Shingles topical creams. Shingles Topical Treatments: Comprehensive Guide to Creams, Ointments, and Lotions

24.09.202308.07.2023 by alexxlab

What are the most effective topical treatments for shingles pain and management. How do different creams, ointments, and lotions compare in managing shingles symptoms. Which over-the-counter and prescription options are available for shingles relief.

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Understanding Shingles and Its Symptoms

Shingles, a condition caused by the reactivation of the varicella-zoster virus, can be a painful and frustrating experience. This virus, which initially causes chickenpox, can lie dormant in the body for decades before resurfacing as shingles. The hallmark symptom of shingles is a distinctive rash that typically appears as a stripe on one side of the body, often wrapping around the torso.

While there is no cure for shingles, various treatments can help manage symptoms and reduce the duration of the outbreak. Antiviral drugs prescribed by doctors play a crucial role in shortening the course of the infection and mitigating its severity. However, topical treatments such as creams, ointments, and lotions can also provide significant relief from irritation, itchiness, and lingering nerve pain known as postherpetic neuralgia (PHN).

Differentiating Between Creams, Lotions, and Ointments

When exploring topical treatments for shingles, it’s essential to understand the differences between creams, lotions, and ointments. These products vary in their composition, particularly in their water and oil content, which affects their consistency and how they interact with the skin.

Creams: Composed of roughly equal parts oil and water, creams offer a balance between moisturizing properties and ease of application. They are thicker than lotions but thinner than ointments, making them versatile for various skin types and conditions.
Lotions: Primarily water-based with less oil content, lotions have a thinner consistency that allows for quick absorption into the skin. Some lotions are oil-free, making them suitable for those with oily skin or who prefer a lighter feel.
Ointments: The thickest of the three, ointments contain at least 80% oil. They are designed to create a protective layer on the skin’s surface rather than being quickly absorbed, providing longer-lasting effects.

Understanding these differences can help individuals choose the most appropriate topical treatment for their shingles symptoms, considering factors such as skin type, the severity of symptoms, and personal preference.

Lidocaine: A Powerful Prescription Option for Shingles Pain

Lidocaine 5% cream and patches stand out as one of the most effective and well-tolerated treatments for postherpetic neuralgia (PHN), a common complication of shingles characterized by persistent nerve pain after the rash has healed. How does lidocaine work to alleviate shingles-related pain?

Lidocaine functions as a local anesthetic, temporarily numbing the affected area and interrupting pain signals sent to the brain. This mechanism provides significant relief for many individuals suffering from the lingering pain of PHN, which affects approximately 10-18% of shingles patients, according to the Centers for Disease Control and Prevention (CDC).

Available only by prescription, lidocaine 5% can be applied as a cream or in patch form. Studies suggest that up to three patches can be safely used within a 12-hour period, offering extended relief for those with severe or persistent pain. The patch formulation can be particularly beneficial as it provides a controlled, sustained release of the medication over time.

Capsaicin Cream: Harnessing Nature’s Heat for Pain Relief

Capsaicin, the compound responsible for the spicy sensation in hot peppers, has found its way into topical treatments for shingles-related pain. How does this natural ingredient help manage the discomfort associated with shingles and PHN?

Capsaicin cream works by desensitizing nerve fibers in the skin, effectively reducing pain signals sent to the brain. This unique mechanism of action makes it a valuable option for managing PHN, particularly for individuals who may not respond well to other treatments.

Available both over-the-counter and by prescription, capsaicin cream offers flexibility in terms of accessibility. However, it’s important to note that while effective, capsaicin is not typically recommended as a first-line treatment due to potential side effects such as burning or stinging sensations upon application.

For those who do use capsaicin cream, a concentration of 0.075% applied four times daily has shown promising results in clinical studies. As with any treatment, it’s crucial to follow the recommended application guidelines and consult with a healthcare provider to determine if capsaicin is appropriate for your specific case.

EMLA Cream: A Specialized Option for Shingles Pain Management

Eutectic Mixture of Local Anesthetics (EMLA) cream represents a specialized prescription option in the arsenal of topical treatments for shingles-related pain. What sets EMLA cream apart from other topical anesthetics?

EMLA cream is a unique formulation containing a 1:1 ratio of 2.5% lidocaine and 2.5% prilocaine. This combination of two local anesthetics provides a potent numbing effect, potentially offering relief from the intense pain associated with shingles and PHN.

While research on EMLA cream specifically for shingles is limited, with most studies dating back to the 1980s and 1990s, recent case studies have shown promising results. A 2018 case report suggested that EMLA cream could be an effective alternative to standard lidocaine cream, particularly for individuals with special circumstances such as kidney failure.

The application of EMLA cream should be done under the guidance of a healthcare professional, as the optimal frequency and duration of use may vary depending on individual factors and the severity of symptoms. As with any prescription medication, it’s essential to follow your doctor’s instructions carefully to maximize benefits and minimize potential side effects.

Topical Antibiotics: Preventing Secondary Infections in Shingles Rashes

While the primary concern with shingles is often the pain and discomfort of the rash itself, secondary bacterial infections can complicate recovery and prolong suffering. How can topical antibiotic creams help in managing shingles?

Prescription topical antibiotics such as mupirocin and soframycin play a crucial role in preventing bacterial infections that can develop in and around shingles blisters. These medications work by inhibiting bacterial growth on the skin’s surface, creating a protective barrier against opportunistic infections.

The application of topical antibiotics is particularly important because the open blisters characteristic of shingles can serve as entry points for bacteria. By keeping these areas clean and protected, the risk of complications from secondary infections is significantly reduced.

It’s important to note that topical antibiotics are available only by prescription. A healthcare provider can assess the need for these medications and provide specific instructions on their application, including frequency and duration of use. Typically, a thin layer of the antibiotic cream is applied to the affected area, but the exact regimen may vary based on individual circumstances and the specific product prescribed.

Over-the-Counter Options for Shingles Symptom Relief

While prescription medications play a crucial role in managing shingles, several over-the-counter (OTC) options can provide additional relief from symptoms. What readily available products can help alleviate the discomfort associated with shingles?

Calamine Lotion: This classic pink lotion, recommended by the CDC, can help soothe itchy skin associated with shingles. It works by creating a cooling sensation on the skin and forming a protective barrier. When applying calamine lotion, it’s important to use a thin layer to avoid crust formation, which can interfere with healing.
Capsaicin Cream: As mentioned earlier, lower-concentration capsaicin creams are available over the counter. These can be effective for some individuals in managing PHN, although they may cause initial discomfort upon application.
Cool Compresses: While not a topical medication, cool, wet compresses can provide significant relief from the burning and itching sensations associated with shingles rashes.
Colloidal Oatmeal Baths: Soaking in a lukewarm bath with colloidal oatmeal can help soothe irritated skin and reduce itching.

These OTC options can be used in conjunction with prescribed treatments, but it’s always advisable to consult with a healthcare provider before combining multiple products to ensure safety and efficacy.

Emerging Topical Treatments for Shingles

As research into shingles management continues, new topical treatments are being explored to provide more effective relief. What innovative approaches are being investigated for shingles symptom management?

One intriguing development is the combination of liquid dimethyl sulfoxide (DMSO) and idoxuridine. Idoxuridine, an antiviral medication approved in Europe for treating shingles, has shown promise when dissolved in DMSO. Some studies suggest that frequent application of a 5-40% idoxuridine solution in DMSO may accelerate healing time for shingles lesions.

However, it’s important to note that in the United States, idoxuridine is currently FDA-approved only for treating keratitis, a herpes simplex virus infection of the eye’s cornea. Its use for shingles remains experimental and off-label in the U.S.

Other areas of research include:

Novel drug delivery systems to enhance the effectiveness of existing topical medications
Combination therapies that target multiple aspects of shingles symptoms simultaneously
Natural and herbal remedies that may offer complementary benefits to conventional treatments

As these emerging treatments continue to be studied, it’s crucial for individuals with shingles to work closely with healthcare providers to access the most current and appropriate treatment options available.

The Importance of Comprehensive Shingles Management

While topical treatments can provide significant relief from shingles symptoms, it’s crucial to remember that they are just one part of a comprehensive management strategy. Antiviral medications prescribed by a doctor remain the cornerstone of shingles treatment, helping to shorten the duration of the outbreak and reduce the risk of complications.

In addition to medication, lifestyle measures such as getting adequate rest, managing stress, and maintaining good nutrition can support the body’s healing process. For individuals experiencing severe pain or complications like PHN, additional interventions such as nerve blocks or systemic pain medications may be necessary.

The key to effective shingles management lies in a personalized approach that takes into account the individual’s overall health, the severity of symptoms, and any underlying conditions. Regular communication with healthcare providers throughout the course of the illness ensures that treatment can be adjusted as needed to provide optimal relief and promote faster recovery.

Preventing Shingles: The Role of Vaccination

While this article focuses on managing shingles symptoms, it’s worth noting the importance of prevention through vaccination. The CDC recommends that adults 50 years and older receive the shingles vaccine, which can significantly reduce the risk of developing shingles and its complications.

Two vaccines are currently available:

Shingrix: A newer, non-live vaccine that is more than 90% effective at preventing shingles. It is recommended for adults 50 and older, including those who have previously received the older vaccine or had shingles.
Zostavax: An older, live vaccine that is no longer available for use in the United States as of November 18, 2020, due to the superiority of Shingrix.

Vaccination represents a proactive approach to shingles prevention, potentially sparing individuals from the pain and discomfort associated with the condition. For those who have already experienced shingles, vaccination can help prevent future outbreaks, as it is possible to develop shingles more than once.

The Future of Shingles Treatment

As our understanding of the varicella-zoster virus and its effects on the nervous system continues to evolve, so too does the landscape of shingles treatment. What might the future hold for those affected by this condition?

Ongoing research is exploring several promising avenues:

Targeted antiviral therapies that can more effectively suppress viral replication
Advanced pain management techniques that address the unique neurological aspects of PHN
Immunomodulatory treatments that can help prevent the reactivation of the virus in high-risk individuals
Improved vaccine formulations that may offer even greater protection against shingles and its complications

As these areas of research progress, individuals affected by shingles can look forward to potentially more effective, targeted, and personalized treatment options. The goal of future therapies will likely focus not only on managing symptoms but also on preventing the reactivation of the virus and mitigating long-term complications like PHN.

In the meantime, the array of topical treatments discussed in this article, along with systemic medications and lifestyle interventions, offer valuable tools for managing the challenges posed by shingles. By staying informed about available treatments and working closely with healthcare providers, individuals can navigate the course of shingles with greater comfort and confidence.

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

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.

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.

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.

Was this helpful?

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