Shingles and Chickenpox (Varicella-Zoster Virus) - Treatment for an Acute Shingles Attack

Treatment for Shingles

The treatment goals for an acute attack of herpes zoster include:

• Reduce pain
• Reduce discomfort
• Hasten healing of blisters
• Prevent the disease from spreading

Over-the-counter (OTC) remedies are often effective in reducing the pain of an attack. Antiviral drugs (acyclovir and others), oral corticosteroids, or both are sometimes given to patients with severe symptoms, particularly if they are older and at risk for postherpetic neuralgia (PHN).

Home Treatments for Shingles

Applied Cold. Cold compresses soaked in Burrow's solution (an over-the-counter powder that is dissolved in water) and cool baths may help relieve the blisters. It is important not to break blisters as this can cause infection. Doctors advise against warm treatments, which can intensify itching. Patients should wear loose clothing and use clean loose gauze coverings over the affected areas.

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Itch Relief. In general, to prevent or reduce itching, home treatments are similar to those used for chickenpox. Patients can try antihistamines (particularly Benadryl), oatmeal baths, and calamine lotion.

Over-the-Counter Pain Relievers. For an acute shingles attack, patients may take over-the-counter pain relievers:

• Children should take acetaminophen. (Shingles is very rare in children.)
• Adults may take aspirin or other nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, other brands, generic). These remedies, however, are not very effective for postherpetic neuralgia.

Antiviral Drugs

Antiviral drugs do not cure shingles, but they can reduce the severity of the attack, hasten healing, and reduce the duration. They may also reduce the risk of postherpetic neuralgia.

Antiviral drugs approved for treatment of shingles include:

• Acyclovir (Zovirax, generic) is the oldest, most studied of these drugs
• Famciclovir (Famvir, generic) and valacyclovir (Valtrex, generic) are now preferred to treat herpes zoster in most patients because they require fewer daily doses than acyclovir.

These anti-viral drugs are usually taken for 7 days. To be effective, they should be started within 72 hours of the onset of infection. The earlier they are given the more effective these drugs are. Side effects may include stomach cramps, nausea, diarrhea, headache, and dizziness. Acyclovir may have more side effects than the other two drugs. People who have kidney problems or weakened immune systems may need to take a lower dose of these medications.

Foscarnet (Foscavir) is an injectable antiviral drug that can be used to treat cases of varicella-zoster infection resistant to acyclovir and similar drugs. It is rarely necessary.

Review Date: 05/03/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).