Certain medications should not be used for shingles.

When you have shingles, you need aggressive treatment with antiviral medication. When the disease progresses to post-herpetic neuralgia, it's important to remember if you've had shingles before...

The Varicella zoster virus, which causes chickenpox in children, then lies dormant in the nerve root ganglia for decades, and when given the opportunity, it causes shingles (herpes zoster), also known as "shingles." Serological tests show that about 90% of adults are infected with the Varicella zoster virus, but only about 0.15-0.3% develop shingles, with an additional 0.2% of cases occurring annually. In young people, the disease is usually benign and rarely leaves sequelae. In older people, the disease is more likely to be severe and often leaves sequelae. Specifically, post-herpetic neuralgia is 15-25 times more common in people over 50 than in those under 30.

Some commonly used medications

Antiviral group

For use in the acute phase, acyclovir, valacylovir, and famcilovir are commonly used. All three have similar functions: shortening the duration of viral shedding, preventing the formation of new lesions, accelerating wound healing, and reducing the severity of acute pain. The medication should be used early, within 24-48 hours of symptom onset, and at a high dose. Topical formulations are ineffective. The medication does not cause any adverse effects; however, the dose should be reduced in patients with renal impairment.

Images of lesions caused by shingles.

Pain relief group

Post-herpetic neuralgia is characterized by pain that appears 30 to 60 days after the rash appears or after the lesions have healed. The pain is very unpleasant: throbbing, burning, or like an electric shock. The pain can last for months or years and is accompanied by various sensory disturbances, most notably dysesthesia (even light touch, such as clothing contact with the affected skin, can cause intense pain). In addition, there may be paresthesia (spontaneous tingling sensations), dysesthesia (abnormal sensations to skin stimuli), and possibly depression. Medications can be used alone or in combination, including:

Lidocaine: available as a 5% patch, up to 3 patches can be used within 12 hours. The drug may cause local irritation, but rarely causes systemic toxicity. It should only be applied to intact skin.

Capsaicin cream (an active ingredient extracted from chili peppers) 0.025 - 0.075%: Apply a low concentration of capsaicin initially, then gradually increase to a higher concentration. The medication causes a burning sensation. It should only be applied to intact skin. Some patients discontinue treatment because they cannot tolerate the burning sensation.

Amtriptyline and nortriptyline are tricyclic antidepressants. Start with a low dose and gradually increase it, divided into three doses per day. These medications can cause sedation, confusion, urinary retention, orthostatic hypotension, dry mouth, and cardiac arrhythmias (use should be limited in the elderly).

Gabapentin: Start with a low dose and gradually increase to a higher dose, divided into 3 doses per day. The drug is well tolerated but may cause dizziness, headache, lethargy, and loss of consciousness.

Some medications should not be used.

Antihistamines: Shingles may have symptoms similar to allergies, but it is not an allergic reaction. Do not use antihistamines (chlorpheniramine, corticosteroids) in this case.

Antibiotics: When shingles reaches the stage of pus formation and ulceration, it may look like a bacterial infection, but it is a viral disease, so antiviral medication is used instead of antibiotics to treat bacterial infections.

Conventional pain relievers: Post-herpetic neuralgia is pain of nerve origin. Using conventional pain relievers (non-steroidal anti-inflammatory drugs) will not be effective.

Do not use herbal remedies: No herbal remedy can fight the virus. Do not apply herbal remedies to shingles lesions (this can easily lead to dangerous infections).

When suffering from shingles, aggressive treatment with antiviral medication is necessary to prevent the disease from worsening. If the disease progresses to post-herpetic neuralgia, it's crucial to remember any previous shingles infections and inform your doctor (if visiting a new clinic) to avoid using inappropriate painkillers. If you experience any eye problems (which often appear late), consult an ophthalmologist.

According to Health & Life-NT