When Should I See My Doctor
See your doctor as soon as possible if you are experiencing any symptoms of shingles. Starting treatment with antiviral medicines within 3 days of the rash appearing should reduce the severity of symptoms and the risk of further complications, including post-herpetic neuralgia.
See your doctor straight away if you have symptoms of shingles and are experiencing the following:
- symptoms that affect your eye area
- a temperature of 38°C or higher
You should also see your doctor if you are pregnant, or have a weakened immune system due to medicine that suppresses the immune system, or a condition that weakens your immune system.
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.
Topical Pain Relief Products
e.g. lidocaine preparations , capsaicin cream
- topical pain relievers can be used in addition to oral pain relief medicines
- lidocaine is a local anaesthetic and numbs the skin
- do not apply lidocaine to broken or irritated skin avoid contact with eyes
- capsaicin cream should NOT be used on active shingles and may only be used to help with post-herpetic neuralgia . It should be discontinued if symptoms persist for longer than 2 weeks
- do not apply capsaicin cream to broken or irritated skin avoid contact with eyes
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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:
Is There A Shingles Vaccination
In the UK there is a shingles vaccine immunisation programme for people aged 70 years to protect against herpes zoster. There is also a catch-up programme which offers the vaccine to anyone aged between 70 and 79 years who has previously missed out on immunisation. The vaccine is licensed for people aged over 50 years, and if you are not eligible for the vaccine on the NHS, your pharmacist may be able to provide the vaccine as a private service.
The chickenpox vaccine is not routinely given to children in the UK but is offered to people who are in close contact with someone who is particularly vulnerable to chickenpox or its complications – eg, people with a weakened immune system.
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What Are The Complications Of Shingles
Symptoms of shingles usually dont last longer than 3 to 5 weeks. However, complications can happen. The main complications that can result from shingles include:
- Postherpetic neuralgia . The most common complication of shingles is called postherpetic neuralgia . This continuous, chronic pain lasts even after the skin lesions have healed. The pain may be severe in the area where the blisters were present. The affected skin may be very sensitive to heat and cold. If you had severe pain during the active rash or have impaired senses, you are at increased risk for PHN. The elderly are also at greater risk. Early treatment of shingles may prevent PHN. Pain relievers and steroid treatment may be used to treat the pain and inflammation. Other treatments include antiviral drugs, antidepressants, anticonvulsants, and topical agents.
- Bacterial infection. A bacterial infection of the skin where the rash happens is another complication. Rarely, infections can lead to more problems, such as tissue death and scarring. When an infection happens near or on the eyes, a corneal infection can happen. This can lead to temporary or permanent blindness.
What Are The Symptoms Of Shingles
Shingles symptoms occur in the area of skin that is supplied by the affected nerve fibres. The usual symptoms are pain and a rash. Occasionally, two or three nerves next to each other are affected.
Very rarely, shingles can cause more widespread infection, or can affect both sides of the body, but this is usually only in people with a weakened immune system.
The most commonly involved nerves are those supplying the skin on the chest or tummy . The upper face is also a common site.
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How About Acupuncture For Shingles
Acupuncture is one of the most effective treatments for pain. My wife Lesley and I are both acupuncturists and we used a lot of it to try and treat this condition. The standard points for shingles are Spleen 10 and Large Intestine 11 . We also did auricular treatment: we bled the apex of the ear, indicated for all inflammatory conditions. This did not show any effect to warrant a repeat attempt.
A heroic procedure recommended by a respected acupuncturist as a gold-standard shingles treatment consisted of whacking the tender recently healed over area where the initial shingle blisters were until it bled profusely. This arduous and painful treatment promised immediate and lasting relief from postherpetic neuralgia. Ive always found that bleeding is the most effective way to immediately resolve inflammation and relieve pain. Fortunately, I took a lot of kratom before and allowed Lesley to perform the treatment. It did not work.
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.
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What Is The Best Medication For Shingles
Your healthcare provider will determine the best medication for your case of shingles based on your symptoms, medical history, and response to shingles treatment. Heres an overview of the popular shingles medications that your doctor may prescribe.
|Best medication for shingles
|One 0.65 ml injection in the upper arm
|Irritation of the injection site or chickenpox-like rash near the injection site or headache
Dosage is determined by your healthcare provider based on your medical condition, response to treatment, age, and weight.
Other possible side effects exist. This is not a complete list.
How Long Does Shingles Last
The shingles virus lasts a lifetime. However, it may remain inactive for many years at a time. A shingles attack or episode may last between two and four weeks. Here is an average timeline:
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What If You Have Shingles Around Or In Your Eye
Community Eye Health
On the surface, says Dr. Taylor, they mainly show up on the cornea, which is the clear dome of tissue that covers your iris , and the conjunctiva the clear tissue that covers the whites of your eye and the inside of your eyelid.
If shingles is in these places, she says, youll be prescribed eye drops with steroids to calm the lesions, and lubricating tears for comfort.
If you have had shingles in your eye, says Taylor, your eye doctor will monitor you for 3 to 12 months to make sure that your eye is returning to health and that no new developments have occurred. You may also be encouraged to have a yearly eye exam until otherwise instructed by your eye doctor.
Antiviral Medicines For Shingles
Antiviral medicines used to treat shingles include aciclovir, famciclovir and valaciclovir. An antiviral medicine is not a cure for shingles, it does not kill the virus but works by stopping the virus from multiplying. So, it may limit the severity of symptoms of the shingles episode.
An antiviral medicine is most useful when started in the early stages of shingles . However, in some cases your doctor may still advise you have an antiviral medicine even if the rash is more than 72 hours old – particularly in elderly people with severe shingles, or if shingles affects an eye.
Antiviral medicines are not advised routinely for everybody with shingles. As a general rule, the following groups of people who develop shingles will normally be advised to take an antiviral medicine:
- If you are over the age of 50. The older you are, the more risk there is of severe shingles or complications developing and the more likely you are to benefit from treatment.
- If you are of any age and have any of the following:
- Shingles that affects the eye or ear.
- A poorly functioning immune system .
- Shingles that affects any parts of the body apart from the trunk .
- Moderate or severe pain.
If prescribed, a course of an antiviral medicine normally lasts seven days.
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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.
How To Use Valacyclovir
This medication works best when started at the first sign of an outbreak, as directed by your doctor. It may not work as well if you delay treatment. For shingles or chickenpox, start taking valacyclovir at the first symptom or as soon as possible after the rash appears. For cold sores or genital herpes, start taking this medication at the first sign or as soon as you feel tingling, itching, or burning.
Valacyclovir works best when the amount of medicine in your body is kept at a constant level. Take this drug at evenly spaced intervals. To help you remember, take it at the same time each day.
Continue to take this medication until the full prescribed amount is finished. Do not change your dose, skip any doses, or stop this medication early without your doctor’s approval.
Tell your doctor if your condition persists or worsens.
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Treat Your Body And Mind
You can get worn down mentally when youâre in constant pain. Stress can make it seem even worse. Self-care starts with treating your rash, but donât stop there. Your mind and emotional state need to be cared for as well.
5. Stick with good habits: Your bodyâs working hard to fight the varicella-zoster virus that causes shingles. To give it the right support, you can:
- Eat nutritious food and have regular meals. Ask someone to make a run to the grocery store for fresh fruit and such if youâre not up for it.
- Try to get a good nightâs sleep and rest anytime you need to.
- Do gentle exercises, such as walking or stretching. Light activity can help take your mind off the pain. Keep it simple though, and check with your doctor if youâre trying something new.
6. Distract yourself: Sometimes, the best thing you can do is to put your focus elsewhere. Here are a few things to try:
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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What Pharmacists Need To Know About Shingles
8. Watson CP. Management issues of neuropathic trigeminal pain from a medical prospective. J Orofac Pain. 2004 18:366-373.9. Parsons B, Tive L, Huang S. Gabapentin: a pooled analysis of adverse events from three clinical trials in patients with postherpetic neuralgia. Am J Geriatr Pharmacother. 2004 2:157-162.10. Barger A, Dukes E, McCarberg B, et al. Change in opioid use after the initiation of gabapentin therapy in patients with postherpetic neuralgia. Clin Ther. 2003 25:2809-2821.11. Hempenstall K, Nurmikko TJ, Johnson RW, et al. Analgesic therapy in postherpetic neuralgia: a quantitative systemic review. PLoS Med. 2005 2:164.12. Oxman MN, Levin MJ, Johnson GR, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005 352:2271-2284.To comment on this article, contact .
A Word About The Shingles Vaccine
If you are age 60 or over and have not had shingles, talk to your doctor about getting the shingles vaccine. Not only will it reduce your risk of developing shingles, but if you do develop shingles, youll be more likely to have a mild case. And, just as important, youll be much less likely to develop PHN if youve had the vaccine.
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Treatment Of Herpes Zoster
The treatment of herpes zoster has three major objectives: treatment of the acute viral infection, treatment of the acute pain associated with herpes zoster and prevention of postherpetic neuralgia. Antiviral agents, oral corticosteroids and adjunctive individualized pain-management modalities are used to achieve these objectives.
Topicals Are Not A Substitute For Medical Treatment
Topical products can help you manage your symptoms. But they arent a substitute for proper medical treatment.
Its important to visit your doctor if youre dealing with shingles. Your doctor can prescribe antiviral drugs and other medications that can shorten the duration of your infection and help you avoid severe complications.
The following creams may be able to help you manage shingles symptoms.
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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.