Cream for Shingles Pain and Management: What’s Available

Shingles is a reactivation of the virus that causes chickenpox, called varicella-zoster. After you recover from chickenpox, this virus can remain dormant, or inactive, in your body for decades before becoming reactivated.

Its hallmark symptom is a rash on one side of your body. The Centers for Disease Control and Prevention (CDC) says that this rash most commonly appears as a stripe around your torso.

Shingles doesn’t have a cure. But doctors often prescribe antiviral drugs to shorten its duration and reduce the severity.

Topical treatments like creams, ointments, and lotions can help you manage irritation and itchiness. They may also help manage lingering nerve pain called postherpetic neuralgia (PHN). Some topical treatments are available over the counter. For others, you will require a prescription from a medical professional.

Here’s an overview of the creams and other topical treatments available for shingles.

What’s the difference between cream, lotion, and ointment?

Ointments, lotions, and creams are three types of substances you can apply to your skin to help manage shingles.

These topicals are similar, but there are slight differences in their makeup. The primary difference is the amount of water and oil they contain.

According to this 2016 primer, creams are made up of about equal parts oil and water and often have moisturizing properties. They’re thicker than lotions but thinner than ointments.

Lotions are similar to creams, but they are made up mostly of water. They have less oil and have a thinner consistency. Because they’re thinner, your skin absorbs them more quickly. Some lotions are oil-free.

Ointments are the thickest of the three. They are made to stay on top of your skin instead of being absorbed immediately. Ointments are made up of at least 80 percent oil.

Topicals are not a substitute for medical treatment

Topical products can help you manage your symptoms. But they aren’t a substitute for proper medical treatment.

It’s important to visit your doctor if you’re dealing with shingles. Your doctor can prescribe antiviral drugs and other medications that can shorten the duration of your infection and help you avoid severe complications.

Was this helpful?

The following creams may be able to help you manage shingles symptoms.

Lidocaine cream and patches

Lidocaine 5% is a prescription medication. This 2017 study suggests that it’s one of the best-tolerated treatments for PHN.

PHN is a complication of shingles characterized by long-term nerve pain after your rash disappears. The CDC says that about 10 to 18 percent of people experience PHN after shingles.

Lidocaine is often administered in patches. The study linked above notes that up to 3 patches can be applied in a 12-hour window.

Capsaicin

cream

Capsaicin is the chemical found in hot peppers that makes them spicy. Capsaicin cream can desensitize nerve fibers and potentially help with PHN. You can get it over the counter (OTC) or with a prescription.

According to this 2016 review, capsaicin patches and creams are usually not recommended as a first-line treatment for PHN. This is because they can cause side effects like stinging or burning.

The 2017 study in the previous section indicates that capsaicin 0.075 percent cream can be applied four times per day.

Eutectic mixture of local anesthetics (EMLA) cream

EMLA cream is a prescription medication made up of a 1-to-1 ratio of 2.5 percent lidocaine and 2.5 percent prilocaine.

A 2018 case study of one person found that EMLA cream may make an effective alternative to lidocaine cream for treating PHN in people with special situations like kidney failure. However, there’s not much available research about its effectiveness. Most existing research is from the 1980s and ’90s.

A doctor can give you specific instructions on how to use EMLA cream.

Topical antibiotic creams

Topical antibiotic creams like mupirocin or soframycin can help prevent bacterial infection around a shingles rash. These antibiotics are only available by prescription. A doctor or pharmacist can recommend how often to apply them.

Other topical solutions that may help you manage your shingles symptoms include:

Calamine lotion

Calamine lotion is an over-the-counter medication that the CDC says may help relieve itchiness. You can apply a thin layer of lotion over your blisters. Try not to put on so much that it forms a crust on your skin.

Liquid dimethyl sulfoxide (DMSO) and idoxuridine

Idoxuridine is an antiviral medication approved in Europe for treating shingles.

One 2015 publication suggested frequent application of 5 to 40 percent idoxuridine dissolved in DMSO may speed up the healing time of shingles. However, in the United States, idoxuridine is only FDA-approved to treat keratitis, a herpes simplex virus infection of the cornea of your eye.

Burow’s solution

Burow’s solution, or aluminum acetate, is an over-the-counter astringent. Astringents have a protective effect against inflamed and irritated skin.

There’s a limited amount of evidence that Burow’s solution can help heal shingles, but it’s possible that it may help soothe blisters.

You can try applying 5 percent aluminum acetate solution for about 30 to 60 minutes at a time.

Saline solution

Bathing your blisters in a saline solution several times a day may help reduce inflammation. You can cover your blisters with a nonstick bandage afterward to keep other people from coming into contact with the blisters.

Aloe and other botanical topical therapies

Aloe vera has antiviral effects. A 2016 study found evidence that it inhibits the growth of herpes simplex virus type 1.

It’s not clear if aloe vera gel is effective at treating shingles, but some people anecdotally report that it helps with redness and inflammation.

In a 2021 case report, one person showed substantial improvement after the application of a topical botanical formulation that included:

• lemon balm
• St. John’s wort
• Siberian ginseng
• English lavender
• licorice
• purple pitcher plant
• versabase gel (containing aloe vera)

When using a topical cream, it’s important to follow your doctor’s instructions or the instructions on the package. This should help you avoid unwanted side effects.

Applying topicals for too long or too often can lead to skin irritation or even more serious side effects.

Topical lidocaine can cause side effects like:

• severe burning, stinging, irritation
• swelling or redness
• confusion
• bruising
• unusual temperature sensation
• itching
• changes in skin color
• bruising or purpleness

Some topical solutions for shingles are available by prescription only. You can find others OTC.

OTC medications don’t require approval from a pharmacist. You can purchase them online, in pharmacies, and in other places that sell medications.

If you suspect that you have shingles, it’s important to visit a healthcare professional as soon as possible. According to the American Academy of Dermatology (AAD), treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain.

Antiviral medications or other medications only available by prescription can shorten the duration of your shingles or lessen the severity.

If a cream or other topical isn’t reducing your pain, it’s a good idea to visit your doctor again. They may recommend trying another treatment like capsaicin cream instead of lidocaine.

If a product is making your symptoms worse, it’s important to stop taking it right away.

You may be able to reduce your symptoms using home remedies while you’re waiting to see a healthcare professional. These include applying a wet cold compress or taking a cool bath.

Learn more about shingles home remedies here.

The AAD suggests that treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain. A doctor may prescribe medications like:

• antiviral drugs, such as acyclovir or valacyclovir, to help your body fight off the virus quicker
• anti-inflammatory drugs, such as ibuprofen, to ease swelling and pain
• opioid medications, such as hydrocodone and tramadol (and less commonly morphine), to reduce pain
• other medications, such as anticonvulsants and tricyclic antidepressants
• antihistamines, such as diphenhydramine, to treat itching
• numbing agents like lidocaine

Learn more about shingles treatment here.

Some creams or other topical medications may help you manage shingles symptoms. But they’re not a substitute for proper medical treatment.

It’s critical to visit a healthcare professional for a proper evaluation if you think you have shingles. They may prescribe antiviral drugs or other medications that can reduce your chances of developing long-term complications.

Cream for Shingles Pain and Management: What’s Available

Shingles is a reactivation of the virus that causes chickenpox, called varicella-zoster. After you recover from chickenpox, this virus can remain dormant, or inactive, in your body for decades before becoming reactivated.

Its hallmark symptom is a rash on one side of your body. The Centers for Disease Control and Prevention (CDC) says that this rash most commonly appears as a stripe around your torso.

Shingles doesn’t have a cure. But doctors often prescribe antiviral drugs to shorten its duration and reduce the severity.

Topical treatments like creams, ointments, and lotions can help you manage irritation and itchiness. They may also help manage lingering nerve pain called postherpetic neuralgia (PHN). Some topical treatments are available over the counter. For others, you will require a prescription from a medical professional.

Here’s an overview of the creams and other topical treatments available for shingles.

What’s the difference between cream, lotion, and ointment?

Ointments, lotions, and creams are three types of substances you can apply to your skin to help manage shingles.

These topicals are similar, but there are slight differences in their makeup. The primary difference is the amount of water and oil they contain.

According to this 2016 primer, creams are made up of about equal parts oil and water and often have moisturizing properties. They’re thicker than lotions but thinner than ointments.

Lotions are similar to creams, but they are made up mostly of water. They have less oil and have a thinner consistency. Because they’re thinner, your skin absorbs them more quickly. Some lotions are oil-free.

Ointments are the thickest of the three. They are made to stay on top of your skin instead of being absorbed immediately. Ointments are made up of at least 80 percent oil.

Topicals are not a substitute for medical treatment

Topical products can help you manage your symptoms. But they aren’t a substitute for proper medical treatment.

It’s important to visit your doctor if you’re dealing with shingles. Your doctor can prescribe antiviral drugs and other medications that can shorten the duration of your infection and help you avoid severe complications.

Was this helpful?

The following creams may be able to help you manage shingles symptoms.

Lidocaine cream and patches

Lidocaine 5% is a prescription medication. This 2017 study suggests that it’s one of the best-tolerated treatments for PHN.

PHN is a complication of shingles characterized by long-term nerve pain after your rash disappears. The CDC says that about 10 to 18 percent of people experience PHN after shingles.

Lidocaine is often administered in patches. The study linked above notes that up to 3 patches can be applied in a 12-hour window.

Capsaicin

cream

Capsaicin is the chemical found in hot peppers that makes them spicy. Capsaicin cream can desensitize nerve fibers and potentially help with PHN. You can get it over the counter (OTC) or with a prescription.

According to this 2016 review, capsaicin patches and creams are usually not recommended as a first-line treatment for PHN. This is because they can cause side effects like stinging or burning.

The 2017 study in the previous section indicates that capsaicin 0.075 percent cream can be applied four times per day.

Eutectic mixture of local anesthetics (EMLA) cream

EMLA cream is a prescription medication made up of a 1-to-1 ratio of 2.5 percent lidocaine and 2.5 percent prilocaine.

A 2018 case study of one person found that EMLA cream may make an effective alternative to lidocaine cream for treating PHN in people with special situations like kidney failure. However, there’s not much available research about its effectiveness. Most existing research is from the 1980s and ’90s.

A doctor can give you specific instructions on how to use EMLA cream.

Topical antibiotic creams

Topical antibiotic creams like mupirocin or soframycin can help prevent bacterial infection around a shingles rash. These antibiotics are only available by prescription. A doctor or pharmacist can recommend how often to apply them.

Other topical solutions that may help you manage your shingles symptoms include:

Calamine lotion

Calamine lotion is an over-the-counter medication that the CDC says may help relieve itchiness. You can apply a thin layer of lotion over your blisters. Try not to put on so much that it forms a crust on your skin.

Liquid dimethyl sulfoxide (DMSO) and idoxuridine

Idoxuridine is an antiviral medication approved in Europe for treating shingles.

One 2015 publication suggested frequent application of 5 to 40 percent idoxuridine dissolved in DMSO may speed up the healing time of shingles. However, in the United States, idoxuridine is only FDA-approved to treat keratitis, a herpes simplex virus infection of the cornea of your eye.

Burow’s solution

Burow’s solution, or aluminum acetate, is an over-the-counter astringent. Astringents have a protective effect against inflamed and irritated skin.

There’s a limited amount of evidence that Burow’s solution can help heal shingles, but it’s possible that it may help soothe blisters.

You can try applying 5 percent aluminum acetate solution for about 30 to 60 minutes at a time.

Saline solution

Bathing your blisters in a saline solution several times a day may help reduce inflammation. You can cover your blisters with a nonstick bandage afterward to keep other people from coming into contact with the blisters.

Aloe and other botanical topical therapies

Aloe vera has antiviral effects. A 2016 study found evidence that it inhibits the growth of herpes simplex virus type 1.

It’s not clear if aloe vera gel is effective at treating shingles, but some people anecdotally report that it helps with redness and inflammation.

In a 2021 case report, one person showed substantial improvement after the application of a topical botanical formulation that included:

• lemon balm
• St. John’s wort
• Siberian ginseng
• English lavender
• licorice
• purple pitcher plant
• versabase gel (containing aloe vera)

When using a topical cream, it’s important to follow your doctor’s instructions or the instructions on the package. This should help you avoid unwanted side effects.

Applying topicals for too long or too often can lead to skin irritation or even more serious side effects.

Topical lidocaine can cause side effects like:

• severe burning, stinging, irritation
• swelling or redness
• confusion
• bruising
• unusual temperature sensation
• itching
• changes in skin color
• bruising or purpleness

Some topical solutions for shingles are available by prescription only. You can find others OTC.

OTC medications don’t require approval from a pharmacist. You can purchase them online, in pharmacies, and in other places that sell medications.

If you suspect that you have shingles, it’s important to visit a healthcare professional as soon as possible. According to the American Academy of Dermatology (AAD), treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain.

Antiviral medications or other medications only available by prescription can shorten the duration of your shingles or lessen the severity.

If a cream or other topical isn’t reducing your pain, it’s a good idea to visit your doctor again. They may recommend trying another treatment like capsaicin cream instead of lidocaine.

If a product is making your symptoms worse, it’s important to stop taking it right away.

You may be able to reduce your symptoms using home remedies while you’re waiting to see a healthcare professional. These include applying a wet cold compress or taking a cool bath.

Learn more about shingles home remedies here.

The AAD suggests that treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain. A doctor may prescribe medications like:

• antiviral drugs, such as acyclovir or valacyclovir, to help your body fight off the virus quicker
• anti-inflammatory drugs, such as ibuprofen, to ease swelling and pain
• opioid medications, such as hydrocodone and tramadol (and less commonly morphine), to reduce pain
• other medications, such as anticonvulsants and tricyclic antidepressants
• antihistamines, such as diphenhydramine, to treat itching
• numbing agents like lidocaine

Learn more about shingles treatment here.

Some creams or other topical medications may help you manage shingles symptoms. But they’re not a substitute for proper medical treatment.

It’s critical to visit a healthcare professional for a proper evaluation if you think you have shingles. They may prescribe antiviral drugs or other medications that can reduce your chances of developing long-term complications.

Acyclovir-belupo cream 5% 10g with free home delivery from VkusVill

VkusVill

Antiviral. It highly selectively affects herpes simplex viruses type 1 and 2, herpes zoster, Epstein-Barr and cytomegalovirus. Easily passes through the corneal epithelium (eye ointment) and creates a therapeutic concentration in the eye fluid. When used locally in the form of a cream, it is not absorbed into the systemic circulation. Penetrates through the BBB and the placental barrier, excreted in breast milk. With herpes, it prevents the formation of new elements of the rash, reduces the likelihood of skin dissemination and visceral complications, accelerates the formation of crusts, and reduces pain in the acute phase of herpes zoster. It has an immunostimulating effect.

Acyclovir-belupo cream 5% 10g / Pharmacy

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Description

Antiviral. It highly selectively affects herpes simplex viruses type 1 and 2, herpes zoster, Epstein-Barr and cytomegalovirus. Easily passes through the corneal epithelium (eye ointment) and creates a therapeutic concentration in the eye fluid. When used locally in the form of a cream, it is not absorbed into the systemic circulation. Penetrates through the BBB and the placental barrier, excreted in breast milk. With herpes, it prevents the formation of new elements of the rash, reduces the likelihood of skin dissemination and visceral complications, accelerates the formation of crusts, and reduces pain in the acute phase of herpes zoster. It has an immunostimulating effect.

Indications for use

Herpes simplex of the skin and mucous membranes, genital herpes (primary and recurrent), localized herpes zoster (auxiliary therapy).

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Belupo

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list of top 5 inexpensive and effective ointments and tablets according to KP with reviews and prices depriving

¹ . The trigger mechanism is often exacerbations of chronic diseases, immunosuppressive drugs, intoxication, infections or reduced immunity ² . People of any age can get shingles, but it is most common in people over 50 years of age.

What is shingles

Basically, shingles is the awakening of a dormant viral infection in the body. Outside of an exacerbation, the virus “lurks” in the posterior roots of the spinal nerves ² . That is why, during an exacerbation, a bubble “girdle” rash appears along the sensory nerves, accompanied by fever.

Shingles symptoms

The main symptoms of shingles include:

• general malaise;
• fever;
• slight itching;
• tingling sensation;
• sharply expressed burning pains in the place of future rashes;
• chickenpox-like rash.

The most common complications of herpes zoster are neuralgic disorders: pain, itching, burning and tingling, which persist for a long time after the onset of the rash ³ . The pains are paroxysmal in nature, aggravated at night.

No special treatment is required for herpes zoster. In most cases, therapy is to reduce pain, prevent complications and speed up recovery ³ . Herpes zoster drugs are usually given to elderly and debilitated patients.

List of top 5 inexpensive drugs for the treatment of shingles in adults according to KP

The most commonly used drugs for the treatment of shingles in adults are from the following pharmacological groups:

• antivirals;
• systemic interferons;
• topical antiseptics;
• non-steroidal anti-inflammatory drugs;
• preparations with central analgesic action.

The therapeutic effect of these drugs is different. Antiviral agents help the body fight the virus, interferons strengthen the immune system, antiseptics prevent infections from developing at the site of the rash, non-steroidal anti-inflammatory drugs reduce pain.

Important! All drugs have side effects and contraindications. Our material is an overview and does not serve as a guide to action. Before buying drugs, consult your doctor.

Antivirals

Antivirals are included in clinical guidelines for the diagnosis and treatment of herpes zoster ⁴ . As the name implies, these drugs suppress the activity of the causative agent of the disease – the herpes virus. They block the synthesis of viral DNA and lead to cell death. As a result, the number of viral particles in the body is reduced, which promotes recovery and reduces the risk of complications.

Antiviral medications for herpes zoster help to reduce the number of rashes, reduce pain in the acute phase of the disease, accelerate the formation of “crusts” and the healing process ⁵ .

Clinical guidelines list three antiviral drugs – acyclovir, famciclovir and varaciclovir.

Contraindications for use depend on the specific drug, but are usually children and breastfeeding. There are groups of patients who should be careful when taking antiviral agents. Such patients include, for example, pregnant women, the elderly and those with impaired renal function.

Systemic Interferons

Interferons are protein molecules that are involved in our immune system. Interferons have immunomodulatory activity and help the body fight viral infection and its consequences.

For the treatment of herpes zoster in adults, interferon gamma is administered by subcutaneous injection ⁴ . In addition, interferon preparations are used in the complex therapy of genital herpes virus infection, hepatitis C, anogenital warts, HIV and AIDS ⁶ .

Possible contraindications for use: autoimmune diseases, diabetes mellitus, individual intolerance, pregnancy.

Antiseptics for external use

This is the well-known “brilliant green”, as well as fucorcin, chlorhexidine and methylene blue solution. Antiseptic agents are applied directly to the rash area with a cotton swab. These medications help dry out the blisters of the rash and prevent fungi and bacteria from infecting damaged skin.

For bullous eruptions, it is recommended to first open the blisters with sterile scissors, and then treat with antiseptics ⁴ . When using antiseptic agents, a short-term burning sensation and pain at the site of application is possible.

Possible contraindications : pregnancy, lactation, individual intolerance to the components.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Drugs from this group are prescribed to relieve pain, which often bothers patients with herpes zoster ⁴ . This condition has been termed “herpes-associated pain”. In some patients, pain does not last long (about 30 days), and in 10–20% of those who recover, postherpetic neuralgia develops, which can last for months and years ⁷ .

Treatment of acute pain begins with first-line drugs, which include paracetamol and NSAIDs ⁷ . It is these drugs that are indicated in the clinical guidelines, as they help reduce pain and inflammation, reduce fever.

NSAIDs have quite a lot of contraindications and side effects, the main of which are the negative impact on the gastrointestinal tract and the cardiovascular system. Therefore, the choice of the drug for a particular patient is the task of the doctor.

Central analgesics

This group includes tricyclic antidepressants and anticonvulsants ⁴ . They are most often prescribed to patients with postherpetic neuralgia, which is accompanied by constant or intermittent pain – pressing, dull, stabbing or burning. This is the so-called neuropathic pain associated with damage to the peripheral nervous system ⁷ .

• Anticonvulsants or anticonvulsants (gabapentin and pregabalin) help reduce pain, are well tolerated, and have little to no interaction with other drugs ⁸ .

They have few contraindications for , usually they are children’s age and individual intolerance.

• Tricyclic antidepressants (eg, amitriptyline) increase the concentration of serotonin and noradrenaline in the body and thus help reduce the subjective perception of pain. In addition, they have an anti-anxiety effect, reduce the manifestations of depression ⁹ .

Among the contraindications to the use of tricyclic antidepressants are children’s age, pregnancy, lactation, angle-closure glaucoma and others.

How to choose drugs for the treatment of herpes zoster

The choice of drug for the treatment of herpes zoster is best left to the doctor, who will prescribe the remedy, based on the severity of the disease and the severity of the symptoms.

– Herpes zoster is a rather formidable dermatological disease associated with the entry of the herpes virus into the human body. There are a large number of types of herpes, in this case the causative agent is type 3 herpes (herpes zoster). Only timely treatment is the key to a quick recovery and overall recovery of the human body. According to dermatological standards, anti-inflammatory, antiviral and pain medications are primarily used for the treatment of herpes zoster, notes PhD, doctor, cosmetologist-dermatologist, trichologist Tatyana Kostsova .

Reviews of doctors about drugs for the treatment of herpes zoster

Antiviral drugs with active ingredients acyclovir, valaciclovir and famciclovir are used to treat herpes zoster.

Popular Questions and Answers

The most popular questions about herpes zoster and its treatment are answered by Ph.D., cosmetologist-dermatologist, trichologist Tatyana Kostsova.

Why is shingles dangerous?

– Herpes zoster (shingles) is dangerous because, in addition to itchy and unpleasant skin rashes, it provokes very strong painful sensations. The danger lies in the fact that, acting on the intercostal nerves, herpes zoster retains this pain for long days, weeks and even months. At the same time, patients can be prescribed not only conventional painkillers, but even narcotic drugs.

How long does shingles last?

– On average, the disease on the skin disappears within 5-15 days, but only if it is a skin rash without neurological symptoms. Then we can assume that the patient got off easy enough. If, after the passage of rashes on the skin, a pronounced pain syndrome persists, this requires a wider and more aggressive treatment.

Is it possible to smear herpes zoster with brilliant green?

– Yes, of course, shingles can be treated with aniline dyes. It dries well and provides an antiseptic effect. However, this often results in clothing being dyed, which is why many refuse to use aniline dyes or brilliant green.

When can I swim if I have shingles?

– Swimming or taking water procedures for shingles is possible only when all blisters on the skin have completely disappeared. The fact is that with water, this disease quickly spreads over the skin and causes a lot of trouble to the patient. Therefore, after the bubble rashes have subsided, the doctor allows you to take a quick shower without a washcloth and an aggressive effect on the rash zone.

Can you get shingles from another person?

– It is almost impossible to catch shingles from another person. But if your immune system is significantly weakened, then cross-infection is possible, and blisters may appear in the form of herpes simplex. But it is necessary to isolate young children from a patient with shingles. Because the causative agent of this disease is a filterable virus that belongs to the varicella-zoster virus group. And small children, when in contact with an infected person, can get chickenpox.

Sources:

1. Guzovskaya T.S. and other Epidemiological and clinical characteristics of herpes zoster // Problems of health and ecology. – 2008. – no. 3 (17). – S. 133-137. https://cyberleninka.ru/article/n/epidemiologicheskaya-i-klinicheskaya-harakteristika-opoyasyvayuschego-lishaya/
2. Shakov I.M. Herpes zoster // Attending physician. – 2011. – no. 10. – S. 14-14. https://www.elibrary.ru/download/elibrary_21801199_70435464.pdf
3. Lavrov V.F. and others. Chicken pox and shingles: features of morbidity and clinical manifestations // Epidemiology and infectious diseases.