News | Published April 10, 2012

Stop shingles in its tracks and get pain relief!

The first thing you feel is a sort of weird sensation on your skin - itchy, burning, painful tingling. What is that? It could be shingles.

Within two days a rash with blisters appears. The most effective thing to do at this point is to get an antiviral medication. This can stop the varicella zoster virus, which causes shingles, from multiplying. It can also speed healing of skin lesions, and reduce the severity and duration of pain. But it has to be started within 72 hours after the blisters appear - so don't delay! Go see your primary care physician to begin treatment.

Shingles follows this course: first the tingling and itchy feeling, then the blisters, then by the third and fourth day the blisters ulcerate, becoming open and painful. By day 10 they scab over. At this point you are not contagious.

The rash is usually present on the chest and trunk area in a predictable pattern along the nerve routes. The word shingles actually comes "cingulum," a Latin word meaning belt or girdle, and it refers to the band or beltlike pattern of the rash.

What causes this rash to erupt? Shingles can occur in individuals of all ages, but only in people who have had chickenpox, which many people have had as children. The chicken pox virus retreats to cells of the nervous system, where it can reside quietly for decades. Later in life, the virus can become active again, possibly due to a weakened immune system.

About 10 percent of those who get shingles will develop PHN (postherpetic neuralgia). This is a serious condition in which people continue to feel pain and or discomfort even after their rash goes away. This pain can last for months or even years.

Some effective treatments for the pain of PHN include:

  • A numbing patch
  • Antidepressants
  • Antiseizure and anticonvulsants
  • Topical anesthetics
  • Acupuncture
  • Injections of steroids
  • Intercostal block
  • Capsaicin

A word about capsaicin treatment: the FDA approved Qutenza patch is available on the market. A single, 1-hour localized treatment in your doctor's office can provide three months of relief from post shingles nerve pain.

The medicine in Qutenza is prescription-strength capsaicin, which is the substance in chili peppers that gives them their heat sensation. Application is a five-step process. First the painful area is identified, washed with mild soap and water, and dried thoroughly. Next the area is made numb with a gel or cream in order to reduce discomfort associated with the patch application.

The Qutenza patch or patches (up to four) can be cut to the shape of the painful area and applied to the skin for 60 minutes. This application de-sensitizes the affected area. After the patch is on for 60 minutes it is then removed and the area is cleansed.

People can reduce the chances of getting shingles by having the shingles vaccine. The vaccine can also make the symptoms of shingles milder. Most people 60 and over should get the shingles vaccine. Talk with your doctor to find out if the shingles vaccine is appropriate for you.