Shingles is a health condition that occurs when the virus that causes chickenpox starts up again in your body. Thus, those who have had chickenpox are at risk of developing shingles. It is characterized by painful, blister-like rashes.
Though there are no cure for shingles, correct treatment can help those with shingles get better and prevent further complications. It can also reduce the pain caused by shingles. Treatment options can include
- Antiviral medicines to reduce pain and duration of shingles
- Pain medicines, antidepressants, and topical creams to relieve pain and reduce infections
Doctors typically start shingles treatment with antiviral medicine once you have been diagnosed. If antiviral medicines are taken within the first 3 days of getting shingles, there is a lower chance of further complications such as postherpetic neuralgia.
Common treatments for shingles can include:
- Antiviral medicines such as acyclovir, famciclovir, or valacyclovir, to reduce pain and duration of shingles
- Pain medicines such as acetaminophen or ibuprofen to aid in relieving the pain caused by shingles. These medicines can be found over-the-counter, thus it is important to be safe with them by reading and following all instructions as directed on the label of the medicines.
- Topical antibiotics, usually in the form of a cream that can be applied directly to the skin, to prevent infections that can be caused by the blisters.
For more severe cases, some doctors may prescribe corticosteroids along with antiviral medicines. There are, however, some studies that show that taking corticosteroid along with an antiviral medicine does not make much of a difference in treating singles than just taking the antiviral medicine by itself.
Ongoing Treatment (if needed)
It is normal to continue to have pain after the shingles rash heals, however if the pain persists for more than a month than you will need to visit a doctor. It is most likely that you have postherpetic neuralgia (PHN), a common complication of shingles that affects every 10-15 out of 100 people who have had shingles. PHN can cause burning, tingling, stinging, aching, or aching pain for months or even years. Treatment is done to help reduce pain, and can include:
- Antidepressant medicines, such as a tricyclic antidepressant
- Topical anesthetics that can include benzocaine. These can be found over-the-counter in the form of a cream or other such things that can be applied directly to the skin.
- Lidocaine patches — another form of topical anesthetics — such as Lidoderm. These patches can only be obtained with prescription
- Anticonvulsant medicines, such as gabapentin or pregabalin
- Other medicines that help treat pain, such as gabapentin enacarbil
Other medicines such as topical creams that contain capsaicin or a high-dose skin patch such as Qutenza that can be obtained with a prescription can be used to treat PHN. However, capsaicin can be known to irritate or burn some people’s skin, so this type of medicine should be used with caution.
Treatment for Worsened Conditions
Though rare, shingles can cause long-term complications. Treatment is dependant on what complication has occurred. Below are some of these complications and some typical treatments for each complication.
- Postherpetic Neuralgia (PHN)
As previously mentioned, this is the most common form of complication of shingles. Pain usually persists for months or even years after the shingles rash has healed. Treatment is done to help reduce or relieve pain, and include anticonvulsants, antidepressants, opioids, and topical anesthetics. Most people with PHN heal within a year.
- Disseminated Zoster
This is a blister-like rash that can cover a large portion of the body. Though it is only visible on the skin, it can affect the heart, lungs, liver, pancreas, joints, and intestinal tract. Treatment is done to prevent even further complications that can be caused by the rash, and include antiviral medicines (to prevent the virus from growing) and antibiotics (to help reduce risk of infection).
- Herpes Zoster Ophthalmicus
This is a condition in which the shingles rash develop on the forehead, cheek, nose, and around one eye. This complication can threaten your sight, as it means the virus that causes chickenpox and shingles can be residing in one of the nerves of your eye. Immediate treatment from an ophthalmologist is strongly suggested. Treatment can include rest, cool compresses, and antiviral medicines.
- Additional complications
If the shingles virus is found to be affecting nerves that originate in the brain, serious complications can occur. These complications can involve damage to the face, eyes, nose, and/or brain. Treatment will vary, depending on the complication.
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