Herpes Zoster Treatment

There is no cure for shingles, but the severity and duration of an attack of shingles can be significantly reduced if you are treated immediately with antiviral drugs, which include acyclovir, valacyclovir, or famcyclovir. Antiviral drugs may also help stave off the painful after-effects of PHN (postherpetic neuralgia). Other treatments for PHN include painkillers, steroids, antidepressants, and antiseizure medicine.

If you suspect you have shingles, see your doctor within 72 hours of the first sign of the rash.
The doctor can confirm the diagnosis, prescribe the antiviral pills, and may also prescribe other drugs such as pain relievers. Patients with long-term pain may also be treated with numbing patches, tricyclic antidepressants, and gabapentin, an anti-seizure medication.

While these treatments can reduce the symptoms of shingles, they are not a cure. The antivirals do weaken the virus and its effects, but the outbreak still tends to run its course. Good hygiene, including daily bathing, can help prevent secondary bacterial infections. It is a good idea to keep fingernails clean and well trimmed to reduce scratching.

Prevention

Transmission. Unlike chickenpox, with shingles, the virus is NOT transmitted by someone breathing or coughing on you. You have to come in contact with the blister fluid itself. Once the blisters scab over, the contagious period is ended.

If you never had chickenpox and were exposed to someone with shingles, you could get chickenpox -- not shingles. Ask your doctor whether the chickenpox vaccine would be advisable to prevent your getting chickenpox.

In contrast, you can't catch shingles. You must already have had a case of chickenpox and harbor the virus in your nervous system to develop shingles. When reactivated — most often because the immune system is weakened, allowing the virus to break out of its dormant state — the virus travels down nerves to the skin causing the painful shingles rash. In shingles, the virus does not normally spread to the bloodstream or lungs, so the virus is not shed in air. Because the shingles rash contains active virus particles however, a person who has never had chickenpox can contract chickenpox by exposure to the shingles rash.

Vaccines. Researchers at the National Institutes of Health are now working on a shingles vaccine -- to prevent shingles in people who have already had chickenpox. It is designed to boost the immune system and protect older adults from shingles later on.

The vaccine is basically a stronger version of the chickenpox shot, which became available in 1995. The chickenpox shot prevents chickenpox in 70 to 90 percent of those vaccinated, and 95 percent of the rest have only mild symptoms. Millions of children and adults have already received the chickenpox shot.

Interestingly, the chickenpox vaccine may reduce the shingles problem. Widespread use of the chickenpox vaccine means that fewer people will get chickenpox in the future. And if people do not get chickenpox, they cannot get shingles. So shingles may one day become a rare disease.

Vaccine research began in the late 1990s when the Department of Veterans Affairs (VA) conducted a nationwide, multicenter trial to study an experimental vaccine aimed at preventing shingles. The Shingles Prevention Study represented a scientific collaboration between the VA, the National Institute of Allergy and Infectious Diseases, and Merck & Co., Inc.—the company that produces the vaccine.

The study tested a more potent version of the vaccine currently used to immunize children against the chickenpox virus. The purpose of the trial was to find out if the vaccine is safe and how effective it is in preventing shingles.

In the 5 1/2-year, double-blind study, participants received either the vaccine or a placebo—neither the doctors nor the study participants knew which injection was given. At the completion of the study researchers found that the vaccine reduced the incidence of shingles by half. The study involved 22 medical centers and nearly 40,000 people aged 60 or older.

In April 2005 the Food and Drug Administration received a license application from the manufacturer for the zoster vaccine. If approved for use, the vaccine has the potential to prevent hundreds of thousands of cases of shingles in the United States each year.

Source: NIH