Shingles Treatment: Medications, Vaccines, Home Remedies and Prevention

Understanding Shingles and Its Causes

Shingles, also known as herpes zoster, is a painful skin rash caused by the reactivation of the varicella-zoster virus, which also causes chickenpox. After a person recovers from chickenpox, the varicella-zoster virus remains dormant in the body's nerve tissues and can reactivate later in life causing shingles.

According to the Centers for Disease Control and Prevention (CDC), about 1 in 3 people in the United States will develop shingles at some point in their lifetime. Anyone who has had chickenpox is at risk of developing shingles, but the risk increases as you get older. About half of all shingles cases occur in men and women 60 years old or older.

It's not fully understood why the varicella-zoster virus reactivates, but factors that can trigger shingles include:

• Advancing age
• Immune system problems
• Cancer
• HIV/AIDS
• Medications that weaken the immune system
• Physical or emotional stress
• Injury to nerves

When the virus reactivates, it can cause inflammation and pain in the nerves along a dermatome or skin area supplied by nerves from a single spinal sensory ganglion. This results in a shingles rash that commonly appears as a stripe of blisters on one side of the face or body. The rash most often occurs on the chest, back, abdomen, or face, but can occur anywhere on the body. Other shingles symptoms include:

• Burning, tingling, numbness or sensitivity to touch in the affected area
• Fever
• Chills
• Headache
• Fatigue
• Upset stomach

Diagnosing Shingles

Diagnosing shingles primarily involves recognizing the distinctive shingles rash and a review of the person's medical history. In some cases, a tissue scraping or culture of the blister fluid can help confirm a varicella-zoster virus infection. It's also important for doctors to rule out other conditions that may cause similar skin lesions, such as impetigo or herpes simplex virus.

If the rash occurs around the forehead, tip of the nose, or eyebrow, there is a potential risk that the virus may spread to the eye. In these cases, an ophthalmologist should promptly examine the individual's eyes.

Shingles Treatment Options

Although shingles cannot be cured, prompt treatment can reduce the severity and duration of symptoms. Treatment for shingles includes:

Antiviral Medications

Antiviral drugs such as acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir) can help shorten the length and severity of a shingles outbreak when started within 72 hours of the rash appearing. These medications do not eliminate the varicella-zoster virus, but they can stop the virus from multiplying further, reducing nerve inflammation and pain.

Pain Medications

Over-the-counter medications such as acetaminophen, ibuprofen, or aspirin can be used to control mild pain caused by shingles. For more intense shingles pain, prescription anti-seizure drugs such as gabapentin (Neurontin) or pregabalin (Lyrica), lidocaine skin patches, or opioids may be prescribed.

Topical Treatments

Cool compresses, calamine lotion, colloidal oatmeal baths, and aluminum acetate (Burow's or Domeboro's solution) can help relieve itching and drying of the shingles rash. Medicated lotions containing ingredients like pramoxine, menthol, or a low-concentration corticosteroid may also provide relief from itching.

Other Medications

Your doctor may prescribe other medications depending on your symptoms. These may include antidepressants for nerve pain, steroids for inflammation, and eye drops to relieve eye involvement.

Home Remedies for Shingles

In addition to medical treatment, the following self-care tips can help speed shingles healing and manage symptoms:

• Rest in bed for a few days if the rash is widespread or very painful.
• Apply cool, wet compresses to weeping blisters to soothe and help dry them out.
• Take colloidal oatmeal or baking soda baths to ease itching.
• Apply calamine lotion after bathing.
• Wear loose-fitting clothing to avoid irritating rashes.
• Distract yourself with relaxation techniques.
• Take over-the-counter medications to reduce pain and inflammation.

See your doctor promptly if symptoms persist or get worse while self-treating at home.

Shingles Complications

About 1 in 5 people who get shingles will develop complications either during or after the rash clears up. Potential shingles complications include:

Postherpetic Neuralgia

Postherpetic neuralgia is the most common shingles complication. It involves nerve pain that continues after the shingles rash goes away and can last for months or years. The pain may be mild to severe, constant, intermittent or triggered by stimulation of the affected skin area.

Vision Loss

If shingles appears around the eye (ophthalmic shingles), severe infection can cause scarring and corneal ulcerations leading to vision loss. Swift treatment is vital to preserve vision.

Hearing or Balance Problems

Ramsay Hunt syndrome occurs when shingles affects the facial nerve near the inner ear. This can lead to facial muscle weakness, hearing loss, ringing in the ears (tinnitus), vertigo or balance problems.

Skin Infections

Shingles blisters can become infected with bacteria, especially in people with weakened immune systems. Signs of a skin infection include honey-colored crusting, warmth and swelling around blisters.

Neurological Problems

If shingles appears on the head or face, inflammation of the brain (encephalitis) or inflammation of the membranes surrounding the brain and spinal cord (meningitis) can occasionally develop.

Preventing Shingles and Complications

Getting vaccinated is the best way to prevent shingles and its potential complications. The CDC recommends two shingles vaccines for adults aged 50 years or older - the recombinant zoster vaccine Shingrix and the live zoster vaccine Zostavax.

Shingrix Vaccine

The Shingrix vaccine is administered in two doses given 2 to 6 months apart. Clinical trials found it over 90% effective at preventing shingles and postherpetic neuralgia. Protection stays above 85% for at least 5 years after vaccination.

Possible side effects of the Shingrix vaccine are much more common than after Zostavax. About three-fourths of recipients experience local reactions such as pain, redness or swelling at the injection site. Headache, fatigue, muscle pain, fever and upset stomach are also fairly common.

Zostavax Vaccine

Zostavax is given as a single injection. Studies indicate it reduces the risk of developing shingles by 51% and the risk of postherpetic neuralgia by 67%. Its protection against shingles decreases to about 37% in the eighth year after receiving the vaccine.

Zostavax side effects are generally mild and temporary, including redness, soreness, swelling, itching, headache or fatigue at the injection site. It may rarely trigger a mild chickenpox-like illness with fever, headache, and a few spots that are mostly on the upper body.

The CDC states Shingrix is preferred over Zostavax for shingles prevention. People who already got the Zostavax shot should receive two doses of Shingrix for maximum protection.

Other precautions to help avoid shingles and complications include prompt treatment with antiviral medications at the first sign of a rash. Keeping the rash clean and covered and avoiding contact with others who have never had chickenpox can also help prevent spreading the virus.

While there is no cure for shingles, early medical care can go a long way toward managing symptoms and potentially avoiding severe nerve pain or other complications. Vaccination remains vital for preventing this painful viral infection.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.