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Shingles: Diagnosis and treatment


How to treat shingles: Pain management

These tips, which you can do at home, can help ease the pain and itch from shingles.

If you think you could have shingles, see a board-certified dermatologist or other health-care provider within 3 days of getting the rash. When started within 3 days, treatment can prevent possible complications, such as long-lasting nerve pain.

Receiving treatment after 3 days still has benefits, so you should still see your doctor if you’ve had the rash for longer than 3 days.

Before taking the medication, it’s important to make sure that you have shingles. The following explains how this condition is diagnosed and treated.

How do dermatologists diagnose shingles?

A dermatologist can often diagnose shingles by looking at the rash on your skin.

If there is any question about whether you have shingles, your dermatologist will scrape a bit of fluid from a blister. This will be sent to a lab where a doctor will look at the fluid under a high-powered microscope.

When you have shingles, the fluid contains the virus that causes shingles. Seeing the virus confirms that you have shingles.

Your dermatologist will also ask about your symptoms. Shingles tends to be painful.

When the shingles rash spreads to an eye, it can affect your eyesight

You can reduce this risk by seeing an ophthalmologist (eye doctor) immediately.

How do dermatologists treat shingles?

An antiviral medication can:

  • Reduce the amount of time that you have a shingles rash

  • Decrease how severe the rash becomes

  • Lower your risk of developing long-lasting nerve pain and other health problems

One of three antiviral medications is usually prescribed—acyclovir, famciclovir, or valacyclovir.

To treat your symptoms, dermatologists typically recommend the following:

Pain: Medication that you can buy without a prescription can help, such as:

  • Acetaminophen

  • Ibuprofen

If you have severe pain, your dermatologist may prescribe a medication that reduces inflammation, such as a corticosteroid.

What is the outcome for someone who has shingles?

Most people get shingles once, but it’s possible to get it again.

If you have a healthy immune system, the blisters tend to clear in 7 to 10 days. The rash tends to go away completely within 2 to 4 weeks. The pain may last longer, but usually stops in 1 or 2 months.

For some people, the pain will last longer than the rash. When it does, it’s called postherpetic neuralgia (PHN), which can come and go or be constant. PHN can last for months, years, or the rest of your life. Treatment can help reduce the amount of pain you feel.

Be sure to tell your doctor if you continue to have pain. Treatment can help you feel more comfortable.

For anyone who has a shingles rash, the right self-care can help ease your discomfort. You’ll find out what dermatologists recommend at, Shingles: Self-care.


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References
Centers for Disease Control and Prevention (CDC). About shingles. Page last reviewed 10/17/2017. Last accessed 4/1/2019.

Dooling KL, Guo A, et al. “Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines.” Morb Mortal Wkly Rep 2018;67:103-8.

Madkan V, Sra K, et al. “Human herpes viruses.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008: 1204-8.

Straus SE, Oxman MN. “Varicella and herpes zoster.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008: 1885-98.

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