Treatment and Medication for Shingles Rash

Shingles is a painful condition. It is a viral infection which proves to affect the surface of the skin and can be quite difficult to manage.

Also known as Herpes Zoster, Shingles is caused by the virus known as Varicella Zoster [1]. The virus infects a nerve area and thus causes rash and pain along the area of skin supplied by the nerve which is affected. Symptoms of Shingles usually subside on their own within 2 weeks to 6 weeks which is the course of duration of the viral infection.

Shingles is not a life threatening disease, but it can prove to be a very irritating and painful condition. Furthermore, there are some very nasty complications that are associated with Shingles if the signs and symptoms of the disease are ignored and the disease is left untreated. In such cases, there may be serious potential hazards which may include paralysis, loss of hearing, loss of vision and even brain infections.

If the signs and symptoms of Shingles

 are suspected or if an individual is suspected to be at a risk of encountering the infection, professional medical consultation must be sought for at the earliest. Not only does an early diagnosis of the infection allow for a quicker and speedier recovery, but proper diagnosis can also prove to help avoid any potential complications associated with Shingles.

Shingles can usually be diagnosed by a general medical practitioner as the appearance of the blisters is a typical symptom. It can be diagnosed by an external visual examination itself and no other diagnostic measures are required. However, in some special cases, a culture of the infected tissue area may be acquired for examination under a microscope in the laboratory, especially if the individual is facing a recurrent episode of the infection, or if the individual is suspected to have a weakened immune system, leading rise to the possibility of complications being developed.

How long does Shingles last?

The Shingles infection is caused by the reactivation of the dormant Varicella Zoster virus in an individual’s body due to some external or some internal stimulus [2]. While it is unclear as to how exactly the dormant virus is reactivated, it is well known that the virus starts spreading out and manifesting its presence in other parts of the body through the nerve cells, beginning from the dorsal root ganglia cells of the brain and the spinal cord and finally appearing in the form of blisters and skin lesions on the surface of the skin.

The pain and rash caused by Shingles typically lasts for about 2 weeks to 6 weeks. After the course of this infection, the signs and symptoms of the disease disappear on their own.

Usually, an individual only experiences a single attack of Shingles in the course of a lifetime. However, there are some rare cases of individuals with extremely weak immune systems, wherein multiple attacks of Shingles are experienced. Even so, having more than three episodes of Shingles is highly unlikely.

However, many individuals report experiencing pain even months after the signs and symptoms of Shingles disappear. This is due to a complication that has been caused by the viral infection which affects and damages the nerves of the body. In such cases, the damaged nerves prove to send out false signals of pain and also greatly exaggerated signals of pain which are not authentic. As such, the individual is led to believe that the infection has not subsided. This complication typically lasts for about three months to six months after the onset of the infection, but in some cases, individuals may experience pain even years after the infection has subsided.

Shingles Treatment

There is no cure for Shingles once it is contracted by an individual and the infection subsides on its own after its normal duration of course. However, treatment with antiviral drugs is often prescribed to reduce the severity of disease and also to eliminate the chances of complications such as postherpetic neuralgia or partial facial paralysis.

Treatment procedures and medications for Shingles primarily aim at diminishing the activity of the virus and in reducing the pain associated with the infection. Several medication options are available and it depends on the medical practitioner to determine which is the best suited treatment procedure and medications for a particular individual suffering from Shingles infection.

Shingles does not require any hospitalization and the majority of cases of infection can be managed by treatment at home. In only some special cases, wherein the immune system of an individual is greatly impaired, is hospitalization required.

Some of the medications that are commonly used for the treatment of Shingles include:

• Antiviral drugs which are prescribed to reduce the virulence of the Varicella Zoster virus. Some of the commonly prescribed antiviral drugs include:
  • Acyclovir also going by the trade name of Zovirax
  • Famciclovir going by the trade name of Famvir
  • Valacyclovir going by the trade name of Valtrex
• Analgesics such as lidocaine which is available in gel, cream or spray to help reduce the pain
• Anticonvulsant drugs such as gabapentin
• Corticosteroids may be prescribed to reduce long term pain
• Tricyclic antidepressants such as imipramine, nortriptyline and amitriptyline can also help in reducing the pain
• Antihistamine medications available over the counter such as Diphenhydramine can also help in alleviating the itching caused by the rashes
• Nerve block injections can be used in order to suppress the extreme pain
• Opioids such as codeine, morphine oxycodone and tramadol may be used to alleviate the pain

These medications are normally prescribed for at least 7-10 days depending upon the severity of disease and prove to do an effective job at controlling the symptoms [3].

Medications that are prescribed for Shingles cannot kill the Varicella Zoster virus, but they can greatly prevent the virus from multiplying. They can help in reducing the severity of the infection, in reducing the duration of the infection and also in preventing the chances of complications.

While medications are quite commonly prescribed, some individuals do experience side effects on usage. Fortunately, most side effects, if any, are mild and may include the following:

• A general feeling of lethargy and being sick
• Nausea and vomiting
• Abdominal pains and diarrhea
• Vertigo and dizziness
• Mild headaches

Pregnant women and children are usually not provided with antiviral medication. However, it is always up to the physician to recommend the usage of medications depending on the specific individual and also on the severity of the infection.

Pain caused due to Shingles blisters can be reduced with the help of various painkilling medications. While some painkillers can be obtained over the counter, others need to be obtained under medical prescription. It is important to consult a medical professional before taking different types of medication.

Some of the side effects on using pain killing medication for Shingles include:

• Individuals suffering from stomach problems or asthma should refrain from using non-steroidal anti-inflammatory drugs
• Tricyclic antidepressants, while effective for pain relief, may cause difficulty in breathing, constipation, dryness of the mouth, a gain in weight, blurred vision and a feeling of drowsiness
• Anticonvulsants can also prove to have some side effects on individuals including an increased appetite, dizziness, drowsiness, a gain in weight, a feeling of lethargy and being sick and also a feeling of nausea and vomiting

Home remedies for Shingles

Along with these medications, home remedies can be used to reduce the severity of the symptoms of this disease to quite some effect. After the formation of rash, the following steps can be resorted to for treatment and also for getting relief from the pain and itching caused due to Shingles:

• It is recommended to wear loose clothes in order to reduce the itching.
• The rash area should be kept as clean and as dry as possible in order to reduce the infections with bacteria over the rash.
• It is advised to take baths with cold water and also to apply slight compressions on the blisters which will help provide relief from pain and itching. This needs to be carried out throughout the duration of the course of the infection.
• Calamine lotion may be used on the infected skin. This will give off a cooling effect to the rash and will also help in providing relief from the itching.
• The sharing your clothes, flannels or towels in diseased state should be avoided at all costs in order to reduce transmission of infections.
• The use of topical antibiotics and any dressings which may prove to be adhesive to the skin need to be avoided as they can slow down the natural process of healing.
• The blisters and rashes need to be covered in order to prevent the contagious transmission of the virus. This should be done using a non-adhesive dressing which can easily be removed from the rash when others are not around.
• A cool and moist wipe cloth can be used to clean the area around the sores of the skin lesions. This should ideally be done a number of times every day in order to keep the area of the infection clean.
• Cloth compresses and cleaning should only be done until the blisters stop oozing. Blisters dry and fall off after the due course and itching should be avoided in order to facilitate quicker healing.
• Baking soda may be applied to the rashes in order to facilitate quicker drying of the sores.

When diagnosed with Shingles and when facing the active phase of the blisters, individuals are advised to refrain from work or school as the blisters may prove to be burst and start oozing and the highly contagious infection can spread to others.

Cost of Shingles Medication

The cost of medication for Shingles depends on whether an individual is covered with health insurance or not and also if the medications which are prescribed are generic or belong to some brand name.

• The patients, who are covered by health insurance, have to perform an out-of the pocket expenditure of $5-$50 or sometimes even more. However, this cost of treatment is mostly covered by the health insurance.
• For the patients who are not covered by health insurance, a single attack of Shingles can cost them around $30-$550. The cost also largely depends on the type of antiviral drug that is being used.

Can you get Shingles twice?

According to research, the risk of getting Shingles again once it has been encountered is one in three cases [4] [5]. This probability is the same as that of getting Shingles in the entire life period. Patients have more chances of getting Shingles again when their previous attack gives more and lasting pain. Most of the times, when pain of previous attack lasts for 60 or more days, then the chances of recurrence increases fivefold. The main pathology behind the recurrence of Shingles is a weak immune system which leads to reactivation of the virus otherwise in a dormant phase.

In order to prevent recurring outbreaks of Shingles infection, individuals are recommended to get the Zoster vaccine which can be quite effective in preventing successive episodes.

In case a recurring episode of the Shingles infection is experienced, medical attention needs to be provided at the earliest in order to prevent any complications from taking place. Complications can prove to be potentially serious and may affect the quality of life of an individual adversely. Complications can be successfully avoided if proper medical attention and care is provided to sufferers as soon as the outbreak of the infection and the signs and symptoms of Shingles are experienced.

The prognosis of individuals suffering from Shingles is fairly positive. Younger individuals who are affected by the infection face lesser complications but older individuals lie at a much higher risk of developing complications associated with Shingles. In most cases, Shingles infection does not even require hospitalization as the symptoms subside with self-care at home. However in the case of individuals who have a weakened or compromised immune system and also elderly individuals may require hospitalization, depending on the severity of the infection of Shingles.

 

References

[1] Clinical Microbiology Reviews: Preventing Varicella-Zoster Disease, Hambleton, S., & Gershon, A. A.; vol. 18 no. 1 Pp. 70-80 – January 2002 – doi: 10.1128/CMR.18.1.70-80.2005 http://cmr.asm.org/content/18/1/70.short

[2] The New England Journal of Medicine: Neurologic Complications of the Reactivation of Varicella–Zoster Virus, Gilden, D. H., Kleinschmidt-DeMasters, B. K., LaGuardia, J. J., Mahalingam, R., & Cohrs, R. J.; N Engl J Med 2000; 342: Pp. 635-645 – March 2000 – DOI: 10.1056/NEJM200003023420906 http://www.nejm.org/doi/full/10.1056/NEJM200003023420906

[3] The Journal of Infectious diseases: Clinical Infectious Diseases, Whitley, R. J., Weiss, H. L., Soong, S. J., & Gnann, J. W.; Volume 179, Issue 1. Pp. 9-15 – May 1999 – DOI:1086/314562 http://jid.oxfordjournals.org/content/179/1/9.short

[4] ICES Journal of Marine Science: Physical and biological impact of marine aggregate extraction along the French coast of the Eastern English Channel: short- and long-term post-dredging restoration, Desprez, M.; Volume 57 Issue 5. Pp. 1428-1438 – March 2000 – doi: 10.1006/jmsc.2000.0926 http://icesjms.oxfordjournals.org/content/57/5/1428.short

[5] The New England Journal of Medicine: A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults, Oxman, M. N., Levin, M., Johnson, G. R., Schmader, K. E., Straus, S. E., Gelb, L. D., … & Silber, J. L.; N Engl J Med 2005; 352. Pp. 2271-2284 – June 2005 – DOI: 10.1056/NEJMoa051016 http://www.nejm.org/doi/full/10.1056/NEJMoa051016