Shingles - aftercare

What to Expect

An outbreak of shingles usually follows this course:

• Blisters and pimples appear on your skin, and you have new feelings of pain.
• A crust forms over the blisters and pimples.
• In 2 - 4 weeks, the blisters and pimples heal. They rarely come back.
• Pain from shingles lasts for 2 - 4 weeks. You may have tingling or a “pins and needles” feeling, itching, burning, and a deep pain. Your skin may be very painful when it is touched.
• You may have a fever.
• You may have short-term weakness of certain muscles. This is rarely lifelong.

To treat shingles, your health care provider may prescribe:

• A medicine called an antiviral to fight the virus
• A medicine called a corticosteroid, such as prednisone
• Medicines to treat your pain

You may have post-herpetic neuralgia (PHN) pain. This is pain that lasts longer than a month after symptoms of shingles start.

Skin Care and Itch Relief for Shingles

To relieve itching and discomfort, these things can help:

• Cool, wet compresses on the affected skin
• Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion
• Zostrix, a cream that contains capsaicin (an extract of pepper)
• Antihistamines to reduce itching (taken by mouth or applied to the skin)

Keep your skin clean. Throw away bandages you use to cover your skin sores. Throw away or wash in hot water clothing that has contact with your skin sores. Wash your sheets and towels in hot water.

While your skin sores are still open and oozing, avoid all contact with anyone who has never had chickenpox -- especially pregnant women.

Managing Pain

Resting in bed until your fever goes down is advised.

For pain, you can take a type of medicine called NSAIDs. You do not need a prescription for these.

• Some examples of NSAIDs are ibuprofen (such as Advil or Motrin), naproxen (such as Aleve or Naprosyn).
• If you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or bleeding, talk with your health care provider before using these medicines.

You may also take acetaminophen (such as Tylenol) for pain relief. If you have liver disease, talk with your health care provider before using it.

You may be given narcotics pain relievers. Take them only as directed. These medicines can:

• Make you sleepy and confused. When you are taking narcotics, do not drink alcohol or use heavy machinery.
• Make your skin feel itchy.
• Cause constipation (not being able to have a bowel movement easily). Try to drink more fluids, eat high-fiber foods, or use stool softeners.
• Make you feel sick to your stomach. Try taking your narcotics with food.

When to Call the Doctor

Call your health care provider if:

• You get a rash that looks or feels like shingles.
• Your shingles pain is not well-managed.
• Your pain symptoms do not go away after 3 - 4 weeks.

Alternate Names

Herpes zoster - treatment

References

Cohen J. Varicella-Zoster virus (chickenpox, shingles). In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia,Pa: Saunders Elsevier; 2011:chap 383.

Warts, herpes simplex, and other viral infections. In: Habif TP, ed. Clinical Dermatology. 5th ed.St. Louis,Mo: Mosby Elsevier; 2009:chap 12.

Update Date: 6/28/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.