Relief from the Shingles Virus

A recurrence of VZV (varicella-zoster virus, which also causes chickenpox) is responsible for a shingles outbreak. The primary treatment for shingles is a course of antiviral drugs, paired with methods to relieve pain; built into the treatment for shingles are preventive measures against postherpetic neuralgia, a condition in which the pain associated with shingles persists after the active shingles rash has cleared up. It also is possible for shingles to recur.

Antivirals

• Shingles rash appears characteristically on only one side of your body, typically on your buttocks and trunk, but also sometimes affecting your face. The prodrome (initial symptoms before rash) of shingles is more painful and less itchy than chickenpox.

  The only element of shingles treatment that targets VZV itself is the use of prescription antiviral drugs, including acyclovir, valacyclovir and famciclovir. According to both GlaxoSmithKline, the manufacturer of Valtrex (a trade name for valacyclovir), and the Mayo Clinic, it is best to begin treatment with antiviral drugs within 72 hours after the first indications of shingles rash. Seth John Stankus, MAJ, MC, et al., report that you need to take acyclovir five times a day for between seven and 10 days, while you can take valacyclovir and famciclovir just three times a day for seven days.

  GlaxoSmithKline reports that the most common side effects are headache, nausea and vomiting.

Analgesics

• The type of analgesic administered for shingles relief will depend on the intensity of the pain you experience, varying from OTC (over-the-counter) to narcotic (opioid) treatments, which are available only by prescription. According Stankus, et al., it is best to have a set schedule for pain medications instead of taking them as needed, in order to avoid unnecessary discomfort and pain. You may need to take these medications, with doses and specific treatments being adjusted, as long as the pain of shingles persists.

Corticosteroids

• Prescription corticosteroids (like prednisone), which act as an anti-inflammatory agent, relieve pain associated with shingles when combined with antiviral therapy. Stankus, et al., recommend a graduated treatment plan of 30 mg twice a day for the first week, 15 mg twice a day for the second week, and 7.5 mg twice a day for the third week.

  According to the Mayo Clinic, the use of corticosteroids during an active shingles outbreak may reduce the chances of developing postherpetic neuralgia.

Topical Relief

• According to Stankus, et al., you can use calamine lotion on open shingles sores to relieve discomfort as needed, while capsaicin may be useful after sores have begun to heal; both of these are available over the counter. Prescription lidocaine patches also may help to relieve shingles pain; you can fit these to treat a specific affected area.

Postherpetic Neuralgia

• You may need a number of additional treatments if the pain of shingles does not clear up along with the rash (meaning you have postherpetic neuralgia). According to Stankus, et al., these treatments include the continued use of topical capsaicin and lidocaine, along with prescription tricylic antidepressants and anticonvulsants. A typical initial dose of a tricyclic antidepressant is 25 mg taken before bed, while you may take 100-300 mg of anticonvulsant medication before bedtime. Your doctor will adjust these medications until you attain maximum pain relief.