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Skin shingles treatment: Shingles – Symptoms and causes

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Shingles: Diagnosis and treatment

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Shingles Treatment, Medication, and Prevention: Pain Relief, Antiviral

Written by WebMD Editorial Contributors

  • Antiviral Medications for Shingles
  • Painkillers for Shingles
  • Other Medications for Shingles
  • Alternative Treatments for Shingles?
  • Self-Care for Shingles
  • Can I Prevent Shingles?
  • Who Shouldn’t Get the Shingles Vaccine?
  • More

The virus that causes chickenpox also causes shingles. It’s called varicella zoster. It can lie quietly in your nerves for decades after causing chickenpox but suddenly wake up and become active.

The main symptom of shingles is a painful rash that comes up on one side of your body or face. See your doctor as soon as you can if you think you might have this condition.

Your doctor may want to put you on medications to control your infection and speed up healing, cut inflammation, and ease your pain. They include:

These medicines may slow down the progress of the shingles rash, especially if you take them within the first 72 hours of having symptoms.

They can also lower your chance of having complications. Your doctor may prescribe:

  • Acyclovir (Sitavig, Zovirax)
  • Famciclovir (Famvir)
  • Valacyclovir (Valtrex)

Talk with your doctor or pharmacist about side effects to watch for if you take one of these drugs.

Shingles causesinflammation and pain. Your doctor can suggest over-the-counter medicines to relieve milder discomfort. They include:

  • Acetaminophen
  • Ibuprofen
  • Naproxen

These may also help you stave off postherpetic neuralgia, which is a burning pain that some people get after the rash and blisters of shingles go away.

If you have severe pain after the rash clears or an infection during your shingles outbreak, your doctor might prescribe:

Capsaicin cream: Be careful not to get it in your eyes.

A numbing medicine: You might get lidocaine (Lidoderm, Xylocaine) for pain. It can come in a variety of forms, such as creams, lotions, patches, powders, and sprays, among others.

Antibiotics: You might need these medicines if bacteria infect your skin and rash. But if bacteria aren’t involved, then antibiotics won’t help.

Tricyclic antidepressants: These medications might help ease the pain that lingers after your skin has healed, such as amitriptyline, desipramine (Norpramin), and nortriptyline (Pamelor). They may also help you with depression, if you have that in addition to shingles. Your doctor can tell you what the risks and benefits are.

Some studies show that various alternative treatments, from acupuncture to supplements, can offer relief. The research isn’t complete, but some show promise. Check with your doctor before you try any of these: 

TENS (transcutaneous electrical nerve stimulation). This therapy uses tiny electrical pulses to relieve pain. A TENS unit is about the size of a smartphone and comes with small patches called electrodes. You put them over the painful area and turn the unit on and off as your pain comes and goes. 

Traditional Chinese medicine. These treatments aim to restore balance in your body. They include acupuncture, the ancient practice of inserting very thin needles into your skin at specific points. Also, moxibustion and cupping, two types of heat therapy, are supposed to draw out toxins. These treatments may be done in combination.

Creams and other skin treatments. A mixture of liquid dimethyl sulfoxide (DMSO) and idoxuridine, an antiviral drug, may reduce swelling and the number of blisters you have when you put it on your rash. And chlorophyll, the chemical that gives plants their green color, is also used directly on the rash as a cream or saline solution. 

Supplements. You’ll find a long list of herbs, pills, and oils that claim to relieve shingles. Most have no research to back them up, but there are a couple of exceptions. Papain, a protein found in papayas, is sold in capsules. And manuka and clover honeys can be put directly on your skin. Very early studies on both show they might be helpful. 

There aren’t home remedies for shingles. But there are things you can do to help your skin heal.

Keep the affected area clean, dry, and exposed to air as much as possible.

The itching can be maddening at times, but try not to scratch or burst the blisters.

Soothe the rash. Your top priority is to find relief for the pain and itching that the rash causes. You might try:

1. Oatmeal baths. Dip into a cool tub of water. For extra relief, add colloidal oatmeal, which is made of oats that have been ground to a very fine powder. This soothing bath may help calm your itching.

2. Cold compresses. Run a washcloth under cool water and place it on your blisters for about 20 minutes at a time. Not only can this relieve itching, it also keeps your blisters clean. That can help you avoid a skin infection. If your blisters aren’t oozing anymore, stop using cold compresses. And if you are using any creams or patches on your rash, don’t use compresses at the same time.

3. Loose clothing. You’ll likely find that relaxed fits made from natural fibers, such as cotton or linen, give you more comfort. If you need to cover your blisters, avoid bandages that might stick to your rash.

4. Calamine lotion. Treat your skin with this smooth, cool, and soothing balm. 

Treat your body and mind. You can get worn down mentally when you’re in constant pain. Stress can make it seem even worse. Self-care starts with treating your rash, but don’t stop there. Your mind and emotional state need to be cared for as well.  

Stick with good habits: Your body is working hard to fight the varicella zoster virus that causes shingles. To give it the right support, you can:

  • Eat nutritious food and have regular meals. Ask someone to make a run to the grocery store for fresh fruit and such if you’re not up for it.
  • Try to get a good night’s sleep and rest anytime you need to.
  • Do gentle exercises, such as walking or stretching. Light activity can help take your mind off the pain. Keep it simple though, and check with your doctor if you’re trying something new.

Distract yourself. Sometimes, the best thing you can do is to put your focus elsewhere. Here are a few things to try:

  • Call a friend.
  • Listen to music that relaxes you.
  • Read a book.
  • Watch a favorite movie.
  • Work on hobbies you enjoy.

Keep calm. Relaxation can be a big help. With a calmer mind, you can better handle your discomfort. You may want to try:

  • Meditation
  • Tai chi
  • Walking (but keep your blisters covered)
  • Yoga

Experiment with these strategies as you get through your shingles outbreak. Different things can help depending on how severe your symptoms are and how you feel from day to day.

There are two shingles vaccines. Shingrix is the recommended vaccine. Zostavax is no longer avilable in the U.S.

Who should get it: The CDC recommends that you get this vaccine if you’re a healthy adult age 50 or older, whether or not you remember having had chickenpox, because most people have been exposed to the virus. If you have had the Zostavax vaccine, you can also get Shingrix.

How many shots do you need? You would need two shots for Shingrix: One at first, with a follow-up in 2 to 6 months.

What it does: Shingrix reduces your chance of getting shingles by more than 90%. Even if you still get shingles, the vaccine may help it be less painful.

I never had chickenpox. Do I still need the shingles vaccine? Yes, you do. Shingrix is recommended for everyone age 50 or older, whether or not you remember having had chickenpox.

If I’ve had shingles, can I still get the vaccine? Yes. It may help prevent another bout of shingles later on. If you have shingles right now, you should wait until the rash is gone before you get vaccinated.

What are the side effects? The most common side effects with Shingrix include pain and swelling where the needle went in you skin, muscle pain, tiredness, headache, chills, fever, and stomach troubles. With any vaccine, there is a chance of a severe allergic reaction. 

Don’t get the Shingrix vaccine if:

  • You’re allergic to any of the ingredients.
  • You’re pregnant or nursing.
  • You have tested negative for immunity to the chickenpox virus. Ask your doctor about the chickenpox vaccine instead.
  • You have shingles now.

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Treatment of herpes zoster in Moscow – Effective methods of treatment of herpes zoster in the H-Clinic

The manifestation of the disease occurs after infection or due to the fact that the hidden virus “awakens” that remains in the body after suffering chicken pox. In this case, the reactivation of the infection is provoked by internal and external factors that contribute to a decrease in immunity. For example, hypothermia, HIV infection, the appearance and growth of malignant tumors, metabolic disorders, etc.

The occurrence of lichen most often occurs in the autumn-spring period, with the onset of the season of colds. At this time, the immunity of each person becomes the most vulnerable. In the presence of chronic diseases and concomitant pathologies, the likelihood of contracting the herpes zoster virus increases several times. As a rule, adult patients apply for the treatment of shingles on the skin. For children, this infection is atypical.

How to treat herpes zoster

Outpatient treatment for the diagnosis of “shingles” involves an integrated approach and includes both different methods of therapy, as well as various methods and means of recovery from the disease. With timely treatment and compliance with the recommendations of the attending physician, the prognosis for this disease is favorable. The exceptions are severe complications of type 3 herpes, which include meningoencephalitis and gangrenous form. The latter is typical for elderly and debilitated patients.

The course of effective treatment for shingles includes drugs to support immunity, as well as antiviral agents. To date, there are many high-quality drugs, but it is important to understand that the degree of effectiveness of all therapy largely depends on the time the patient seeks help. The factor “when the treatment was started” plays an important role in this matter.

To normalize metabolic processes, support the immune system and feel good, vitamins B1, B6, B12, ascorbic acid, rutin and antihistamines are prescribed.

Pain in shingles is relieved with non-steroidal anti-inflammatory drugs and analgesics. Forms of the disease complicated by a secondary infection or comorbidities require the inclusion of broad-spectrum antibiotics in therapy.

In addition, the methods of treatment of herpes zoster used in the complex course include physiotherapeutic agents:

  • Ultraviolet irradiation;
  • Electrophoresis;
  • Microwave irradiation of lesions;
  • UHF and others

Local treatment of herpes zoster on the face, neck, or back involves spot treatment with interferon lotions, antiviral ointments, and other agents that promote faster recovery. Such a combined scheme is especially effective with frequent recurrences of this infection. Anti-relapse therapy can also be prescribed outside of lichen exacerbation.

Terms of treatment

The duration of therapy for herpes zoster largely depends on the severity of the disease and the presence of complications. A significant factor in this matter is the patient’s immune status, the presence of chronic diseases, the body’s reaction to the development of infection. Treatment of herpes with antiviral and antibacterial drugs usually lasts 7-10 days, however, with severe lesions, in particular with the gangrenous form of the disease, the duration of the course may increase. It is impossible to name the exact terms in the treatment of herpes zoster in HIV-infected patients – the effectiveness of therapy in this case depends heavily on the individual reaction of the body. The doctor will be able to announce the approximate duration of taking medications and undergoing additional medical procedures only after examining and studying the patient’s history.

Where to treat shingles in Moscow

In Moscow, lichen and other infectious diseases are treated by experts at the H-Clinic. Here you can undergo a comprehensive diagnosis of herpes, get recommendations and qualified assistance in the treatment of herpes infection. After completing the course of therapy and eliminating the external signs of the disease, the patient is treated by specialists in related areas, in particular, a neurologist who is working to eliminate neurological symptoms caused by herpes zoster.

You can make an appointment with the infectious disease specialists of the H-Clinic by calling +7 (495) 120-42-12. You can also check the cost of clinic services by the specified number. Your appeal at any stage of the diagnosis and treatment of herpes, if necessary, can be anonymous.

Services and prices

Name/Price

Primary appointment (examination, consultation) with an infectious disease specialist

4,000 ₽

Primary appointment (examination, consultation) with an infectious disease specialist, PhD / MD

5 000 ₽

Reception (examination, consultation) of an infectious disease specialist, primary doctor of medical sciences, senior researcher, ch. doctor

7 000 ₽

Appointment (examination, consultation) with an infectious disease specialist primary, family

7,000 ₽

Reception (examination, consultation) of an infectious disease specialist, primary, family, PhD / MD

7 500 ₽

Reception (examination, consultation) of an infectious disease specialist, primary, family, c.m.s. / d.m.s., senior researcher, ch. doctor

11 000 ₽

Appointment (examination, consultation) with an infectious disease specialist at home

15,000 ₽

Appointment (examination, consultation) with an infectious disease specialist at home (outside the Moscow Ring Road)

20 000 ₽

Repeated appointment (examination, consultation) with an infectious disease specialist

3,500 ₽

Services for the medical rehabilitation of a patient with diseases of the nervous system, kinesio taping 3 zones

2 500 ₽

Reception (examination, consultation) of an infectious disease specialist repeated, c. m.s./d.m.s.

4 500 ₽

Reception (examination, consultation) of an infectious disease specialist repeated, c.m.s. / d.m.s., senior researcher, ch. doctor

6 000 ₽

Reception (examination, consultation) of an infectious disease specialist repeated, family

6 000 ₽

Reception (examination, consultation) of an infectious disease specialist repeated, family, c.m.s./d.m.s.

7 000 ₽

Reception (examination, consultation) of an infectious disease specialist repeated, family, c.m.s. / d.m.s., senior researcher, ch. doctor

10 000 ₽

Repeated appointment (consultation) with an infectious disease specialist, interpretation of test results

2,000 ₽

Consultation (remote support) of an infectious disease specialist repeated, “doctor in touch”

3 000 ₽

Shingles (Herpes zoster) – treatment in adults and children, symptoms, is it contagious, prevention, which doctor treats

Herpes

Rash

Intoxication

921

August, 26th

Shingles (Herpes zoster): causes, symptoms, diagnosis and treatment.

Herpes zoster is an infectious disease whose pathogen (herpesvirus type 3) also causes chicken pox.

Since the virus, penetrating into sensitive nerve endings, is integrated into the genetic apparatus of nerve cells, it is impossible to remove it from the body. In those who have had chickenpox, the virus goes into a latent (inactive) state.

When the immune system is weakened, the virus is activated, affecting the skin. The disease often develops in the elderly and in immunocompromised individuals.

Causes of the disease

The virus is transmitted from a patient with chicken pox or shingles by contact or airborne droplets. The person who becomes infected first (most often a child) becomes ill with chickenpox. Penetrating through the mucous membranes into the blood and lymph, the virus reaches the nerve cells, where it begins to multiply. After recovery, the virus remains in the body for life, often being in an inactive state. The awakening of the infection is associated with weakened immunity caused by hypothermia, long-term use of steroid hormones, immunosuppression (after transplantation), chemotherapy and radiation therapy, as well as a general decrease in immunity in patients with blood diseases, oncological and viral diseases. Shingles is very severe in HIV-infected patients.

Classification of herpes zoster

The clinical picture of herpes zoster consists of skin manifestations and neurological disorders. There are typical and atypical forms of the disease. With an atypical form, an erased course of the disease is possible, in which papules develop in the foci of hyperemia, which do not transform into vesicles.

In herpes zoster, the spread of the pathological process corresponds to a certain area of ​​the skin and does not cross the anatomical midline of the trunk. In most patients, the rash is preceded by a burning or itching sensation in a specific area of ​​the skin, as well as pain, which can be stabbing, throbbing, shooting, paroxysmal or constant. In a number of patients, the pain syndrome is accompanied by general systemic inflammatory manifestations: fever, malaise, myalgia, and headache.

Infection of the central nervous system and involvement of the meninges can produce meningeal, encephalic (symptoms suggest virus involvement of the brain and/or spinal cord and meninges), or mixed forms of herpes zoster. If the infection spreads along the optic nerve, ophthalmic herpes develops.

When a rash appears over the entire surface of the skin and on parenchymal organs (eg, liver, kidneys), a generalized form of herpes zoster develops. Another type of shingles is hemorrhagic. A characteristic feature is the bloody fluid inside the vesicles.

Herpes zoster symptoms

The onset of the disease is accompanied by general intoxication, malaise and fever. Nausea and vomiting are possible. Lymph nodes are enlarged.

There are pronounced pains along the affected nerve, which can be permanent, but more often they are paroxysmal itchy in nature, intensifying at night.

As a rule, they are provoked by any irritants: touching the skin, cold, movement. Some patients complain of loss of sensation in certain areas of the skin, which may be combined with increased pain response. Sometimes the pain syndrome in the absence of skin rashes can resemble angina pectoris, myocardial infarction, renal colic, or pancreatitis. The period of neuralgia preceding the rash lasts up to 7 days. Then nodules appear on one side of the body, from which bubbles form with transparent contents, which gradually become cloudy. After 3-7 days, most of the bubbles dry up with the formation of yellow-brown crusts. When the bubbles are injured, bright red sores are exposed. After the sores heal, small scabs or scars remain on the skin.

Most often, rash and pain are noted in the region of the ribs, lower back and sacrum, less often along the branches of the trigeminal, facial and ear nerve and on the extremities.

In rare cases, the mucous membranes are affected.

Herpes zoster diagnostics

It is possible to make a diagnosis after examining and questioning the patient. The doctor pays attention to the nature of the rash (localized and unilateral), the type of vesicles and complaints of itchy burning pain. It is more difficult to identify the atypical form of herpes zoster. With an erased form, pain and other neurological symptoms may be absent. In case of neurogenic disorders before the appearance of rashes, the diagnosis can be made on the basis of the results of laboratory tests. In this case, a histological examination is used, and the virus is isolated in cell culture. The Zanck test helps to quickly confirm the herpetic nature of the rashes: giant multinucleated cells are found in the scraping of the material taken from the base of the vesicle. However, this test does not make it possible to determine the type of herpes. The methods of enzyme immunoassay and indirect immunofluorescent reaction are also used. Recently, the diagnosis of viral infections is carried out using the polymerase chain reaction (PCR).

Varicella-Zoster IgG antibodies (Varicella-Zoster Virus IgG, anti-VZV IgG, IgG antibodies to varicella-zoster virus)

Synonyms: Blood test for antibodies to the chickenpox virus; Chicken pox; Human herpes virus type 3; HBV-3 type; varicellae-zoster virus; Herpes zoster.

chickenpox; Human h…

Up to 4 business days

Available with house call

RUB 965

Add to cart

Antibodies of the IgM class to the Varicella-Zoster virus (Varicella-Zoster Virus IgM, anti-VZV IgM, antibodies of the IgM class to the varicella-zoster virus and shingles)

Synonyms: Blood test for antibodies to the chickenpox virus; Chicken pox; Human herpes virus type 3; HBV-3 type; varicellae-zoster virus; Herpes zoster.

chickenpox; Human herp…

Up to 2 business days

Available with house call

1 050 RUB

Add to cart

Which doctors to contact

Depending on the primary symptoms, patients with herpes zoster may see different specialists. However, first of all, you should go to
therapist for examination and referrals for tests. If limited, localized skin rashes appear and there are no pain symptoms, it is necessary to contact a dermatologist for differential diagnosis of erysipelas (caused by bacteria), eczema, etc. In case of severe pain syndrome, movement disorders, consultation is necessary
neurologist. In case of damage to the eyes, pain when moving the eyeballs, an ophthalmologist’s consultation is required. The generalized form of herpes often requires hospitalization and the combined efforts of an immunologist, a neurologist, and a dermatologist.

Herpes zoster treatment

With any localization of rashes, antiviral agents are first prescribed (the drug, the frequency of administration and dosage are determined by the attending physician!).

Their action is especially effective in the first 72 hours from the onset of clinical manifestations.

In the presence of a strong pain syndrome, the doctor may recommend anti-inflammatory therapy. However, contraindications must be taken into account (for example, chronic diseases such as arterial hypertension, diabetes mellitus, erosive lesions of the intestine, peptic ulcer of the stomach and duodenum). If analgesics don’t work, your doctor may prescribe central analgesics (often prescription drugs) and nerve blocks. External (topical) treatment is necessary to eliminate inflammation and prevent infection of the skin by other agents (eg, bacteria). With erosive forms of herpes zoster, creams and ointments with antibacterial action are applied to the affected areas.

Your doctor may also recommend treatments to improve immunity, such as taking vitamins (particularly B vitamins).

Complications

When the vesicles open, a secondary infection (bacterial infection of the skin) is possible, which is accompanied by fever and general intoxication.

Typical complications of herpes zoster include neuritis, paresis and paralysis of sensory and motor nerves.

Postherpetic neuralgia is difficult to treat.

The ocular form of herpes can lead to keratitis (inflammation of the cornea), less often to iritis (inflammation of the iris) or glaucoma (increased intraocular pressure). In addition, the development of optic neuritis is possible, sometimes with its subsequent atrophy and blindness. With the defeat of the branch of the oculomotor nerve, ptosis develops (drooping of the upper eyelid). Sometimes patients complain of hearing loss, damage to the vestibular apparatus, in severe cases – paralysis and paresis of the oral cavity. In addition, patients may report tinnitus or increased sensitivity to sounds. Damage to the lumbosacral nerve nodes sometimes leads to urinary retention, constipation or diarrhea. In patients with significantly weakened immunity (with HIV infection, oncological diseases), herpes zoster often occurs in a generalized form and is complicated by meningitis, encephalitis, or meningoencephalitis.

Shingles prevention

Since shingles is caused by the same pathogen as varicella, the prevention of the disease will be based on the same measures as for chickenpox.

To prevent the spread of infection, isolation of the patient is necessary, which lasts up to 5 days from the moment the last element of the rash appears.

Persons who have been in contact with a patient with chickenpox are observed for 21 days. Active (vaccination) and passive (immunoglobulin administration) immunization are used as emergency prophylaxis. Vaccination is carried out for children older than 12 months and adults with no contraindications in the first 72-96 hours after probable contact with a person with chickenpox or shingles. Passive immunization with anti-varicella immunoglobulin is indicated for people with low immunity who have contraindications to vaccinations, pregnant women, children under 12 months of age and newborns whose mothers fell ill with chicken pox within 5 days before the birth of the child. The introduction of immunoglobulin is also carried out within 72-96 hours after contact with a patient with chicken pox or herpes zoster.

References

  1. Herpes zoster: Clinical guidelines.