Shingles is a reactivation of the virus that causes chickenpox, called varicella-zoster. After you recover from chickenpox, this virus can remain dormant, or inactive, in your body for decades before becoming reactivated.

Its hallmark symptom is a rash on one side of your body. The Centers for Disease Control and Prevention (CDC) says that this rash most commonly appears as a stripe around your torso.

Shingles doesn’t have a cure. But doctors often prescribe antiviral drugs to shorten its duration and reduce the severity.

Topical treatments like creams, ointments, and lotions can help you manage irritation and itchiness. They may also help manage lingering nerve pain called postherpetic neuralgia (PHN). Some topical treatments are available over the counter. For others, you will require a prescription from a medical professional.

Here’s an overview of the creams and other topical treatments available for shingles.

What’s the difference between cream, lotion, and ointment?

Ointments, lotions, and creams are three types of substances you can apply to your skin to help manage shingles.

These topicals are similar, but there are slight differences in their makeup. The primary difference is the amount of water and oil they contain.

According to this 2016 primer, creams are made up of about equal parts oil and water and often have moisturizing properties. They’re thicker than lotions but thinner than ointments.

Lotions are similar to creams, but they are made up mostly of water. They have less oil and have a thinner consistency. Because they’re thinner, your skin absorbs them more quickly. Some lotions are oil-free.

Ointments are the thickest of the three. They are made to stay on top of your skin instead of being absorbed immediately. Ointments are made up of at least 80 percent oil.

Topicals are not a substitute for medical treatment

Topical products can help you manage your symptoms. But they aren’t a substitute for proper medical treatment.

It’s important to visit your doctor if you’re dealing with shingles. Your doctor can prescribe antiviral drugs and other medications that can shorten the duration of your infection and help you avoid severe complications.

The following creams may be able to help you manage shingles symptoms.

Lidocaine cream and patches

Lidocaine 5% is a prescription medication. This 2017 study suggests that it’s one of the best-tolerated treatments for PHN.

PHN is a complication of shingles characterized by long-term nerve pain after your rash disappears. The CDC says that about 10 to 18 percent of people experience PHN after shingles.

Lidocaine is often administered in patches. The study linked above notes that up to 3 patches can be applied in a 12-hour window.

Capsaicincream

Capsaicin is the chemical found in hot peppers that makes them spicy. Capsaicin cream can desensitize nerve fibers and potentially help with PHN. You can get it over the counter (OTC) or with a prescription.

According to this 2016 review, capsaicin patches and creams are usually not recommended as a first-line treatment for PHN. This is because they can cause side effects like stinging or burning.

The 2017 study in the previous section indicates that capsaicin 0.075 percent cream can be applied four times per day.

Eutectic mixture of local anesthetics (EMLA) cream

EMLA cream is a prescription medication made up of a 1-to-1 ratio of 2.5 percent lidocaine and 2.5 percent prilocaine.

A 2018 case study of one person found that EMLA cream may make an effective alternative to lidocaine cream for treating PHN in people with special situations like kidney failure. However, there’s not much available research about its effectiveness. Most existing research is from the 1980s and ’90s.

A doctor can give you specific instructions on how to use EMLA cream.

Topical antibiotic creams

Topical antibiotic creams like mupirocin or soframycin can help prevent bacterial infection around a shingles rash. These antibiotics are only available by prescription. A doctor or pharmacist can recommend how often to apply them.

Other topical solutions that may help you manage your shingles symptoms include:

Calamine lotion

Calamine lotion is an over-the-counter medication that the CDC says may help relieve itchiness. You can apply a thin layer of lotion over your blisters. Try not to put on so much that it forms a crust on your skin.

Liquid dimethyl sulfoxide (DMSO) and idoxuridine

Idoxuridine is an antiviral medication approved in Europe for treating shingles.

One 2015 publication suggested frequent application of 5 to 40 percent idoxuridine dissolved in DMSO may speed up the healing time of shingles. However, in the United States, idoxuridine is only FDA-approved to treat keratitis, a herpes simplex virus infection of the cornea of your eye.

Burow’s solution

Burow’s solution, or aluminum acetate, is an over-the-counter astringent. Astringents have a protective effect against inflamed and irritated skin.

There’s a limited amount of evidence that Burow’s solution can help heal shingles, but it’s possible that it may help soothe blisters.

You can try applying 5 percent aluminum acetate solution for about 30 to 60 minutes at a time.

Saline solution

Bathing your blisters in a saline solution several times a day may help reduce inflammation. You can cover your blisters with a nonstick bandage afterward to keep other people from coming into contact with the blisters.

Aloe and other botanical topical therapies

Aloe vera has antiviral effects. A 2016 study found evidence that it inhibits the growth of herpes simplex virus type 1.

It’s not clear if aloe vera gel is effective at treating shingles, but some people anecdotally report that it helps with redness and inflammation.

In a 2021 case report, one person showed substantial improvement after the application of a topical botanical formulation that included:

When using a topical cream, it’s important to follow your doctor’s instructions or the instructions on the package. This should help you avoid unwanted side effects.

Applying topicals for too long or too often can lead to skin irritation or even more serious side effects.

Topical lidocaine can cause side effects like:

  • severe burning, stinging, irritation
  • swelling or redness
  • confusion
  • bruising
  • unusual temperature sensation
  • itching
  • changes in skin color
  • bruising or purpleness

Some topical solutions for shingles are available by prescription only. You can find others OTC.

OTC medications don’t require approval from a pharmacist. You can purchase them online, in pharmacies, and in other places that sell medications.

If you suspect that you have shingles, it’s important to visit a healthcare professional as soon as possible. According to the American Academy of Dermatology (AAD), treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain.

Antiviral medications or other medications only available by prescription can shorten the duration of your shingles or lessen the severity.

If a cream or other topical isn’t reducing your pain, it’s a good idea to visit your doctor again. They may recommend trying another treatment like capsaicin cream instead of lidocaine.

If a product is making your symptoms worse, it’s important to stop taking it right away.

You may be able to reduce your symptoms using home remedies while you’re waiting to see a healthcare professional. These include applying a wet cold compress or taking a cool bath.

Learn more about shingles home remedies here.

The AAD suggests that treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain. A doctor may prescribe medications like:

  • antiviral drugs, such as acyclovir or valacyclovir, to help your body fight off the virus quicker
  • anti-inflammatory drugs, such as ibuprofen, to ease swelling and pain
  • opioid medications, such as hydrocodone and tramadol (and less commonly morphine), to reduce pain
  • other medications, such as anticonvulsants and tricyclic antidepressants
  • antihistamines, such as diphenhydramine, to treat itching
  • numbing agents like lidocaine

Learn more about shingles treatment here.

Some creams or other topical medications may help you manage shingles symptoms. But they’re not a substitute for proper medical treatment.

It’s critical to visit a healthcare professional for a proper evaluation if you think you have shingles. They may prescribe antiviral drugs or other medications that can reduce your chances of developing long-term complications.