What are the available shingles treatments?

Shingles which is caused by the chickenpox virus (varicella-zoster virus) is typically characterised by a blistering rash, on one side of the body that is often excruciatingly painful.^1,2 Shingles most commonly occurs in patients ≥50 years of age and the risk of shingles and related complications increases with age.¹

If you think you are possibly experiencing symptoms of shingles, please consult your doctor as soon as possible so they can start treatment early.

The available shingles treatments given by your doctor aim to address the sudden reactivation of the chickenpox virus (i.e. the viral infection) and the associated pain.^1,2,4

Antiviral medication

Antivirals are medications used to treat the virus causing the disease and aim to slow the progress of the shingles rash.⁴ If taken within the first 72 hours of having symptoms, these medications have been shown to reduce the time for the rash to heal and the severity and duration of the acute (immediate) pain from shingles.⁴

In two studies conducted in Singapore, up to 96% of patients were started on antiviral treatment.^2,5

Pain medication

Pain medications are commonly prescribed by a doctor to manage the pain of shingles and any persistent nerve pain or post-herpetic neuralgia (PHN).^{2, 4-7}

Examples of the types of pain medications that may be prescribed by your doctor include:^6,8

• Simple analgesics – e.g. paracetamol and other non-steroidal anti-inflammatory drugs like ibuprofen
• Medications that have a sedative effect and offer some pain relief – e.g. tricyclic antidepressants
• Certain medications that are used to treat epilepsy, as these have shown to offer a reasonable relief for PHN
• Opioids
• Topical agents – e.g. pain patches and gels

Your doctor will advise you on the appropriate type of treatment depending on your situation.

If the pain is very severe or the response to pain medications is inadequate, patients should be referred to a pain specialist or admitted to the hospital for pain management.⁴

Early referral to a pain specialist for the treatment of uncontrolled shingles pain or PHN is beneficial.^9,10

Challenges to the treatment of shingles

Shingles is treatable and most patients eventually recover fully.^1,2,4

However, it is important that antiviral and pain medications are started early. Antivirals work best if started within 72 hours of the rash onset.^6,7 This can be a challenge as most individuals present late to the doctor.⁶ However, even if started early, unfortunately antiviral treatment may not reduce the risk of developing persistent nerve pain or PHN.⁶ It is not uncommon for multiple pain medications to be required to manage shingles pain or PHN and not everyone achieves full pain relief.^9,10

In Singapore, the average cost of shingles treatment is approximately $267-470. However, if complications occur (e.g. hospitalisation, PHN) the direct costs of treatment can be expected to be higher at around $3,000.^2,5,11

Other self-care methods to help manage shingles

It is important to consult a doctor early so that treatment can be started to reduce the duration and severity of the disease, and help manage the pain.^1,6,7 On top of treatment, some other self-care methods that a doctor may discuss to help manage shingles include:¹²

• Wear loose-fitting, natural-fibre clothing
• Apply a cool washcloth to the blisters to ease the pain and help dry the blisters.
• Keep the affected area clean and don’t scratch them to prevent infection and scarring
• Get plenty of rest
• Try and avoid stress as it might make the pain worse

Although there’s no cure for shingles, there are numerous treatments and also preventative options.¹³

Find out more about the prevention of shingles by clicking here.

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