From the Guidelines
Acyclovir cream is not recommended for treating shingles. For shingles treatment, oral antiviral medications such as oral acyclovir (800 mg five times daily), valacyclovir (1000 mg three times daily), or famciclovir (500 mg three times daily) are the standard treatment, typically taken for 7 days. These oral medications are much more effective because they achieve higher concentrations in the body and can reach the nerve roots where the virus is replicating. Topical acyclovir cream has poor penetration into the skin and cannot reach the deeper nerve tissues involved in shingles. Additionally, shingles often covers larger areas of the body, making topical application impractical. According to a study published in MMWR Recommendations and Reports 1, oral acyclovir, when administered within 72 hours of rash onset, has accelerated the rate of cutaneous healing and reduced the severity of acute pain in adults who have shingles. Some key points to consider when treating shingles include:
- Starting treatment within 72 hours of rash onset for maximum effectiveness in reducing pain, speeding healing, and potentially reducing the risk of postherpetic neuralgia
- Using oral antiviral medications as the standard treatment
- Avoiding topical acyclovir cream due to its poor penetration into the skin and inability to reach the deeper nerve tissues involved in shingles. If you suspect you have shingles, consult a healthcare provider promptly for proper diagnosis and appropriate oral antiviral therapy.
From the Research
Efficacy of Acyclovir Cream for Shingles
- Acyclovir cream has been shown to decrease the course of herpes simplex virus infections by 1 to 2 days 2.
- However, there is limited evidence on the effectiveness of acyclovir cream specifically for shingles.
- Topical acyclovir has been found to be more effective than oral acyclovir in some cases, but its efficacy in treating shingles is not well established 2, 3.
Comparison with Other Antiviral Drugs
- Valaciclovir, a prodrug of acyclovir, has been shown to be more effective than acyclovir in treating herpes zoster, with a simpler dosing regimen and a favorable safety profile 4, 5.
- Famciclovir, another antiviral drug, has also been found to be effective in treating herpes zoster, with similar efficacy to valaciclovir 6, 5.
Treatment of Herpes Zoster
- Acyclovir, in its oral or intravenous form, has been shown to be effective in treating herpes zoster, particularly in reducing the duration of post-herpetic neuralgia (PHN) 6, 2.
- However, the efficacy of acyclovir cream in treating shingles is not well established, and more research is needed to determine its effectiveness in this context.