There is a vaccine that can help prevent shingles, but if you do get the viral infection, prompt treatment with antivirals can help.
While there’s no cure for shingles, getting immediate treatment can help speed the healing process and reduce your risk of complications.Antiviral drugs, such as Valtrex (valacyclovir), can shorten the duration and severity of shingles, but they’re most effective if you start them as quickly as possible after the rash emerges, or even before it erupts, according to the Centers for Disease Control and Prevention (CDC).
Prescription or over-the-counter (OTC) pain medication may also help relieve pain, along with home remedies like oatmeal baths, wet compresses, and calamine lotion.
What Drugs Are Prescribed for Shingles?
Per the CDC, to help diminish the length and severity of shingles, your physician may prescribe an antiviral drug, such as the following:
Ideally, you should take antiviral medication as soon as the rash appears (if not sooner). Taking these drugs within 72 hours of the eruption of the rash will help prevent postherpetic neuralgia (PHN), according to Mayo Clinic.
PHN is a condition in which nerve fibers, inflamed or damaged by shingles, continue to send pain signals to your brain months or even years after the blisters have gone away.Shingles can cause severe pain. Per Mayo Clinic, in addition to antivirals, your doctor may prescribe the following treatments for pain:
- Capsaicin topical patch (Qutenza)
- Antiepileptic drugs, such as gabapentin (Neurontin)
- Tricyclic antidepressants, such as amitriptyline
- Numbing agents, such as lidocaine
- Narcotics, such as codeine
- An injection including corticosteroids and local anesthetics
If postherpetic neuralgia develops, similar medications are used to treat PHN pain.
While it may seem strange for your doctor to prescribe drugs for shingles that are commonly used to treat depression and prevent seizures, shingles is at root a nerve disorder, and these drugs work in different ways to calm overactive nerves.
“Antiepileptics in general are thought to reduce the ability of the neurons to fire at high frequency,” says Sangeetha Kodoth, MD, an allergist and immunologist with Allergy Specialists of Knoxville in Tennessee.
It’s believed that tricyclic antidepressants — an older class of antidepressants — work by increasing the levels of the neurotransmitters serotonin and norepinephrine, which then modify pain response.Per the Cleveland Clinic, you can also take the following OTC pain medications and nonsteroidal anti-inflammatory drugs (NSAIDs) to treat mild pain caused by shingles:
Antibacterial agents may also be prescribed if a bacterial infection occurs with the shingles rash.
Before taking any medication for shingles, be sure to talk to your doctor about possible side effects.
What if You Have Shingles Around — or in — Your Eye?
According to MedlinePlus, it’s estimated that up to 20 percent of cases of shingles cases appear in or around the eye, which can cause permanent vision impairment.
Prompt antiviral treatment can reduce the risk of chronic eye complications by 20 to 30 percent, according to an article published in March 2020 in Community Eye Health.
On the surface, says Dr. Taylor, they mainly show up on the cornea, which is the clear dome of tissue that covers your iris (where you put your contact lenses), and the conjunctiva — the clear tissue that covers the whites of your eye and the inside of your eyelid.
“If shingles is in these places,” she says, “you’ll be prescribed eye drops with steroids to calm the lesions, and lubricating tears for comfort.”
If you have had shingles in your eye, says Taylor, your eye doctor will monitor you for 3 to 12 months to make sure that your eye is returning to health and that no new developments have occurred. You may also be encouraged to have a yearly eye exam (if you don’t already) until otherwise instructed by your eye doctor.
Who Should Get the Shingles Vaccine?
Getting a shingles vaccine is the only way to reduce the risk of developing shingles and to lessen the risk of postherpetic neuralgia.
The recombinant zoster vaccine, known as Shingrix, has been approved for use since 2017 in the United States. Sales of an older, live vaccine, Zostavax, were discontinued in July 2020.The shingles vaccine is recommended for people age 50 and older. Even if you’ve already had shingles, received Zostavax, or aren’t sure whether you ever had chickenpox, you should get vaccinated, per the CDC.
Shingrix is given as two shots that are two to six months apart.
How Effective Is the Shingles Vaccine?
In an 18-country study published in 2015 in The New England Journal of Medicine, researchers found that Shingrix was 97.2 percent effective in preventing shingles among those ages 50 and older.
In a second study, published in 2016 in The New England Journal of Medicine, the same researchers found that Shingrix had a 91.2 percent effectiveness rate in preventing postherpetic neuralgia in adults ages 50 and older. It was 88.8 percent effective in preventing it in adults age 70 years and older.
Out-of-pocket costs for Shingrix may vary. Many private health insurance plans cover the vaccine, but there may be some cost to you depending on which plan you have, per the CDC.
By Cathy CassataMedically Reviewed by Laura Martin, MDReviewed: October 18, 2021
Shingles Treatment and Prevention: Vaccines and Medications | Everyday Health