The so-called treatments for shingles are actually a misnomer because the varicella zoster virus that causes the disease cannot be killed; it becomes permanently attached to the nerve cell bodies of its human host. Instead, shingles treatments focus on two goals: to shorten the duration of the illness and to prevent complications, specifically postherpetic neuralgia.
The main goals of the primary treatment are to shorten the duration of the disease, and to treat its signs and symptoms, specifically pain. First and foremost in this treatment is the use of antiviral medications to shorten the disease course. An added benefit of antiviral drugs is that, when promptly given during the first two days of the onset of shingles rashes when the virus is most vulnerable, it would help in lowering the risk of complications such as postherpetic neuralgia.
Since shingles can be itchy as well as painful, there is a tendency for blisters to be scratched, causing them to pop and leave open wounds that are susceptible to bacterial pathogens. Application of topical antibiotics to the blisters and then covering with soft gauze will help prevent infection.
The most troublesome symptom of shingles is pain. Pain results because the latent varicella zoster virus within the nerve cell body becomes active and travels down the nerve axons to spread along the area of the skin that it innervates. Pain relievers, such as acetaminophen and ibuprofen, are prescribed to lessen nerve pain. If you have shingles and you are below 50 years old, your doctor might prescribe corticosteroids for adequate pain relief.
Ongoing Treatment for Persistent Symptoms
The main goal here is to treat pain that persists for a month or more after the shingles rashes have healed. There is no cure for postherpetic neuralgia, and if you have it, pain may be so severe that it may interfere with your daily life.
Studies have shown that the persistence of pain is aggravated in part by feelings of depression. Anticonvulsants, such as gabapentin or pregabalin, are often given in combination with antidepressants for nerve pain relief. Topical anesthetics, such as lidocaine creams and patches, applied over the affected area accord some measure of relief by acting directly on the blisters. In cases of severe pain, opioids, such as codeine, are prescribed.
Treatments for Recurrences and Complications
Because the virus lies latent within the nerve cell bodies, there is a tendency for recurrences and the development of more serious complications. The best (although not surefire) preventive measure against shingles recurrence is vaccination. Immunity boosting is achieved through intake of higher doses of vitamins, specifically vitamins C and B complex. For persistent cases of severe pain, a nerve block or even surgical ablation may be indicated to stop the transmission of pain signals to the brain.
For disseminated zoster, wherein the blisters cover a large portion of the body, antiviral drugs and antibiotics are given to prevent virus spread to vital organs, such as the heart, lungs, liver and pancreas.
Herpes zoster ophthalmicus is a condition that can result in blindness. If you have this, your ophthalmologist would prescribe antiviral medications and the application of soothing cold compresses over your eyes.