Shingles

  • Alternative Names

    Herpes zoster


    Treatment

    Your doctor may prescribe a medicine that fights the virus, called an antiviral. The drug helps reduce pain and complications and shorten the course of the disease. Acyclovir, famciclovir, and valacyclovir may be used.

    The medications should be started within 24 hours of feeling pain or burning, and preferably before the blisters appear. The drugs are usually given in pill form, in doses many times greater than those recommended for herpes simplex or genital herpes. Some people may need to receive the medicine through a vein (by IV).

    Strong anti-inflammatory medicines called corticosteroids, such as prednisone, may be used to reduce swelling and the risk of continued pain. These drugs do not work in all patients.

    Other medicines may include:

    • Antihistamines to reduce itching (taken by mouth or applied to the skin)
    • Pain medicines
    • Zostrix, a cream containing capsaicin (an extract of pepper) that may reduce the risk of postherpetic neuralgia

    Cool wet compresses can be used to reduce pain. Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion, may help to relieve itching and discomfort.

    Resting in bed until the fever goes down is recommended.

    The skin should be kept clean, and contaminated items should not be reused. Nondisposable items should be washed in boiling water or otherwise disinfected before reuse. The person may need to be isolated while lesions are oozing to prevent infecting other people who have never had chickenpox -- especially pregnant women.


    Expectations (prognosis)

    Herpes zoster usually clears in 2 to 3 weeks and rarely recurs. If the virus affects the nerves that control movement (the motor nerves), you may have temporary or permanent weakness or paralysis.

    Sometimes, the pain in the area where the shingles occurred may last from months to years. See: Postherpetic neuralgia


    Complications

    Sometimes, the pain in the area where the shingles occurred may last for months or years. This pain is called postherpetic neuralgia. It occurs when the nerves have been damaged after an outbreak of shingles. Pain ranges from mild to very severe pain. It is more likely to occur in people over 60 years.

    Other complications may include:

    • Another attack of shingles
    • Blindness (if shingles occurs in the eye)
    • Deafness
    • Infection, including encephalitis or sepsis (blood infection) in persons with weakened immune systems
    • Bacterial skin infections
    • Ramsay Hunt syndrome if shingles affected the nerves in the face

    Calling your health care provider

    Call your health care provider if you have symptoms of shingles, particularly if you have a weakened immune system or if your symptoms persist or worsen. Shingles that affects the eye may lead to permanent blindness if you do not receive emergency medical care.