What medications can help treat shingles?

Shingles is a condition that can be incredibly painful.  It is manifested by an outbreak of skin lesions that look kind of like chicken pox.  They occur along the area of a nerve and are generally on one side.  They can appear anywhere on the body even on the face. If a shingles lesion appears on the tip of the nose, it is important to see an eye doctor as it generally signals that the eye may be involved.  This requires special treatment with antiviral drops.


The outbreak is usually preceded by pain for several days.  It is key that antiviral medication such as Valtrex, Famvir or Acyclovir is started within 72 hours of the appearance of the skin lesions.  These medications may shorten the course and help alleviate the pain. 

If a shingles patient is experiencing severe pain, often times narcotics may be required.   There is a patch called Lidoderm which actually numbs the area of the shingles that I have found very helpful to patients.  Once the shingles lesions are healed, there is an over the counter cream that is made from cayenne pepper called Zostrix that may help.


For those over 60 years old the shingles vaccine is recommended and I urge my patients to get it.  It does not necessarily mean that they will never get shingles, but if they do the course may be less severe.

Medicines can help limit the pain and discomfort caused by shingles, shorten the time you have symptoms and prevent the spread of the disease. Medicines also may reduce your chances of developing shingles complications, such as postherpetic neuralgia (PHN) or disseminated zoster. Early treatment of shingles is important, because the possible complications can be serious and resistant to treatment. For example, 40 to 50 out of 100 people who have PHN do not respond to treatment.

Medication choices - Medicines to treat shingles when the rash is present (active stage) may include:

• Over-the-counter pain medicines, such as acetaminophen, aspirin or ibuprofen, to help reduce pain.
• Antiviral medicines, to reduce the pain and duration of shingles.
• Topical antibiotics, which are applied directly to the skin, to stop infection of the blisters.

Medicines to treat postherpetic neuralgia pain may include:

• Over-the-counter pain medicines, such as acetaminophen, aspirin or ibuprofen.
• Tricyclic antidepressants, such as amitriptyline.
• Topical medicines, such as a lidocaine patch.
• Anticonvulsants, such as gabapentin or pregabalin.
• Corticosteroids, such as prednisone.
• Nerve block injections.
• Opioids, such as codeine, oxycodone and morphine.

What to think about - For some people, nonprescription pain relievers (analgesics) are enough to help control pain caused by shingles or postherpetic neuralgia. But for others, stronger medicines may be needed. And if prescription medicines don't help control your pain, you may need to see a pain specialist about other ways to treat PHN.

A prescription medicine called pregabalin (Lyrica) has been approved for the treatment of pain caused by postherpetic neuralgia. In tests, it provided rapid and long-lasting pain relief.