Bad case of shingles

Last clinically updated in September 2019 by Maria Yiangou, a registered pharmacist in our Health at Hand team.

Thank you for contacting the Health at Hand team.

Shingles (herpes varicella-zoster) is likely to manifest itself in the form of a blistery rash affecting the torso (front / back). At times it can affect the body and face.

Common treatments for shingles

Clobavate should be applied as directed by your GP daily for a duration of four weeks. If the condition worsens or does not improve within four weeks, treatment and diagnosis should be re-evaluated.

Diprobase cream is an emollient, moisturising and protective cream that should be applied to the dry skin areas as often as is required and rubbed well into the skin.

Amitriptyline is commonly prescribed to treat the long term issues associated with shingles; it works by blocking the pain.

Post-herpetic neuralgia

Post-herpetic neuralgia (PHN), is long-term nerve pain associated with shingles that can last for months, even years after the rash heals.

Common symptoms of PHN include:

• itching
• irritation
• burning sensation
• tingling
• super sensitivity
• pain
• numbness
• soreness.

There are alternative treatments that your doctor could prescribe. These can take up to 4 weeks to take full effect. Examples include:  

Gabapentin - an antiepileptic medicine that is also used to treat nerve pain

Pregabalin - am antiepileptic, also used to treat nerve pain and sleep problems. 

Axsain cream (capsaicin)- applied topically to help relieve nerve pain associated with shingles. 

Versatis plasters (patches) – can be worn for 12 hours (day or night as preferred) on or near the painful area. The skin is left uncovered for the other 12 hours so that it can breathe. 

If symptoms persist, stronger painkillers may be prescribed by your doctor for a short time, examples include:

Tramadol or morphine- stronger opioids that might be considered if pain remains severe.

Alternative treatment for the pain associated with shingles and post-herpetic neuralgia

An alternative to medication would be to try a TENS machine. Tens machines transmit very low voltage electrical impulses to a small area.  This is felt as a buzzing sensation and it can prevent the nerves from sending pain messages to the brain. A variety of TENS machines are available to buy in store or online. A with anything of this nature it's important to research the various options and ideally consult with your GP or pain specialist to ensure you settle on one from a reputable supplier that's suitable for your needs. You may also be able to try this option at a pain clinic.

Self-help tips for managing the symptoms of shingles and post-herpetic neuralgia

Finally, there are some things you can do to help ease the pain and prevent symptoms worstening:

• Wear loose-fitting clothing - this may help you to feel more comfortable
  
  
• Avoid using scented soaps or bath oil
  
  
• Cover lesions that are not under clothes if the rash is still weeping
  
  
• Keep the rash clean and dry to prevent bacterial super infection.

Should I have the shingles vaccine if I've already had shingles?

It's okay to have the shingles vaccine if you've already had shingles. The shingles vaccine has been known to work well in people who've had shingle, as it can boost immunity against further shingles attacks.

Those who are aged 70 or 78 years old are eligible for the shingles Vaccine

In addition, anyone who was previously eligible (born on or after 2 September 1942) but missed a vaccination opportunity remains eligible until their 80th birthday. When you're eligible, you can have the shingles vaccination at any time of year.

The shingles vaccine is not available on the NHS to those aged 80 or over as it seems to be less effective in this age group

I hope this is of some help to you.

Further information

Shingles and scarring - AXA Health

How do you catch shingles? - AXA Health

Can flying with shingles affect my hearing? - AXA Health

Shingles - NHS factsheet

Post-herpetic neuralgia - NHS factsheet