Are there ear drops available for the treatment of herpes zoster (shingles) oticus?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 9, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

There are no ear drops specifically designed for treating shingles in the ear, and instead, systemic antiviral medications are required to manage the condition, as stated in the clinical practice guideline for acute otitis externa 1. When considering treatment for shingles in the ear, also known as Ramsay Hunt syndrome, it is crucial to prioritize systemic antiviral therapy to address the viral infection effectively.

  • The recommended treatment typically involves antiviral medications such as acyclovir, valacyclovir, or famciclovir, which should be started within 72 hours of rash onset to maximize their effectiveness 1.
  • Pain management may include oral analgesics like acetaminophen or ibuprofen, and corticosteroids such as prednisone might be added to reduce inflammation and nerve pain.
  • It is essential to seek immediate medical attention if shingles in the ear is suspected, as prompt treatment can help prevent complications like hearing loss, balance problems, and facial paralysis.
  • Over-the-counter ear drops should not be used to treat ear shingles, as they will not address the underlying viral infection and could potentially worsen symptoms, emphasizing the need for evidence-based treatment approaches like those outlined in the clinical practice guideline 1.

From the Research

Ear Drops for Shingles in the Ear

There is no specific mention of ear drops for shingles in the ear in the provided studies 2, 3, 4, 5.

Treatment Options for Shingles

  • The treatment options for shingles include antiviral medications such as acyclovir, valacyclovir, and famciclovir, which are most effective when started within 72 hours after the onset of the rash 2, 3.
  • Topical lidocaine or capsaicin and oral gabapentin, pregabalin, or tricyclic antidepressants may be used to control pain and symptoms 3.
  • Vaccination with a live attenuated vaccine, Zostavax®, or a recombinant subunit vaccine, Shingrix®, is recommended for older adults to prevent herpes zoster 5.

Complications of Shingles

  • Ocular involvement in herpes zoster can lead to rare but serious complications and generally merits referral to an ophthalmologist 2.
  • Postherpetic neuralgia is a common complication of herpes zoster, characterized by pain that persists for at least 90 days after the acute outbreak 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Herpes zoster: A primary care approach to diagnosis and treatment.

JAAPA : official journal of the American Academy of Physician Assistants, 2022

Research

Shingrix for Herpes Zoster: A Review.

Skin therapy letter, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.