Herpes zoster Health Article

Treatment

Herpes zoster usually disappears on its own. You may only need treatment to relieve pain.

Your doctor may prescribe an antiviral medicine called acyclovir. This drug helps reduce pain and complications and shorten the course of the disease. Desciclovir, famciclovir, valacyclovir, and penciclovir are similar to acyclovir and may be also be used.

The medications should be started within 24 hours of feeling pain or burning, and preferably before the blisters appear. The drugs are usually given in pill form, in doses many times greater than those recommended for herpes simplex or genital herpes. Some people may need to receive the medicine through a vein (by IV).

Strong anti-inflammatory medicines called corticosteroids, such as prednisone, may be used to reduce swelling and the risk of continued pain. These drugs do not work in all patients.

Other medicines may include:

• Antihistamines to reduce itching (taken by mouth or applied to the skin)
• Pain medicines
• Zostrix, a cream containing capsaicin (an extract of pepper) to prevent postherpetic neuralgia

Cool wet compresses can be used to reduce pain. Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion, may help to relieve itching and discomfort.

Resting in bed until the fever goes down is recommended.

The skin should be kept clean, and contaminated items should not be reused. Nondisposable items should be washed in boiling water or otherwise disinfected before reuse. The person may need to be isolated while lesions are oozing to prevent infection of others -- especially pregnant women.

Expectations (prognosis)

Herpes zoster usually clears in 2 to 3 weeks and rarely recurs. If the virus affects the nerves that control movement (the motor nerves), you may have temporary or permanent weakness or paralysis.

Sometimes, the pain in the area where the shingles occurred may last from months to years. This pain, called postherpetic neuralgia, can be extremely severe. The elderly are at higher risk for this complication.

Complications

Involvement of the facial nerve may cause Ramsay Hunt syndrome, which can lead to loss of movement in the face, hearing loss, loss of taste, and other symptoms.

Other complications may include:

• Another attack of shingles
• Blindness (if lesions occur in the eye)
• Deafness
• Infection, lesions in body organs, encephalitis or sepsis in persons with weakened immune systems
• Postherpetic neuralgia
• Secondary bacterial skin infections