months after the shingles rash goes away,” Rice tells WebMD. “But if they have pain longer than that, it is not going to go away on its own. In either case, a person must deal with the pain.”
Shingles And Your Eyes
If the shingles rash breaks out on the face, near the eye, the vision may be affected. An ophthalmologist should be consulted right away when pain or other symptoms of shingles affect the eye or the area near the eye.
Shingles painand other symptoms from an outbreak of herpes zosterusually lasts between three to five weeks. Most people experience shingles once, but in some instances, people will continue to experience pain. When this happens, its called postherpetic neuralgia .
How Is Shingles Treated
Shingles cannot be cured. The following medicines can decrease your pain and help prevent complications:
- Antiviral medicine fights the virus causing your shingles. Start this medicine within 3 days after you notice the first symptoms. This may help prevent nerve pain. A shingles outbreak can cause nerve pain called post-herpetic neuralgia . PHN can last a long time after you heal from shingles.
- Topical anesthetics are used to numb the skin and decrease pain. They can be a cream, gel, spray, or patch.
- Anticonvulsants and antidepressants decrease nerve pain and may help you sleep at night.
- Antihistamines may help decrease itching.
- Acetaminophen decreases pain and fever. It is available without a doctor’s order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor’s order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
- A steroid and numbing medicine injection may decrease severe pain that does not get better with other medicines.
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Before Taking This Medicine
You should not use gabapentin if you are allergic to it.
To make sure gabapentin is safe for you, tell your doctor if you have ever had:
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heart disease or
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if you are a day sleeper or work a night shift.
Some people have thoughts about suicide while taking this medicine. Children taking gabapentin may have behavior changes. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Seizure control is very important during pregnancy, and having a seizure could harm both mother and baby. Do not start or stop taking gabapentin for seizures without your doctor’s advice, and tell your doctor right away if you become pregnant.
If you are pregnant, your name may be listed on a pregnancy registry to track the effects of gabapentin on the baby.
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
What To Do If You Think You Have Shingles
If you suspect that you have shingles, its important to visit a healthcare professional as soon as possible. According to the American Academy of Dermatology , treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain.
Antiviral medications or other medications only available by prescription can shorten the duration of your shingles or lessen the severity.
If a cream or other topical isnt reducing your pain, its a good idea to visit your doctor again. They may recommend trying another treatment like capsaicin cream instead of lidocaine.
If a product is making your symptoms worse, its important to stop taking it right away.
You may be able to reduce your symptoms using home remedies while youre waiting to see a healthcare professional. These include applying a wet cold compress or taking a cool bath.
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How Should I Take Gabapentin
Take gabapentin exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take in larger or smaller amounts or for longer than recommended.
If your doctor changes your brand, strength, or type of gabapentin, your dosage needs may change. Ask your pharmacist if you have any questions about the new kind of gabapentin you receive at the pharmacy.
Both Gralise and Horizant should be taken with food.
Neurontin can be taken with or without food.
If you break a Neurontin tablet and take only half of it, take the other half at your next dose. Any tablet that has been broken should be used as soon as possible or within a few days.
Swallow the capsule or tablet whole and do not crush, chew, break, or open it.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device .
Do not stop taking this medicine suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.
In case of emergency, wear or carry medical identification to let others know you have seizures.
This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using gabapentin.
Store both the tablets and capsules at room temperature away from light and moisture.
Store the liquid medicine in the refrigerator. Do not freeze.
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
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Liquid Dimethyl Sulfoxide And Idoxuridine
Idoxuridine is an antiviral medication approved in Europe for treating shingles.
One 2015 publication suggested frequent application of 5 to 40 percent idoxuridine dissolved in DMSO may speed up the healing time of shingles. However, in the United States, idoxuridine is only FDA-approved to treat keratitis, a herpes simplex virus infection of the cornea of your eye.
Treating The Pain Of Phn
Exactly how best to deal with the pain is a difficult question. Rice led a research team that looked at 35 clinical trials of various treatments. The findings appear in the July issue of the free-access online journal PloS Medicine.
“The most important thing to realize is these are painkillers,” Rice says. “You are treating the pain, not the disease itself. And this is due to permanent nerve damage. It is like a stroke. We can’t make the nerve damage better, but we can treat the disability. And for PHN, pain is one of those disabilities.”
What helps? Rice’s team found good evidence supporting:
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Get Shingles Treatment Online
Speak to a board-certified doctor securely from your phone or computer and get medication for shingles in 15 minutes. Shingles, also known as herpes zoster, is a viral infection that causes a painful rash. Although shingles can appear anywhere on the body, it most often is a single stripe of blisters that wraps around the left or right side of your torso. With our same-day treatment service, you can meet with a top online doctor, get diagnosed, and receive the medication you need.
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.
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Can I Give Shingles To Others
No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:
- Anyone who has never had chickenpox
- Babies under 12 months old
- Very sick people
Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.
When To Contact A Doctor
Its important to visit your doctor as soon as possible if you suspect you have shingles, especially if youre somebody at an increased risk of developing it.
The American Academy of Dermatology recommends visiting a dermatologist or other healthcare professional within 3 days to prevent long-term complications.
Shingles typically clears up within a few weeks and does not commonly recur. If your symptoms have not lessened within 10 days, contact a doctor for a follow-up and reevaluation.
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What Brings On An Attack Of Shingles
Its difficult to predict when a shingles episode might happen again. However, there are some risk factors you should consider.
- Unhealthy lifestyle
- Acute on chronic stress
The first risk factor is age. If you are above the age of 50, ask your doctor about the shingles vaccine. In addition to being an effective shingles treatment, this vaccine is used to prevent shingles.
The second risk factor of shingles is immunity. If your immune system is weakened by illness or medication, you are at risk for contracting shingles or experiencing another shingles episode. Fortunately, you can naturally strengthen your immune system with the right diet and vitamins.
Citrus fruits, green vegetables, organic meat, eggs, whole grains, and dairy products are all part of a healthy diet. You should avoid sugar, refined carbohydrates, saturated fat, and arginine-rich foods, like nuts and seeds.
Additionally, take a multivitamin that includes vitamin A, B-12, C, and E. The amino acid lysine is also protective against infection. Many people over the age of 60 are deficient in zinc, selenium, and vitamin D. You may need to incorporate these supplements into your daily routine as well. Ask your healthcare provider for recommendations as to which vitamins and supplements you need.
How Is Shingles Diagnosed
Schedule an appointment with your primary care provider or urgent care facility if you experience any symptoms of shingles . You may require immediate medical attention if shingles develops in the eye, if it is widespread across the body, if youre 60 years old or older, or if you have a weakened immune system from another chronic illness. Consider contacting an ophthalmologist for urgent care as you may be able to get an appointment sooner.
Your primary care provider can diagnose shingles. However, if symptoms appear in the eye, then you might need to see an ophthalmologist.
Shingles can usually be diagnosed with a simple physical exam, as symptoms are usually distinctive. However, if your symptoms are atypical, your doctor may send a tissue scraping or culture from the blisters to the lab for testing. Blood, cerebrospinal fluid, or saliva tests may be necessary if you have nerve pain without a skin rash.
Your healthcare provider may also ask the following questions to help confirm the diagnosis:
- Have you had chickenpox before?
- Are you over the age of 60?
- Have you had the shingles vaccine?
- Are you stressed?
- Do you have a chronic illness or are you taking medications that could weaken your immune system?
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Whats The Difference Between Cream Lotion And Ointment
Ointments, lotions, and creams are three types of substances you can apply to your skin to help manage shingles.
These topicals are similar, but there are slight differences in their makeup. The primary difference is the amount of water and oil they contain.
According to this 2016 primer, creams are made up of about equal parts oil and water and often have moisturizing properties. Theyre thicker than lotions but thinner than ointments.
Lotions are similar to creams, but they are made up mostly of water. They have less oil and have a thinner consistency. Because theyre thinner, your skin absorbs them more quickly. Some lotions are oil-free.
Ointments are the thickest of the three. They are made to stay on top of your skin instead of being absorbed immediately. Ointments are made up of at least 80 percent oil.
Are There Alternative Treatments
Some studies show that various alternative treatments, from acupuncture to supplements, can offer relief. The research isnât complete, but some shows promise. Check with your doctor before you try any of these:
TENS . 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 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: Youâll 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.
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Lidocaine Cream And Patches
2017 study suggests that its one of the best-tolerated treatments for PHN.
PHN is a complication of shingles characterized by long-term nerve pain after your rash disappears. The CDC says that about 10 to 18 percent of people experience PHN after shingles.
Lidocaine is often administered in patches. The study linked above notes that up to 3 patches can be applied in a 12-hour window.
How Does Shingles Spread
Someone with shingles can pass the virus to someone who hasnt had chickenpox or shingles before. That person is likely to contract chickenpox first. Then, the virus may reactivate later with symptoms of shingles.
The virus cannot be passed to someone who has already had chickenpox because they already have the virus. If they experience shingles, its because they already had the virusnot because they came into contact with you.
You can go to work, school, and other public places with shingles as long as youre otherwise healthy. However, you should take precautions and keep the shingles rash covered, regularly wash your hands, and avoid at-risk people. Infants, children, pregnant women, and people with weak immune systems are at higher risk for contracting a virus, like shingles, than other people.
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Home Remedies And Lifestyle
In addition to triggering an uncomfortable rash, shingles can cause symptoms that are similar to those of other viral infections.
While prescription and over-the-counter drugs can help, one of the most important things you can do while dealing with the illness is to take good care of yourself. If you’re caring for someone else who has shingles, “creature comforts” can be enormously soothing.
Verywell / Laura Porter
Integrate these basic tactics into even the busiest daily routine: