Shingles Pain Management

Shingles, also known as Herpes Zoster is a viral infection that afflicts over a million people every year in the United States. The common symptoms of Shingles include a red rash that eventually turns to painful blisters that leak a clear fluid.

Shingles is caused by the same virus that causes chickenpox. However, the difference is that this virus remains dormant in the body for many years until something weakens the immune system. Once the immune system is compromised, the virus becomes reactivated.

What causes the Immune System to be compromised?

Shingles or VZV can be distinguished from Varicella or Chickenpox by the fact that it begins as a tingling or burning of the skin which follows the nerve route and only appears on one side of the body. Common causes for this viral infection include prolonged exposure to stress, chemotherapy patients, anti-rejection medications for transplant recipients and HIV/AIDS. All these sources weaken the immune system, thus allowing the dormant virus to come alive wreaking havoc on the body.

The pain and discomfort from Herpes Zoster can be debilitating and must be managed with pain medications. In order for the pain medications to work, they must be taken within 72 hours of the first onset of symptoms. Unfortunately, the pain and discomfort can last up to six months and in some case become chronic, lasting for many years.

How to deal with the pain:

Discomfort due to herpes zoster can be debilitating, requiring pain medication and antivirals to manage the symptoms. In order for antivirals to have an effect, the drug should be taken within 72 hours of onset of the rash.

Medication Management:

Corticosteroids: This is comprised of a drug called Prednisone which is combined with acyclovir which together reduces inflammation to the nerves while decreasing pain. In addition, they have also been proven to reduce residual nerve damage.

Analgesics: For many with mild to moderate pain, over-the-counter medications for pain can relieve this symptom. However, if the pain is severe, a doctor may need to prescribe a narcotic in order to manage the pain.

Skin lotions such as calamine are great for combating pain when applied to the leaking blisters. In addition, capsaicin is effective for blisters that have crusted over. Furthermore, pain patches such as lidocaine or Xylocaine and nerve blocks are highly effective in easing zoster infection pain.

Eye Shingles or Herpes Zoster Keratitis is a severe complication of shingles. This condition is generally treated with antivirals and can lead to temporary or permanent vision loss. This condition requires immediate medical attention.

An additional serious complication of the zoster infection is Postherpetic Neuralgia. This condition is comprised of severe, debilitating pain that occurs long after the blisters have healed. Unfortunately, it can last for six months or longer and requires medications such as topical skin applications, analgesics, antidepressants, and anticonvulsants in order to manage it.

Herpes zoster is mostly seen in people 60 years of age and older, although children and young adults get it as well. Having had a prior chickenpox infection makes you vulnerable for developing shingles. However, if you have never had chickenpox before and have never been vaccinated against it, avoid people who have an active shingles infection, or you could find yourself with your first case of chickenpox!

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