Shingles Treatment

Are you experiencing a Shingles attack?

Reduced pain, Improve healing and reduce complications.

shingles on back
Shingles

what is shingles?

Shingles are caused by the reactivation of a virus. It can manifest as red, painful rash with small blisters on your skin. Very often, this may not be obvious in the first few days when shingles infection first appears. Shingles treatment with anti-viral medication is effective, and reduces suffering and complications from the viral infection. 

shingles on thigh

why do i get shingles?

The lifetime incidence of shingles is about 10-20%, and this rises with advancing age, with more than 60% of patients affected by the disease being more than 50 years of age.

After one recovers from chickenpox, the virus never goes away but stays resident in the nerve roots. Shingles develop because of the reactivation of the varicella-zoster virus in your nerve roots. The exact reason of the reactivation of the virus is not precisely known but may be associated with stress, infections, or re-exposure to the virus.

Shingles often starts with a painful rash that progress to the appearance of groups of small blisters (vesicles) on the background of red skin, following, which the vesicles will rupture and crust over during the healing phase. Shingles can affect any part of the body, but common areas include the trunk, limbs and face. Symptoms last about 2 weeks, and healing may take up to a month.

Shingles Treatment

The primary goals of shingles treatment are to reduce pain, accelerate healing, and prevent complications. Early intervention is crucial for optimal outcomes.

Antiviral Medications:

  1. Acyclovir, Valacyclovir, and Famciclovir: These antiviral drugs are the cornerstone of shingles treatment. They work by inhibiting the replication of the virus, thereby reducing the severity and duration of the outbreak. For maximum effectiveness, antiviral therapy should be initiated within 72 hours of the appearance of the rash.
  2. Dosage and Administration: The specific antiviral medication and dosage are determined based on the patient’s age, kidney function, and overall health. Treatment typically lasts 7 to 10 days.

Pain Management:

  1. Analgesics: Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate mild to moderate pain.
  2. Nerve Pain Medications: For more severe pain, especially if it involves nerve pain, medications such as gabapentin, pregabalin, or tricyclic antidepressants may be prescribed.
  3. Topical Treatments: Lidocaine patches or capsaicin cream can be applied to the affected area to provide localized pain relief.

Corticosteroids:

In some cases, corticosteroids may be used in conjunction with antiviral medications to reduce inflammation and pain. However, their use must be carefully evaluated by a healthcare professional due to potential side effects.

Preventive Measures:

  1. Shingles Vaccine: Vaccination is the most effective way to prevent shingles and its complications. The shingles vaccine (Shingrix) is recommended for adults aged 50 and older, as well as for immunocompromised individuals aged 19 and older.
  2. Postherpetic Neuralgia Prevention: Early and adequate antiviral treatment can reduce the risk of developing postherpetic neuralgia (PHN), a chronic nerve pain condition that can persist after the rash has healed.

Supportive Care:

  1. Skin Care: Keeping the rash clean and dry can prevent secondary bacterial infections. Cool compresses and soothing baths may provide additional relief.
  2. Rest and Hydration: Adequate rest and hydration support the body’s healing process.

Follow-Up and Monitoring:

Regular follow-up appointments are essential to monitor the progress of the treatment and address any complications promptly. Patients should report any new or worsening symptoms to their doctor immediately.

Complications of Shingles

Complications for shingles are fortunately uncommon. They mostly occur in the elderly, above 60 years of age.

The most common complication is Post-Herpetic Neuralgia (PHN). PHN may occur shortly after the acute attack of shingles, or develop weeks to months following the shingles attack. It causes chronic pain that can persists over months to years.

Shingles that occurs over the facial and eye region, have an increased risk of causing eyesight problems such inflammation, ulcers and blindness. Shingles may also causes weakness in facial muscles and deafness in some cases.

Shingles may be more severe in individuals with a weakened immune system. Examples include having diabetes, advanced age, and immune system deficiency disorders. Hospitalisation for treatment and observation are recommended in these cases. 

 

frequently asked questions

Anyone who has had chickenpox is at risk for developing shingles. The risk increases with age, particularly for individuals over 50. People with weakened immune systems, such as those with HIV/AIDS, cancer, or undergoing certain medical treatments, are also at higher risk.

Symptoms of shingles include:

  • Pain, burning, or tingling sensation
  • A red rash that develops a few days after the pain
  • Fluid-filled blisters that break open and crust over
  • Itching
  • Fever, headache, and fatigue in some cases

Shingles is typically diagnosed based on the characteristic appearance of the rash and associated pain. A healthcare provider may also take a sample of the fluid from the blisters to test for the varicella-zoster virus.

Shingles is not contagious in the same way chickenpox is. However, the varicella-zoster virus can spread from someone with active shingles to someone who has never had chickenpox or the chickenpox vaccine, causing them to develop chickenpox. Direct contact with the fluid from the blisters is required for transmission.

Potential complications of shingles include:

  • Postherpetic neuralgia (PHN): Persistent nerve pain that lasts for months or even years after the rash has healed.
  • Vision loss: If shingles occurs in or around the eyes (ophthalmic shingles).
  • Neurological problems: Such as encephalitis, hearing loss, or facial paralysis, depending on the nerves affected.
  • Skin infections: If the blisters become infected.

The acute phase of shingles typically lasts 2 to 4 weeks. However, some people may experience lingering pain (postherpetic neuralgia) that can last for months or even years.

Yes, although it is uncommon, some people can experience shingles more than once. The shingles vaccine can help reduce the risk of recurrence.

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References:

  1. Dworkin RH, Johnson RW, Breuer J, Gnann JW, et al. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007 Jan 1. 44 Suppl 1:S1-26.
  2. Sanford M, Keating GM. Zoster vaccine (Zostavax): a review of its use in preventing herpes zoster and postherpetic neuralgia in older adults. Drugs Aging. 2010 Feb 1. 27(2):159-76.