Shingles Treatment and Prevention


“Shingles can be very, very painful,” says Tout. “The pain is related to inflammation of the nerves and is often described as burning, throbbing, stabbing, or an electric-shock sensation.”

In addition to antivirals, your doctor may prescribe the following treatments for pain.

  • Acetaminophen (Tylenol)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve)
  • Capsaicin topical patch (Qutenza)
  • Anticonvulsant drugs such as gabapentin (Neurontin, Gralise) and pregabalin (Lyrica)
  • Tricyclic antidepressants such as amitriptyline and nortriptyline (Pamelor)
  • Numbing medications such as lidocaine
  • Opioids such as tramadol, oxycodone, or morphine
  • An injection of corticosteroids and local anesthetic
  • Oral corticosteroids

“[W]hile [pain medications] can be somewhat helpful, they often have drawbacks, especially in older adults or individuals with certain health conditions like diabetes,” Tout says. “Starting antiviral medication promptly has been shown to reduce the severity and duration of time with shingles-related pain, but it doesn’t make the pain medications themselves work better.”

If postherpetic neuralgia develops, similar medications are used to treat the related pain.

While it may seem strange for your doctor to prescribe drugs that are commonly used to treat depression and prevent seizures, shingles is a nerve disorder at its root, and these drugs work in different ways to calm damaged nerves.

Anticonvulsant medications used to prevent seizures are thought to work by disrupting the pain signals sent out by damaged nerves.

And it’s believed that tricyclic antidepressants — an older class of antidepressants — work by increasing the levels of the neurotransmitters (brain chemicals) that modify pain response.

“Like the pain-relieving treatments for shingles itself, the medications we use for treating postherpetic neuralgia are less effective than we would like and can often come with side effects,” Tout says.

“It is expected [you’ll] need less and less pain medications over time, and most people experience resolution by three months. However some [people], most commonly older individuals, can experience pain for up to two years or even longer.”



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