Shingles: Treatment and Managing Pain

Clinicians can help relieve patient pain and discomfort caused by shingles with these treatment options.

Shingles: Treatment and Managing Pain

 

Did you know that one in three people in the United States is affected by shingles? This common and very painful skin condition also happens to be made worse by stress – like hospitalization and other chronic illnesses. As clinicians, we are in the position to help reduce patient pain and discomfort as best we can. There is no cure, but there are a variety of treatments that can help.

What Is Shingles?

Shingles is caused by the varicella virus, which continues to live in the body after a bout with chickenpox. The virus lives in the root of the nerve and lies dormant until aging, stress or a lowered immunity allows it to flare up again as shingles.

As clinicians, we treat to shorten the length of time the resulting blisters and rash are present. We also seek to reduce the itching, pain and possible post-herpetic neuralgia. About 10% of adults who get shingles experience long-term nerve pain where the blisters occurred. This pain sometimes lasts for months or even years.

Treatment for Shingles

Shingles can begin with a burning sensation and redness. If you can treat shingles at this stage with an anti-viral medication, you may be able to prevent a full blister outbreak. Do this, and you will avert much of the discomfort.

What is an outbreak like? Blisters erupt in clusters, or follow the line (or dermatome) of the infected nerve. The blisters eventually crust and heal after one to two weeks. Other symptoms include fatigue, low-grade fever, mild muscle aches, and hypersensitivity to touch, like clothing or bedding.

Shingles can make your patients – especially older ones – feel more stressed out and burdened than ever. Here are treatment options that can reduce symptoms.

In-hospital or home care treatments:

  • Prescribed anti-viral medications. Start as early as possible to shorten blister duration and prevent chronic neuralgia. Examples include: Zovirax PO and/or topically; Famvir; and Valtrex.
  • Pain medications, anti-depressants, steroids, and topical anesthetics. Usual pain medications like ASA or ibuprofen can help. For severe cases, steroids may be ordered. Antidepressants can address chronic neuralgia. Lyrica (pregabalin) PO targets nerve signals for pain after shingles.
  • Topical treatments. Regenecare HA hydrogel contains lidocaine and aloe vera to reduce pain. Medical grade honey reduces pain by drawing fluid from the blisters, and is antimicrobial and antiviral. Medihoney HCS provides honey in a hydrogel sheet which soothes and protects the area from contact with bedding and clothes. Calamine lotion and zinc ointments are also often used.
  • Because the shingles rash is contagious for chickenpox (though not shingles), covering the blisters with a dressing helps protect from friction and rupture, reducing possible contamination and lessening pain. Note: do not use adhesive dressings with blisters.

Natural and over-the-counter treatments that help with symptoms: 

  • Manuka honey
  • Regenecare HA spray

Best dressings for protection:

  • Foam dressings
  • Non-adherent
  • Contact layers with creams or honeys applied underneath
  • Silver dressings, if blisters/crusts look inflamed or colonized with bacteria

Do You Have Shingles Stories?

How do you relieve your patients’ pain from shingles? What type of treatments have you used? What made the biggest difference? We would love to hear about your experiences. Please share your thoughts and ideas below.

 

Wound Care Education Institute® provides online and onsite courses in the fields of Skin, Wound, Diabetic and Ostomy Management. Eligible clinicians may sit for the prestigious WCC®, DWC® and OMS national board certification exam through the National Alliance of Wound Care and Ostomy® (NAWCO®). For details see wcei.net.

 

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Shingles: Treatment and Managing Pain - Clinicians can help relieve patient pain and discomfort caused by shingles with these treatment options.

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