Shingles

Care & Treatment

Treatment Starts with Prevention

The Centers for Disease Control and Prevention (CDC) recommends that every adult over the age of 50 be vaccinated. Even if you don’t remember whether you had chickenpox, you should be vaccinated anyway, since practically everyone (99% of people) over 60 in this country had exposure to the varicella-zoster virus that causes chickenpox as a child.

If you have had a vaccine and still develop shingles, your illness will be milder than if you never received the vaccine. The CDC also recommends that you get the vaccination even if you have already had an episode of shingles, because shingles can come back even if you’ve already had it.

Shingrix is the vaccine recommended to prevent shingles in the United States. Zostavax will no longer be sold in the US market as of November 2020.

Shingrix only helps to prevent shingles. Vaccination won’t help you if you have already become ill with the condition or have a complication like post-herpetic neuralgia. However, the intensity of pain might be reduced in vaccinated individuals compared to nonvaccinated people.

Shingrix

Shingrix was approved in 2017 for the prevention of shingles and it is a two-dose series. This means you will receive one injection and then take a booster after 2-6 months to receive ongoing protection. If you receive your first shot at your local pharmacy, they can contact and remind you of your next dose. It is an FDA-approved vaccine for the prevention of shingles in adults 50 years and older. Shingrix is the only shingles vaccine proven to be up to 90% effective in clinical trials.

Most people experience mild or moderate pain at the injection site. Some people experience fatigue, muscle pain, a headache, chills, fever, stomach pain, or nausea. About 1 out of 6 people who get Shingrix experienced side effects that prevented them from doing regular activities.  Symptoms went away on their own in about 2 to 3 days. These reactions can occur after the first or second dose or both doses of Shingrix.

Can I receive Shingrix if I’ve already received a Zostavax vaccination?

Yes. Speak with your healthcare provider or pharmacist about receiving Shingrix.

Vaccination Isn't for Everyone

Despite the benefits of Shingrix, some people should not be vaccinated. Your healthcare provider should not give you the vaccine if you:

  • have ever had a severe allergic reaction to any component of the vaccine or after a dose of Shingrix.
  • tested negative for immunity to varicella zoster virus. If you test negative, you should get chickenpox vaccine.
  • currently have shingles.
  • currently are pregnant or breastfeeding. Women who are pregnant or breastfeeding should wait to get Shingrix
  • have a moderate or severe acute illness. You should usually wait until you recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.

Prescription Treatment

Medications are available that are often very effective at controlling shingles symptoms. These antiviral drugs actually attack the virus. They include acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). The drugs are taken for 7 to 10 days.

The earlier you start taking an antiviral medication, the better. Try to see your healthcare provider as soon as you feel any pain or burning, and before the rash appears, so that you can start taking the treatment within 24 hours. The window of opportunity closes about 72 hours after the first signs of the rash. After that, the antiviral medications are no longer effective for reducing symptoms of shingles or any of the complications that may occur.

If the antiviral drug is taken promptly, it is likely to:

  • Reduce pain
  • Reduce the length of time of your illness
  • Stop the disease from getting worse
  • Reduce the formation of blisters
  • Reduce the number of viruses in the blisters
  • Lower the risk of complications

Medications to Soothe Symptoms

Your healthcare professional may also prescribe medications to help you manage your pain, rash, and other symptoms. These include:

  • Pain relievers such as anti-inflammatory drugs (NSAIDs) or other treatments, depending upon your pain level and how long your pain lasts
  • Antihistamines to reduce itching (taken by mouth or applied directly to the skin)
  • Numbing patches and local anesthetics
  • Corticosteroids (such as prednisone)
  • Capsaicin cream (a hot pepper extract such as Zostrix)

Other drugs that can help control symptoms, especially in cases of long-term discomfort, include:

  • Pregabalin
  • Gabapentin (Neurontin), an anti-seizure medication
  • Tricyclic antidepressants

Non-Prescription Therapies

You may find that some approaches that don’t involve medications are soothing, for example:

  • Cool, wet compresses
  • Acupuncture
  • Soothing baths (such as starch or oatmeal baths)
  • Lotions (such as calamine)

Last Updated August 2020