(Herpes Zoster; Post-herpetic Neuralgia)
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- Age: 50 or older
- Gender: Women may be more likely to develop shingles.
- Compromised immune system (eg, HIV, lymphoma, leukemia)
- Radiation therapy
- Is red and has a slightly raised band or patch often with multiple small fluid-filled blisters (blisters dry out and crust within several days)
- Develops on one side of the body, but typically does not cross the midline
- Spreads to multiple parts of the body
- Affects mostly the torso and face
- Affected eyes (in severe cases), which can seriously threaten vision
- Sensitivity and pain on the skin at the site of the rash (may be severe)
- Tingling or itchiness on the skin (may start a few days before the rash)
- Easing symptoms
- Speeding recovery
- Preventing PHN
Home Remedies and Over-the-Counter Products
- Calamine lotion
- Wet compresses
- Frequent oatmeal baths
- Over-the-counter pain relievers (eg, acetaminophen, ibuprofen, and naproxen, Capsaicin cream)
- Acyclovir (Zovirax)
- Famciclovir (Famvir)
- Valacyclovir (Valtrex)
Treatment for Post-herpetic Neuralgia
- Tricyclic antidepressants
- Selective serotonin reuptake inhibitor (SSRIs)
- Gabapentin (anti-seizure medicine)
- Prescription pain medicine (eg, long-acting opiates, pregabalin)
- Capsaicin cream
- Lidoderm patch
- Nerve blocks
- Transcutaneous electrical nerve stimulation (a device that generates low-level pulses of electrical current on the skin's surface)
- Keep all blisters covered with a bandage until they are dry and crusted over.
- If you are a healthcare worker, do not return to work until the blisters are dry and crusted over.
Avoid contact with people who are at risk to getting severe varicella, such as:
- Pregnant women
- Premature infants
- People who have a compromised immune system (eg, cancer, HIV)
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/
VZV Research Foundation http://www.vzvfoundation.org/
Canadian Family Physician http://www.cfpc.ca/
Public Health Agency of Canada http://www.phac-aspc.gc.ca/
Shingles. Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/shingles.html . Updated January 2011. Accessed September 7, 2012.
Shingles (herpes zoster). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/shingles/about/overview.html . Updated January 10, 2011. Accessed September 7, 2012.
1/14/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Tseng HF, Smith N, Harpaz R, Bialek SR, Sy LS, Jacobsen SJ. Herpes zoster vaccine in older adults and the risk of subsequent herpes zoster disease. JAMA . 2011;305(2):160-166.
- Reviewer: Peter Lucas, MD
- Review Date: 09/2012 -
- Update Date: 00/92/2012 -