What are the treatments for shingles (herpes zoster)?

Shingles treatments

Shingles treatments are available to minimize pain and reduce the duration of skin symptoms.

Antiviral drugs – antiviral drugs are effective at reducing the severity of shingles pain and symptoms. Acyclovir, valacyclovir, and famcicylovir are all clinically proven to reduce the pain and duration of shingles rashes. Medication is most effective when taken as soon as the rash develops, preferably within 72 hours.

Steroid drugs – corticosteroids when taken with antiviral drugs can help heal the skin rash and blisters faster than antiviral medication alone. Steroid treatment is not suitable for some patients with diabetes, high blood pressure, or osteoporosis.

Pain medications – pain symptoms should be treated early to reduce future complications. Patients with shingles pain should begin with low strength pain treatments and progress to higher strength, if required.

Postherpetic neuralgia (PTN) treatment - Postherpetic neuralgia results from damage to the nerve cells from a shingles outbreak. PTN is defined as persistent pain from shingles that lingers for at least 4 months. Treatment of PTN is limited to pain management therapy or medications and efficacy varies between patients. Gabapentin or pregabalin (antiepileptic drugs) is a common first treatment to manage shingles pain. Oxycodone and tricyclic antidepressants are also different medications used to manage pain. Lidocaine patches or capsaicin cream can be applied topically on the skin.