Herpes Zoster

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Herpes Zoster Treatment

Herpes zoster usually resolves spontaneously, and may not require treatment except for symptomatic relief, such as pain medication.

Acyclovir is an antiviral medication that may be prescribed to shorten the course, reduce pain, reduce complications, or protect an immunocompromised individual. Desciclovir, famciclovir, valacyclovir, and penciclovir are similar to acyclovir and may be used to treat zoster.

For the greatest effect, acyclovir-like medications should be started within 24 hours of the appearance of pain or burning sensation, and preferably before the appearance of the characteristic blisters.

Typically, the drugs are given in oral doses four times greater than those recommended for herpes simplex or herpes genitalia. Severely immunocompromised individuals may require intravenous acyclovir therapy.

Corticosteroids, such as prednisone, may occasionally be used to reduce inflammation and risk of post-herpetic neuralgia. They have been shown to be most effective in the elderly population. Corticosteroids have certain risks that should be considered before using them.

Analgesics, mild to strong, may be needed to control pain. Antihistamines may be used topically (direct application to the body) or orally to reduce itching. Zostrix, a cream containing Capzasin (an extract of pepper), may possibly prevent post-herpetic neuralgia.

Cool wet compresses can be used to reduce pain. Soothing baths and lotions (such as colloidal oatmeal bath, starch baths, or lotions and calamine lotion) may help to relieve itching and discomfort. Rest in bed until fever resolves.

Keep the skin clean, and do not re-use contaminated items. Nondisposable items should be washed in boiling water or otherwise disinfected before re-use. The person may need to be isolated while lesions are oozing to prevent infection of others -- especially pregnant women.