How to Treat Shingles
Shingles is a painful rash that lasts for weeks and comes with a risk of debilitating long-term complications, which is why it's important to know how to treat shingles.
The CDC estimates that one in three people are likely to develop shingles in their lifetime and that over half of them will be people over 60. After the acute phase of shingles, around one in five people will experience nerve pain for an extended period.
Read on to find out how to treat shingles and how you can relieve symptoms. We also discuss steps you can take to prevent it.
What Causes Shingles?
Shingles, or herpes zoster, is caused by the chickenpox virus. After a bout of chickenpox, the virus often settles in one or more nerves near the spinal cord. This dormant virus can be reactivated when a person’s natural immunity is under strain and this leads to shingles.
Causes of a weakened or compromised immune system include:
- Severe acute infections (for example, COVID-19).
- Chronic conditions, such as diabetes, which affects most systems in the body.
- Waning immunity in the elderly.
- Poor nutrition.
- Emotional stress (for example, the death of a loved one).
- Conditions that affect the immune system specifically, such as HIV and certain cancers.
- Drugs that suppress the immune system. This includes chemotherapy and drugs prescribed after organ transplants and for autoimmune conditions, like rheumatoid arthritis.
Shingles Symptoms
Because it is important to seek medical attention, you should know when to suspect that a rash might be shingles
The person usually feels generally unwell for two to three days, with a headache and fever. Their skin may itch, burn and\or be painful before the typical rash appears. The rash usually occurs on the torso, but can also involve the face, often affecting the eyes or ears.
The rash consists of small itchy blisters, filled with fluid. After 7 to 10 days the blisters become cloudy and crust over.
In the majority of cases, a shingles rash has two distinguishing characteristics:
- It appears on the part of the body supplied by the affected nerve, in a broad stripe and on only one side of the body.
- It is accompanied by pain that ranges from mild to severe.
While the rash usually heals in two to four weeks, the nerve pain can continue for 90 days or longer. If the nerve pain lasts for more than 90 days it is viewed as a complication, postherpetic neuralgia, caused by damage to the infected nerve. This complication is seen in around 20% of cases and mostly in the elderly.
Top Treatments for Shingles
There is no cure for shingles, so treatment is aimed at relieving and shortening the duration of the symptoms. Treatment might also reduce the chance of complications, although this has not been clearly established by research.
The following drug and home treatments are those which have been found to be the most effective.
1. Antivirals
Antivirals are prescription drugs and should ideally be started within 72 hours after the rash has appeared. They disrupt viral replication and shorten the duration of the rash. They also reduce pain. Examples are Acyclovir and Famiciclovir.
2. Glucocorticoids
Glucocorticoids (for example, prednisone) are prescription drugs that were used to treat severe shingles before antivirals became widely available. Today, they are given together with antiviral drugs to help to reduce pain and promote healing.
3. Pain Medication
Treatment of the nerve pain associated with acute shingles will depend on how severe it is.
Mild pain from shingles can be treated with over-the-counter pain medications, such as acetaminophen and anti-inflammatory ibuprofen.
For severe pain, a health care provider might prescribe an opioid drug. However, opioid-based pain medication is usually prescribed only with care, especially in the elderly, because of potential side-effects and the risk of addiction.
People experiencing postherpetic neuralgia should consult their health care provider. There are various treatments, other than usual pain medications, which have been found to relieve the nerve pain caused by this condition.
4. Topical Antihistamines
Antihistamine creams, lotions or gels can relieve the itching and burning of the rash. They might be prescribed or can be bought over the counter.
Frequent or heavy use of these products should be avoided, as they prevent the blisters from drying out and can thus delay healing.
5. Capsicin
Capsicin is the active ingredient in chilli peppers, which causes the burn, and it is known to relieve nerve pain by blocking the pain signals from the nerve to the brain.
Capsicin cream can be used to relieve shingles pain after the rash is fully healed, although it does take a few weeks before the full effect is reached. It is available over the counter at pharmacies and the recommended strength is 0.075%, which is to be applied four times a day. Before using it you should test it for tolerance on a small patch of skin.
6. Traditional Remedies to Relieve Itching
Many of the tried and tested traditional remedies for soothing itchy rashes can also provide relief for shingles. Among the most widely suggested remedies for shingles are:
- Calamine lotion. This relieves the itch and helps to dry out the lesions.
- A cool bath or shower or cool wet compresses. This decreases blood flow to the area, thereby reducing inflammation.
- Soaking in a lukewarm bath with 1 to 2 cups of colloidal oatmeal or cornstarch. Avoid a hot bath, as this increases blood flow.
- Applying witch hazel to cool and soothe the itchiness and inflammation.
- Spraying the area with colloidal silver. This relieves itching and inflammation and it is also believed to have antiviral properties.
- Compresses with tea tree oil diluted in water. Studies have shown that tea tree oil has antiviral properties and it is also anti-inflammatory and helps to dry out the rash.
7. Boosting Immunity
As shingles is directly associated with a weakened immune system, it makes sense to take steps to boost immunity which will, at the same time, promote healing.
Follow a healthy, balanced diet with plenty of fruit and vegetables. Avoid sugar and refined carbohydrates, as these are known to increase inflammation and slow the healing process.
Consider vitamins A, B12, C, D and E supplements as these vitamins are particularly important for healthy immunity.
Adequate hydration, rest, fresh air and sunshine also boost the immune system.
Preventing Shingles
One of the reasons why shingles is more common in the elderly is that their childhood immunity against the virus has waned over the years.
The CDC recommends that people over the age of 50 receive two doses of Shingrix, a vaccine against the varicella zoster virus. This provides protection against shingles and its possible long-term complications.
The vaccine is especially recommended for those with health conditions placing them at high risk for shingles. However, it not recommended for those who are already immunocompromised or who currently have shingles.
Shingles – One More Reason for a Healthy Lifestyle
One in three people can expect at least one episode of shingles in their lifetime, especially after 60 years of age. Shingles is caused by reactivation of the dormant chickenpox virus when the person’s natural immunity is weakened.
The shingles rash and nerve pain cannot be cured but treatment can reduce the severity and duration of the symptoms.
While a vaccine is now available to prevent shingles it might be out of reach for many. Shingles can also be prevented by adopting a healthy lifestyle, which will not only help you to maintain robust immunity, but also to slow aging, maintain overall good health and reduce the risk of chronic conditions.